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Specifications Manual for Joint Commission
National Quality Core Measures
Table of Contents
Acknowledgment and Conditions of Use
Introduction
Using the Specifications Manual for Joint Commission National Quality Core Measures
Section 1: Introduction to the Data Dictionary
Introduction to the Data Dictionary
Alphabetical List of Data Elements
Section 2: Measure Information Forms
Hospital Based Inpatient Psychiatric Services (HBIPS)
HBIPS-1
HBIPS-2
HBIPS-3
HBIPS-4
HBIPS-5
HBIPS-6
HBIPS-7
Perinatal Care (PC)
PC-01
PC-02
PC-03
PC-04
PC-05
Section 3: Missing and Invalid Data
Missing and Invalid Data
Section 4: Population and Sampling Specifications
Population and Sampling Specifications
Section 5: Joint Commission National Quality Core Measure Verification Process
(The Joint Commission ORYX Vendors® Only) This section has been moved to the ORYX Technical
Implementation Guide and is available to ORYX Vendors via the Joint Commission’s extranet site for
measurement systems (PET).
Section 6: Joint Commission National Quality Core Measures Data Transmission
Joint Commission National Quality Core Measures Data Transmission
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Transmission Data Elements
Transmission Data Processing Flow: Clinical
Transmission Data Processing Flow: Population and Sampling
Appendices
A. ICD-9-CM Code Tables
B. Medication Tables
C. Glossary of General Terms
D. Overview of Measure Information Form and Flowchart Formats
E. Miscellaneous Tables
F. Resources
P. Preview ICD-10-CM Version of Code Tables
ICD-9-CM to ICD-10-CM Crosswalk of Code Tables
Release Notes
Release Notes for Manual v2013B - February 4, 2013
Show previous release notes...
Printable Version
Download a PDF version of the entire HBIPS Manual
Download a PDF version of the entire Perinatal Care Manual
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Acknowledgement
No royalty or use fee is required for copying or reprinting this manual, but the following are required as a condition
of usage: 1) disclosure that the Specifications Manual is periodically updated, and that the version being copied or
reprinted may not be up-to-date when used unless the copier or printer has verified the version to be up-to-date and
affirms that, and 2) users participating in Joint Commission accreditation, including ORYX® vendors, are required
to update their software and associated documentation based on the published manual production timelines.
Example Acknowledgement: The Specifications Manual for Joint Commission National Quality Core Measures
[Version XX, Month, Year] is periodically updated by The Joint Commission. Users of the Specifications Manual for
Joint Commission National Quality Core Measures must update their software and associated documentation
based on the published manual production timelines.
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Introduction and Background
The Joint Commission Quality Initiative
In 1987, The Joint Commission announced its Agenda for Change, which outlined a series of major steps
designed to modernize the accreditation process. A key component of the Agenda for Change was the eventual
introduction of standardized core performance measures into the accreditation process. As the vision to integrate
performance measurement into accreditation became more focused, the name ORYX® was chosen for the entire
initiative. ORYX® is The Joint Commission’s performance measurement and improvement initiative, which
integrates outcomes and other performance measure data into the accreditation process.
The ORYX® initiative became operational in March of 1999, when performance measurement systems began
transmitting data to The Joint Commission on behalf of accredited hospitals. ORYX® measurement requirements
are intended to support Joint Commission accredited organizations in their quality improvement efforts.
The initial phase of the ORYX® initiative provided healthcare organizations a great degree of flexibility in terms of
the measures that could be reported. Over time, the ORYX® measures have evolved into standardized sets of valid,
reliable, and evidence-based quality measures
Related Joint Commission Activities
Accreditation Process
In January 2000, Joint Commission surveyors began using organization-specific ORYX® Pre-Survey Reports,
effectively commencing the use of performance measure data in the survey process.
In 2004, the survey process was substantially modified to be more data-driven and patient-centered thus enhancing
its value, relevance, and credibility. Many of the key components of the survey process utilize data derived from the
national hospital inpatient quality measures. The survey process now has a greater focus on evaluating actual care
processes because patients are traced through the care, treatment and/or services they receive. In addition,
surveyors conduct “systems tracers” to analyze key operational systems that directly impact the quality and safety of
patient care.
In June 2010 The Joint Commission categorized its process core performance measures into accountability and
non-accountability measures. This approach places more emphasis on an organization’s performance on
accountability measures – quality measures that meet four criteria designed to identify measures that produce the
greatest positive impact on patient outcomes when hospitals demonstrate improvement:
Research: Strong scientific evidence demonstrates that performing the evidence-based care process
improves health outcomes (either directly or by reducing risk of adverse outcomes).
Proximity: Performing the care process is closely connected to the patient outcome; there are relatively few
clinical processes that occur after the one that is measured and before the improved outcome occurs.
Accuracy: The measure accurately assesses whether or not the care process has actually been provided.
That is, the measure should be capable of indicating whether the process has been delivered with sufficient
effectiveness to make improved outcomes likely.
Adverse Effects: Implementing the measure has little or no chance of inducing unintended adverse
consequences.
Those measures that were determined not to meet these criteria have been designated as non-accountability
measures. Four of the six non-accountability measures that were common between CMS and The Joint
Commission were retired by both organizations. The Joint Commission will continue to support the two remaining
non-accountability measures (discharge instructions and LVS function assessment [heart failure care]) that are in
common with CMS.
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Beginning in January 2012, The Joint Commission also incorporated a standards-based expectation for minimum
performance on ORYX® accountability measures against which hospitals are surveyed and requirements for
improvement (RFIs) can be made
Data Analysis
The Joint Commission has developed a target measure range approach (target analysis) as a basis to evaluate
Joint Commission accredited organizations’ rating for the performance measures.
The use of target analysis in addition to a control chart is a key feature of the Joint Commission’s analytic methods
in the ORYX® initiative. The two analyses are alike in that an organization’s actual (or observed) performance level
is evaluated against a comparative norm, but are fundamentally different as to how such a norm is established. In
control chart analysis, the norm is determined from an organization’s own historic data so that one may assess the
organization’s internal process stability. In target analysis, the norm is obtained based on multiple organizations’
performance data to evaluate an organization’s relative performance level. Therefore, the two analyses evaluate an
organization’s performance in two distinct perspectives and, as a result, can provide a more comprehensive
framework to assess an organization’s overall performance level.
Priority Focus Process
The Priority Focus Process (PFP) is a data-driven tool that helps focus survey activity on issues most relevant to
patient safety and quality of care at the specific health care organization being surveyed. The survey is directed by a
PFP that aggregates organization-specific information through an automated, rules-based tool. Input information
includes ORYX® measure data, previous recommendations, demographic data related to clinical service groups
and diagnostic-related groups, complaints, sentinel event information, and MedPar data. The process identifies
systems and processes that are relevant to patient safety and healthcare quality.
ORYX® Performance Measure Report
The ORYX® Performance Measure Report assists health care organizations in using their ORYX® data for ongoing
performance improvement activities. Joint Commission surveyors receive an identical copy of the report prior to an
onsite survey. Surveyors use the report as a guide to understanding how the organization uses and responds to
performance measure data. The report, available quarterly, summarizes performance measure information at both
the measure set and individual measure level. This includes highlighting measures with standards compliance
issues and performance issues.
Strategic Surveillance System(S3™)
The Strategic Surveillance System is a benefit provided to hospitals accredited by the Joint Commission. S3™ is a
tool that provides a series of risk assessment and comparative performance measure reports to help hospitals
improve their care processes. Specifically S3™ uses data the Joint Commission currently has, which includes past
survey findings, ORYX® core measure data, data from the Office of Quality Monitoring (complaints and non-self
reported sentinel events), data from an organization’s electronic application and MedPAR data.
Quality Check™
In July 2004, The Joint Commission launched a new generation of reporting healthcare information about the quality
and safety of care provided in its accredited healthcare organizations across the country.
The Joint Commission's Quality Check™ provides clear, objective data to individuals for the purpose of comparing
the performance of local hospitals, home care agencies, nursing homes, laboratories, and ambulatory care
organizations with others on state and national levels. Additionally, The Joint Commission provides hospitalspecific information about clinical performance in the care of patients for the ORYX® core measures. In addition,
Quality Check™ includes HCAHPs data and the CMS 30-day mortality measures.
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Individuals are also able to determine how healthcare organizations compare with others in meeting national
requirements that help them prevent devastating medical accidents. The requirements specifically seek to avoid
misidentification of patients, surgery on the wrong body part, miscommunication among caregivers, unsafe use of
infusion pumps, medication mix-ups, problems with equipment alarm systems, and infections acquired in the
healthcare setting.
Consumers can access Quality Check™ at http://www.qualitycheck.org and search for healthcare organizations by
name, type, and/or location. Interactive links to information are designed to help individuals better understand how
to use and interpret the information presented.
Annual Report
Improving America’s Hospitals: The Joint Commission’s Annual Report on Quality and Safety has been released
annually since 2008. This comprehensive report summarizes the performance of all Joint Commission-accredited
hospitals on ORYX® accountability measures.
Top Performers
In 2012, The Joint Commission introduced the Top Performers on Key Quality Measures™ program. This initiative
recognizes accredited hospitals that attain excellence on accountability measure performance.
Related National Activities
National Quality Forum
The NQF has approved a set of national voluntary consensus standards for measuring the quality of hospital care.
These measures will permit consumers, providers, purchasers, and quality improvement professionals to evaluate
and compare the quality of care in general acute care hospitals across the nation using a standard set of measures.
The majority of the Joint Commission’s measures are endorsed by NQF and are denoted on the measure
information forms.
National Quality Measures Clearinghouse
The National Quality Measures Clearinghouse (NQMC™), sponsored by AHRQ, U.S. Department of HHS, has
included Joint Commission measures in its public database for evidence-based quality measures and measure
sets. NQMC is sponsored by AHRQ to promote widespread access to quality measures by the healthcare
community and other interested individuals.
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Using The Specifications Manual for Joint
Commission National Quality Core Measures
This portion of The Specifications Manual provides a brief overview of the information contained within each
section of the manual. It is intended for use as a quick reference to assist in the implementation of the Joint
Commission national quality core measures. The sections of this manual are interrelated and are most useful when
considered together.
Section 1: Data Dictionary
The Data Dictionary describes the patient-level and facility-level data elements required to capture and calculate
individual measurements. It specifies those data elements that must be collected for each patient that falls into the
selected measure population and the data elements needed for a specific measure.
Section 2 - Measurement Information
The HBIPS and PC measure set sections contain specific measure information forms for each measure. This is
followed by a data element list for the measures, including the general data elements, algorithm output data
elements, and the specific measure data elements. Next is a document that describes the initial patient population
and sample size requirements for each measure set. Also included are subsections for each specific measure.
These contain a Measure Information Form (MIF) and the Performance Measure Algorithm.
The algorithms and data elements needed to calculate each of the Joint Commission national quality core
measures are identified in the MIF. Each algorithm provides the logical steps, data element evaluation, arithmetic
calculations, and data manipulation steps that are required to calculate a given measure.
Section 3: Missing and Invalid Data
This section addresses the Joint Commission’s approach to missing and invalid data. Missing data refers to data
elements that have no values present for one or more episodes of care and invalid data refers to data element
values that fall outside the range of the allowable values. Information and examples are provided on how the “Unable
to Determine” (UTD) value is utilized within the measure algorithm and on submission into the Joint Commission’s
Data Warehouse. This section also describes the general and measure specific data elements that are required for
submission and how missing and/or invalid data will be handled.
Section 4: Population and Sampling Methods
Sampling is an available option for all Joint Commission national quality core measures if certain requirements are
met. This section provides guidance on defining the hospital’s Initial Patient Population and information and
examples on the order of data flow, sample size requirements, sampling approaches and the transmission of Initial
Patient Population and sample data elements to the Joint Commission’s Data Warehouse. Specific measure set
sample size requirements tables are located in the Measure Information section.
Section 5 – Joint Commission National Quality Core Measure Verification Process
This section has been moved to the ORYX Technical Implementation Guide and is available to ORYX Vendors
via the Joint Commission’s extranet site for measurement systems (PET).
Section 6 – Joint Commission National Quality Core Measures Data Transmission
This section of the manual is provided to highlight the unique data transmission specifications for Joint Commission
national quality core measure data. This section is divided into four parts: Joint Commission National Quality Core
Measure Data Transmission, Guidelines for Submission of Data, Transmission Data Element List, and
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Transmission Data Processing Flow.
The Joint Commission Data Transmission section provides information related to the transmission of Joint
Commission national quality core measure data to the Joint Commission’s Data Warehouse. The Guidelines for
Submission of Data includes an overview of the data required to be submitted to the Joint Commission’s Data
Warehouse, as well as the Hospital Clinical Data XML file layout and the Hospital Initial Patient Population Data
XML file Layout.
The Transmission Data Element List describes the data elements that are either used to identify the hospital and
measure set associated to the transmitted data or are calculated by the vendor using the hospital’s patient-level
data and measure results. These data elements are not used in the Initial Patient Population Algorithms or Measure
Algorithms. The Transmission Data Processing Flows contains information regarding the order in which the Joint
Commission’s Data Warehouse evaluates the Joint Commission national quality core measures and the population
and sampling data.
Appendix A - ICD-9-CM Code Tables
For many of the measures, eligibility for inclusion or exclusion in the Initial Patient Population of interest is defined
by the presence of certain ICD-9-CM diagnosis and procedure codes within the patient-level record. Appendix A
contains the ICD-9-CM code tables that define these indicator populations for all measures within each measure
set. There is a description of the code as defined in a coding manual and a shortened description that may be used
in a data abstraction tool. The Measure Information Section also refers to the codes or tables provided in this
section. ICD-9-CM codes are modified by the National Center for Health Statistics (NCHS) and the Centers for
Medicare & Medicaid Services (CMS). The code tables in this Appendix are evaluated semiannually and modified
based on these changes. Potential changes become effective beginning with either April 1st or October 1st
discharges. Updates will be provided as indicated.
Appendix B – Medication Tables
Some of the Joint Commission national quality core measures address the use of certain medications. This
Appendix contains tables with the specific names of medications that may be associated with medication
categories (e.g., trade names). For example, Haloperidol may also be documented as Haldol. These tables are
provided to facilitate appropriate data collection of applicable medications. These tables are not meant to be an
inclusive list of all available therapeutic agents; rather they represent current information available at the time of
publication. Approved medication tables will be updated regularly. Discrepancies must be reported. See the
Resource Section of this manual for contact information.
Appendix C – Glossary of General Terms
Appendix D – Overview of Measure Information Form and Flowchart Formats
Each measure has an associated Measure Information Form and Flowchart (calculation algorithm). This Appendix
explains each of the terms used on the Measure Information Form and provides a brief introduction to flowcharting,
including an explanation of flowchart symbols.
Appendix E – Miscellaneous Tables
The tables in this Appendix contain clinical information to supplement the data element dictionary and provide
additional details for data abstraction. They are referenced under the data dictionary under the Notes for
Abstraction or the Guidelines for Abstraction.
Appendix F- Resources
This section lists resources that are available to assist with the Joint Commission measures.
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Appendix P – Preview Section
The preview section is intended to provide an overview of future updates. The information provided in this section is
not to be programmed or submitted. Placement in this appendix does not assume that the information listed will be
implemented in a future manual.
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Perinatal Care (PC)
Set Measures
Set Measure ID
PC-01
PC-02
PC-03
PC-04
PC-05
Measure Short Name
Elective Delivery
Cesarean Section
Antenatal Steroids
Health Care-Associated Bloodstream Infections in Newborns
Exclusive Breast Milk Feeding
General Data Elements
Element Name
Birthdate
CMS Certification Number
Clinical Trial
Discharge Date
Health Care Organization Identifier
Hispanic Ethnicity
ICD-9-CM Other Diagnosis Codes
ICD-9-CM Other Procedure Codes
ICD-9-CM Other Procedure Dates
ICD-9-CM Principal Diagnosis Code
ICD-9-CM Principal Procedure Code
ICD-9-CM Principal Procedure Date
Payment Source
Race
Sex
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Collected For
All Records,
Hospital Clinical Data File, Optional for
All Records,
All Records,
All Records, Not collected for HBIPS-2
and HBIPS-3
All Records, Aggregate Data File,
Patient Population Data File, Hospital
Clinical Data File,
All Records,
All Records, Optional for HBIPS-2,
HBIPS-3 and PBM; Used in algorithm
for PC-01, 02, 03, 04, and 05
All Records, Optional for All HBIPS
Records; Used in algorithm for PC-01,
02, 04 and 05;
All Records, Optional for All HBIPS and
PBM Records
All Records, Optional for HBIPS-2 and
HBIPS-3; Used in algorithm for PC-01,
02, 03, 04, 05 and PBM-03
All Records, Optional for All HBIPS
Records; Used in algorithm for PC-01,
02, 04 and 05
All Records, Optional for All HBIPS and
PBM Records
All Records, Optional for HBIPS-2 and
HBIPS-3
All Records,
All Records,
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Algorithm Output Data Elements
Element Name
Measure Category Assignment
Collected For
Calculation, Transmission, Hospital
Clinical Data File
Measure Set Specific Data Elements
Element Name
Admission Date
Admission to NICU
Antenatal Steroid Therapy Initiated
Birth Weight
Bloodstream Infection Present on Admission
Discharge Disposition
Exclusive Breast Milk Feeding
Gestational Age
Labor
Parity
Prior Uterine Surgery
Reason for Not Exclusively Feeding Breast Milk
Reason for Not Initiating Antenatal Steroid Therapy
Spontaneous Rupture of Membranes
Collected For
PC,
PC-05,
PC-03,
PC-04,
PC-04,
PC-04, PC-05,
PC-05,
PC-01, PC-02, PC-03,
PC-01,
PC-02,
PC-01,
PC-05,
PC-03,
PC-01,
Related Materials
Document Name
a. Cover page for the Joint Commission Manual
a. Table of Contents
a1. Acknowledgment and Conditions of Use
a2. Introduction to the Manual
a3. Using the The Joint Commission's National Measure Specifications Manual
b. Data Dictionary
d. Missing and Invalid Data
e. Sampling
g1. Transmission of Data
g2. Transmission Alpha Data Dictionary
g3. Transmission Data Processing Flow: Clinical
g4. Transmission Data Processing Flow: Population and Sampling
z. Appendix A - ICD-9-CM Code Tables
z. Appendix B - Medication Tables
z. Appendix C - Glossary of Terms
z. Appendix D - Overview of Measure Information Form and Flowchart Formats
z. Appendix E - Miscellaneous Tables
z. Appendix F - Resources
z. Appendix P - preview section of ICD-10 Code Tables
z. Appendix P of TJC Manual - preview section for ICD-10 crosswalks of code tables
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Perinatal Care (PC) Initial Patient Population
The PC measure set is unique in that there are two distinct Initial Patient Populations within the
measure set, mothers and newborns.
Mothers
The population of the PC-Mother measures (PC-01, 02, and 03) are identified using 4 data
elements:
•
•
•
•
Admission Date
Birthdate
Discharge Date
ICD-9-CM Principal or Other Diagnosis Code
Patients admitted to the hospital for inpatient acute care are included in the PC Mother Initial
sampling group if they have: ICD-9-CM Principal or Other Diagnosis Code as defined in Appendix
A, Tables 11.01, 11.02, 11.03, or 11.04, a Patient Age (Admission Date – Birthdate) >= 8 years and
< 65 and a Length of Stay (Discharge Date - Admission Date) ≤ 120 days.
Note: Hospitals are NOT required to sample their data. If sampling offers minimal benefit (i.e., a
hospital has 80 cases for the quarter and must select a sample of 76 cases), or if the hospital has
access to a data source which makes medical record review unnecessary (e.g., using vital records
as a data source for some of the maternal measures in the perinatal measure set), the hospital may
choose to use all cases.
Newborns
The population of the PC-Newborn measure (PC-04 and 05) are identified using 5 data elements:
• Admission Date
• Birthdate
• Discharge Date
(PC-05 only)
• ICD-9-CM Principal or Other Diagnosis Code
• ICD-9-CM Principal or Other Procedure Code
Within the PC-Newborn population, there are two 2 subpopulations, i.e Newborns with Blood
Stream Infection or BSI, Newborns with Breast Feeding, each identified by Patient Age at
admission and a specific group of diagnosis and procedure codes or lack thereof. The patients in
each subpopulation are processed independently through each initial patient population flow.
Patients may fall in both subpopulations depending on the presence or absence of the diagnosis
codes or procedure codes and other data elements defined by the respective initial patient
subpopulations.
Measures
Initial Patient Population definition
PC-04
The count of all patients in PC-Newborns with BSI
PC-05
The count of all patients in PC-Newborns with Breast Feeding
Patients admitted to the hospital for inpatient acute care are included in one of the PC Newborn
subpopulations if they have:
Newborns with BSI - Patients with a Newborn Patient Age at admission (Admission Date –
Birthdate) ≤ 2 days AND satisfy conditions #1 through #3.
1. NO ICD-9-CM Principal Diagnosis Code as defined in Appendix A, Table 11.10.2,
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2. ONE of the following:
◦ an ICD-9-CM Other Diagnosis Code as defined in Appendix A, Tables 11.12, 11.13,
11.13.1, 11.14 Or Birth Weight >= 500g and <= 1499g
◦ an ICD-9-CM Other Diagnosis Code as defined in Appendix A, Tables 11.15, 11.16,
11.16.1, 11.17 Or Birth Weight >=1500g with ANY OF THE FOLLOWING:
■ an ICD-9-CM-Principal or Other Procedure Code as defined in Appendix A, Tables
11.18 or 11.19
■ Discharge Disposition of 6 (expired) or a Missing Discharge Disposition
■ NO ICD-9-CM Principal Diagnosis Code as defined in Appendix A, Table 11.10.3
◦ Birth Weight Missing or Unable To Determine (UTD).
3. NO ICD-9-CM Other Diagnosis Code as defined in Appendix A, Table 11.20 Or Birth Weight
< 500g
There is NO sampling for this measure.
Newborns with Breast Feeding - Patient Age at admission (Admission Date – Birthdate) ≤ 2 days,
Length of Stay (Discharge Date - Admission Date) ≤ 120 days, an ICD-9-CM Principal as defined in
Appendix A, Table 11.20.1, NO ICD-9-CM Other Diagnosis Codes as defined in Appendix A, Table
11.21, NO ICD-9-CM-Principal or Other Procedure Code as defined in Appendix A, Table 11.22
and NO ICD-9-CM Other Diagnosis Codes as defined in Appendix A, Table 11.23 are included in
this subpopulation and are eligible to be sampled.
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Initial Patient Population Algorithm
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Sample Size Requirements
Hospitals that choose to sample have the option of sampling quarterly or sampling monthly. A
hospital may choose to use a larger sample size than is required. Hospitals whose Initial Patient
Population size is less than the minimum number of cases per quarter/month for the sampling
group cannot sample that sampling group. Hospitals that have five or fewer discharges for the three
combined PC sampling groups (both Medicare and non-Medicare combined) in a quarter are not
required to submit PC patient level data to the Joint Commission’s Data Warehouse.
A hospital may choose to use vital records to identify the PC-Mother Initial Patient Population as
given in the Population section earlier. If a hospital uses this method to identify the initial patient
population, then the hospital is encouraged to submit all the records of the initial population rather
than using sampling to identify the cases for submission. Submitting all the initial patient population
provides a more precise estimate of the performance rate for the measures.
Regardless of the option used, hospital samples must be monitored to ensure that sampling
procedures consistently produce statistically valid and useful data. Due to exclusions and
contraindications, hospitals selecting sample cases MUST submit AT LEAST the minimum required
sample size.
The following sample size tables for each option automatically build in the number of cases needed
to obtain the required sample sizes. For information concerning how to perform sampling, refer to
the Population and Sampling Specifications section in this manual.
Quarterly Sampling
A modified sampling procedure is required for hospitals performing quarterly sampling for PC.
Hospitals selecting sample cases must ensure that each individual sampling group Initial Patient
Population and sample size meet the following conditions:
• Select within the two individual measure sampling groups (mothers and babies).
• Select independently from each of the Newborn subpopulation.
Hospitals selecting sample cases for the PC-Mothers must ensure that the Initial Patient
Population and sample size for this PC sampling group meets the following conditions:
Quarterly Sample Size
Based on Initial Patient Population for Mothers
Hospital's Measure
Average Quarterly
Initial Patient
Sample Group Size
“N”
Minimum Required
Sampling Group Sample Size
“n”
>= 1501
301
376 – 1500
20% of the Initial Patient Population size
75 – 375
75
< 75
No sampling; 100% of the Initial Patient Population required
Within the PC-Newborn population, there are two subpopulations each identified by Patient Age at
admission and a specific group of diagnosis and procedure codes or lack thereof:
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• The PC-Newborns with BSI subpopulation is not eligible for sampling and will use the entire
Newborns with BSI Initial Patient subpopulation for reporting.
• Hospitals sampling for the PC-Newborns with Breast Feeding must ensure the sample size
calculations should be based on the newborns with breast feed subpopulation count
ONLY. Hospitals selecting cases for the PC-Newborns with Breastfeeding must ensure that
the patient population size for this subpopulation meets the following conditions:
Quarterly Sample Size Based on Initial Patient Population for PC-Newborns with
Breastfeeding
Hospital's Measure
Average Quarterly
Initial Patient
Sample Group Size
“N”
Minimum Required
Sample Size
“n”
>= 541
109
136 – 540
20% of the Initial Patient Population size
27 – 135
27
< 27
No sampling; 100% of Initial Patient Population required
Monthly Sampling
Hospitals selecting sample cases for the Mothers must ensure that the Initial Patient Population
and sample size for this sampling group meets the following conditions:
Monthly Sample Size
Based on Initial Patient Population for Mothers
Hospital's Measure
Average Monthly
Initial Patient
Sample Group Size
“N”
Minimum Required Sampling Group
Sample Size
“n”
>= 501
101
126 – 500
20% of the Initial Patient Population
25 – 125
25
< 25
No sampling; 100% Initial Patient Population required
Within the PC-Newborn population, there are two sampling groups each identified by Patient Age
at admission and a specific group of diagnosis codes, or lack there of:
• The PC-Newborns with BSI subpopulation is not eligible for sampling and will use the entire
Newborns with BSI Initial Patient subpopulation for reporting.
• Hospitals sampling for the PC-Newborns with Breast Feeding must ensure the sample size
calculations should be based on the newborns with breast feed subpopulation count
ONLY. Hospitals selecting cases for the PC-Newborns with Breastfeeding must ensure that
the patient population size for this subpopulation meets the following conditions:
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Monthly Sample Size Based on Initial Patient Population for Newborns with Breast Feeding
Hospital's Measure
Average Monthly
Initial Patient
Sample Group Size
“N”
Minimum Required Sampling Group
Sample Size
“n”
>= 181
37
46 – 180
20% of the Initial Patient Population
9 – 45
9
<9
No sampling; 100% Initial Patient Population required
Sample Size Examples
Note: PC-Mothers: All sampling groups in PC-Mother population should be used in the calculation
of all PC-Mother measures. All of the PC measures' specific exclusion criteria are used to filter out
cases that do not belong in the measure denominator. PC-Newborns: Cases falling within each
newborns subpopulation should be run through the respective Newborn measures only. Cases
falling in the Newborns with BSI subpopulation ONLY will flow through the PC-04 measure and
cases falling in the Newborns with Breast Feeding subpopulation ONLY will flow through the PC-05
measure only. Cases may fall in both subpopulations and in such scenarios will be processed
through both measures. It should be noted that cases should be processed independently through
each of newborn initial subpopulation flows to obtain cases for sampling and abstraction.
Quarterly Sampling
Mother Population
• A hospital’s Mother Population size is 2300 cases during the second quarter. Using the
quarterly sampling table for the Mother population, the sample size required is 301 cases for
the quarter.
• A hospital’s Mother Population size is 1500 cases during the second quarter. Using the
quarterly sampling table for the Mother population, the sample size required is 20% of this
sub-population or 300 cases for the quarter.
• A hospital’s Mother Population size is 300 cases during the second quarter. Using the
quarterly sampling table for the Mother population, the sample size required 75 cases for the
quarter.
• A hospital’s Mother Population size is 72 cases during the second quarter. Using the quarterly
sampling table for the Mother population, the sample size is less than the minimum required
quarterly sample size, so 100% of this sub-population or all 72 cases are sampled.
Newborns with Breast Feeding
• A hospital’s Newborns with Breast Feeding Population size is 600 cases during the second
quarter. Using the quarterly sampling table for the Newborns with Breast Feeding population,
the sample size required is 109 cases.
• A hospital’s Newborns with Breast Feeding Population size is 350 cases during the second
quarter. Using the quarterly sampling table for the Newborns with Breast Feeding population,
the sample size required is 20% of this sub-population or 70 cases for the quarter .
• A hospital’s Newborns with Breast Feeding Population size is 99 cases during the second
quarter. Using the quarterly sampling table for the Newborns with Breast Feeding population,
the sample size required 27 cases for the quarter.
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• A hospital’s Newborns with Breast Feeding Population size is 25 cases during the second
quarter. Using the quarterly sampling table for the Newborns with Breast Feeding population,
the sample size is less than the minimum required quarterly sample size, so 100% of this sub
-population or all 25 cases are sampled.
Newborns with BSI The Newborns with BSI population is not eligible for sampling and will use the
entire Newborns with BSI Initial Patient sampling group for reporting.
Monthly Sampling
Mother Population
• A hospital’s Mother Population size is 510 cases during March. Using the monthly sampling
table for the Mother population, the sample size required is 101 cases for the month.
• A hospital’s Mother Population size is 400 cases during March. Using the monthly sampling
table for the Mother population, the sample size required is 20% of this sub-population or 80
cases for the month.
• A hospital’s Mother Population size is 125 cases during March. Using the monthly sampling
table for the Mother population, the sample size required is 25 cases for the month.
• A hospital’s Mother Population size is 20 cases during March. Using the quarterly sampling
table for the Mothers population, the sample size is less than the minimum required quarterly
sample size, so 100% of this sub-population or all 20 cases are sampled.
Newborns with Breast Feeding
• A hospital’s Newborns with Breast Feeding Population size is 200 cases for the month of
March. Using the monthly sampling table for the Newborns with Breast Feeding population,
the sample size required is 37 cases.
• A hospital’s Newborns with Breast Feeding Population size is 100 cases for the month of
March. Using the monthly sampling table for the Newborns with Breast Feeding population,
the sample size required is 20% of this sub-population or 20 cases for the month.
• A hospital’s Newborns with Breast Feeding Population size is 30 cases for the month of
March. Using the monthly sampling table for the Newborns with Breast Feeding population,
the sample size required 9 cases for the month.
• A hospital’s Newborns with Breast Feeding Population size is 8 cases during the second
quarter. Using the monthly sampling table for the Newborns with Breast Feeding population,
the sample size is less than the minimum required monthly sample size, so 100% of this subpopulation or all 8 cases are sampled.
Newborns with BSI The Newborns with BSI population is not eligible for sampling and will use the
entire Newborns with BSI Initial Patient sampling group for reporting.
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**NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE**
Measure Information Form
Measure Set: Perinatal Care(PC)
Set Measure ID: PC-01
Performance Measure Name: Elective Delivery
Description: Patients with elective vaginal deliveries or elective cesarean sections at >= 37 and <
39 weeks of gestation completed
Rationale: For almost 3 decades, the American College of Obstetricians and Gynecologists
(ACOG) and the American Academy of Pediatrics (AAP) have had in place a standard requiring 39
completed weeks gestation prior to ELECTIVE delivery, either vaginal or operative (ACOG, 1996).
A survey conducted in 2007 of almost 20,000 births in HCA hospitals throughout the U.S. carried
out in conjunction with the March of Dimes at the request of ACOG revealed that almost 1/3 of all
babies delivered in the United States are electively delivered with 5% of all deliveries in the U.S.
delivered in a manner violating ACOG/AAP guidelines. Most of these are for convenience, and
result in significant short term neonatal morbidity (neonatal intensive care unit admission rates of
13- 21%) (Clark et al., 2009).
According to Glantz (2005), compared to spontaneous labor, elective inductions result in more
cesarean deliveries and longer maternal length of stay. The American Academy of Family
Physicians (2000) also notes that elective induction doubles the cesarean delivery rate. Repeat
elective cesarean sections before 39 weeks gestation also result in higher rates of adverse
respiratory outcomes, mechanical ventilation, sepsis and hypoglycemia for the newborns (Tita et
al., 2009).
Type of Measure: Process
Improvement Noted As: Decrease in the rate
Numerator Statement: Patients with elective deliveries
Included Populations: ICD-9-CM Principal Procedure Code or ICD-9-CM Other
Procedure Codes for one or more of the following:
• Medical induction of labor as defined in Appendix A, Table 11.05
• Cesarean section as defined in Appendix A, Table 11.06 and all of the following:
◦ not in Labor
◦ not experiencing Spontaneous Rupture of Membranes
◦ no history of a Prior Uterine Surgery
Excluded Populations: None
Data Elements:
• ICD-9-CM Other Procedure Codes
• ICD-9-CM Principal Procedure Code
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• Labor
• Prior Uterine Surgery
• Spontaneous Rupture of Membranes
Denominator Statement: Patients delivering newborns with >= 37 and < 39 weeks of gestation
completed
Included Populations:
• ICD-9-CM Principal or Other Diagnosis Codes for pregnancy as defined in
Appendix A, Tables 11.01, 11.02, 11.03 or 11.04
• ICD-9-CM Principal Diagnosis Code or ICD-9-CM Other Diagnosis Codes for
planned cesarean section in labor as defined in Appendix A, Table 11.06.1
Excluded Populations:
• ICD-9-CM Principal Diagnosis Code or ICD-9-CM Other Diagnosis Codes for
conditions possibly justifying elective delivery prior to 39 weeks gestation as
defined in Appendix A, Table 11.07
• Less than 8 years of age
• Greater than or equal to 65 years of age
• Length of stay > 120 days
• Enrolled in clinical trials
• Gestational Age < 37 or >= 39 weeks
Data Elements:
•
•
•
•
•
•
•
Admission Date
Birthdate
Clinical Trial
Discharge Date
Gestational Age
ICD-9-CM Other Diagnosis Codes
ICD-9-CM Principal Diagnosis Code
Risk Adjustment: No.
Data Collection Approach: Retrospective data sources for required data elements include
administrative data and medical records.
Data Accuracy: Variation may exist in the assignment of ICD-9-CM codes; therefore, coding
practices may require evaluation to ensure consistency.
Measure Analysis Suggestions: In order to identify areas for improvement, hospitals may want to
review results based on specific ICD-9 codes or patient populations. Data could be analyzed further
to determine specific patterns or trends to help reduce elective deliveries.
Sampling: Yes. For additional information see the Sampling Section.
Data Reported As: Aggregate rate generated from count data reported as a proportion.
Selected References:
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• American Academy of Family Physicians. (2000). Tips from Other Journals: Elective induction
doubles cesarean delivery rate, 61, 4.Retrieved December 29, 2008 at:
http://www.aafp.org/afp/20000215/tips/39.html.
• American College of Obstetricians and Gynecologists. (November 1996). ACOG Educational
Bulletin.
• Clark, S., Miller, D., Belfort, M., Dildy, G., Frye, D., & Meyers, J. (2009). Neonatal and
maternal outcomes associated with elective delivery. [Electronic Version]. Am J Obstet
Gynecol. 200:156.e1-156.e4.
• Glantz, J. (Apr.2005). Elective induction vs. spontaneous labor associations and outcomes.
[Electronic Version]. J Reprod Med. 50(4):235-40.
• Tita, A., Landon, M., Spong, C., Lai, Y., Leveno, K., Varner, M, et al. (2009). Timing of
elective repeat cesarean delivery at term and neonatal outcomes. [Electronic Version]. NEJM.
360:2, 111-120.
Original Performance Measure Source / Developer:
Hospital Corporation of America-Women's and Children's Clinical Services
Adopted for CMS Hospital Inpatient Quality Reporting Program FY 2015 and Stage 2 Medicare and
Medicaid EHR Incentive Program
Measure Algorithm:
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**NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE**
Measure Information Form
Measure Set: Perinatal Care(PC)
Set Measure ID: PC-02
Performance Measure Name: Cesarean Section
Description: Nulliparous women with a term, singleton baby in a vertex position delivered by
cesarean section
Rationale: The removal of any pressure to not perform a cesarean birth has led to a skyrocketing
of hospital, state and national cesarean section (CS) rates. Some hospitals now have CS rates
over 50%. Hospitals with CS rates at 15-20% have infant outcomes that are just as good and better
maternal outcomes (Gould et al., 2004). There are no data that higher rates improve any outcomes,
yet the CS rates continue to rise. This measure seeks to focus attention on the most variable
portion of the CS epidemic, the term labor CS in nulliparous women. This population segment
accounts for the large majority of the variable portion of the CS rate, and is the area most affected
by subjectivity.
As compared to other CS measures, what is different about NTSV CS rate (Low-risk Primary CS in
first births) is that there are clear cut quality improvement activities that can be done to address the
differences. Main et al. (2006) found that over 60% of the variation among hospitals can be
attributed to first birth labor induction rates and first birth early labor admission rates. The results
showed if labor was forced when the cervix was not ready the outcomes were poorer. Alfirevic et al.
(2004) also showed that labor and delivery guidelines can make a difference in labor outcomes.
Many authors have shown that physician factors, rather than patient characteristics or obstetric
diagnoses are the major driver for the difference in rates within a hospital (Berkowitz, et al., 1989;
Goyert et al., 1989; Luthy et al., 2003). The dramatic variation in NTSV rates seen in all populations
studied is striking according to Menacker (2006). Hospitals within a state (Coonrod et al., 2008;
California Office of Statewide Hospital Planning and Development [OSHPD], 2007) and physicians
within a hospital (Main, 1999) have rates with a 3-5 fold variation.
Type of Measure: Outcome
Improvement Noted As: Decrease in the rate
Numerator Statement: Patients with cesarean sections
Included Populations: ICD-9-CM Principal Procedure Code or ICD-9-CM Other
Procedure Codes for cesarean section as defined in Appendix A, Table 11.06
Excluded Populations: None
Data Elements:
• ICD-9-CM Other Procedure Codes
• ICD-9-CM Principal Procedure Code
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Denominator Statement: Nulliparous patients delivered of a live term singleton newborn in vertex
presentation
Included Populations:
• ICD-9-CM Principal or Other Diagnosis Codes for pregnancy as defined in
Appendix A, Tables 11.01, 11.02, 11.03 or 11.04
• Nulliparous patients with ICD-9-CM Principal Diagnosis Code or ICD-9-CM Other
Diagnosis Codes for outcome of delivery as defined in Appendix A, Table 11.08
and with a delivery of a newborn with 37 weeks or more of gestation completed
Excluded Populations: ICD-9-CM Principal Diagnosis Code or ICD-9-CM Other
Diagnosis Codes, for contraindications to vaginal delivery as defined in Appendix A,
Table 11.09
•
•
•
•
•
Less than 8 years of age
Greater than or equal to 65 years of age
Length of Stay >120 days
Enrolled in clinical trials
Gestational Age < 37 weeks
Data Elements:
•
•
•
•
•
•
•
•
•
•
Admission Date
Birthdate
Clinical Trial
Discharge Date
Gestational Age
ICD-9-CM Other Diagnosis Codes
ICD-9-CM Other Procedure Codes
ICD-9-CM Principal Diagnosis Code
ICD-9-CM Principal Procedure Code
Parity
Risk Adjustment: Yes. Applied through direct standardization. This section has been moved to the
ORYX Risk Adjustment Guide. This guide is available to the public on the Joint Commission’s
website and, in addition, it is available to performance measurement systems via the Joint
Commission’s extranet site for measurement systems (PET)
Data Elements
• Birthdate
Data Collection Approach: Retrospective data sources for required data elements include
administrative data and medical records.
Data Accuracy: Variation may exist in the assignment of ICD-9-CM codes; therefore, coding
practices may require evaluation to ensure consistency.
Measure Analysis Suggestions: In order to identify areas for improvement, hospitals may want to
review results based on specific ICD-9 codes or patient populations. Data could then be analyzed
further determine specific patterns or trends to help reduce cesarean sections.
Sampling: Yes. For additional information see the Sampling Section.
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Data Reported As: Aggregate rate generated from count data reported as a proportion.
Selected References:
• Agency for Healthcare Research and Quality. (2002). AHRQ Quality Indicators—Guide to
Inpatient Quality Indicators: Quality of Care in Hospitals—Volume, Mortality, and Utilization.
Revision 4 (December 22, 2004). AHRQ Pub. No. 02-RO204.
• Alfirevic, Z., Edwards, G., & Platt, M.J. (2004). The impact of delivery suite guidelines on
intrapartum care in “standard primigravida.” Eur J Obstet Gynecol Reprod Biol.115:28-31.
• American College of Obstetricians and Gynecologists. (2000). Task Force on Cesarean
Delivery Rates. Evaluation of Cesarean Delivery. (Developed under the direction of the Task
Force on Cesarean Delivery Rates, Roger K. Freeman, MD, Chair, Arnold W. Cohen, MD,
Richard Depp III, MD, Fredric D. Frigoletto Jr, MD, Gary D.V. Hankins, MD, Ellice Lieberman,
MD, DrPH, M. Kathryn Menard, MD, David A. Nagey, MD, Carol W. Saffold, MD, Lisa Sams,
RNC, MSN and ACOG Staff: Stanley Zinberg, MD, MS, Debra A. Hawks, MPH, and Elizabeth
Steele).
• Bailit, J.L., Garrett, J.M., Miller, W.C., McMahon, M.J., & Cefalo, R.C. (2002). Hospital primary
cesarean delivery rates and the risk of poor neonatal outcomes. Am J Obstet Gynecol. 187
(3):721-7.
• Bailit, J. & Garrett, J. (2003). Comparison of risk-adjustment methodologies. Am J Obstet
Gynecol.102:45-51.
• Bailit, J.L., Love, T.E., & Dawson, N.V. (2006). Quality of obstetric care and risk-adjusted
primary cesarean delivery rates. Am J Obstet Gynecol.194:402.
• Bailit, J.L. (2007). Measuring the quality of inpatient obstetrical care. Ob Gyn Sur. 62:207213.
• Berkowitz, G.S., Fiarman, G.S., Mojica, M.A., et al. (1989). Effect of physician characteristics
on the cesarean birth rate. Am J Obstet Gynecol. 161:146-9.
• California Office of Statewide Hospital Planning and Development. (2006). Utilization Rates
for Selected Medical Procedures in California Hospitals, Retrieved from the Internet on
February 11, 2010 at:
http://www.oshpd.ca.gov/HID/Products/PatDischargeData/ResearchReports/HospIPQualInd/Vo
-Util_IndicatorsRpt/2007Util.pdf
• Cleary, R., Beard, R.W., Chapple, J., Coles, J., Griffin, M., & Joffe, M. (1996). The standard
primipara as a basis for inter-unit comparisons of maternity care. Br J Obstet Gynecol.
103:223-9.
• Coonrod, D.V., Drachman, D., Hobson, P., & Manriquez, M. (2008). Nulliparous term
singleton vertex cesarean delivery rates: institutional and individual level predictors. Am J
Obstet Gynecol. 694-696.
• DiGiuseppe, D.L., Aron, D.C., Payne, S.M., Snow, R.J., Dieker, L., & Rosenthal, G.E. (2001).
Risk adjusting cesarean delivery rates: a comparison of hospital profiles based on medical
record and birth certificate data. Health Serv Res.36:959-77.
• Gould, J., Danielson, B., Korst, L., Phibbs, R., Chance, K.,& Main, E.K., et al. (2004).
Cesarean delivery rate and neonatal morbidity in a low-risk population. Am J Obstet Gynecol,
104:11-19.
• Goyert, G.L., Bottoms, F.S., Treadwell, M.C., et al. (1989). The physician factor in cesarean
birth rates. N Engl J Med.320:706-9.
• Le Ray, C., Carayol, M., Zeitlin, J., Berat, G., & Goffinet, F. (2006). Level of perinatal care of
the maternity unit and rate of cesarean in low-risk nulliparas. Am J Obstet Gynecol. 107:126977.
• Luthy, D.A., Malmgren, J.A., Zingheim, R.W., & Leininger, C.J. (2003). Physician contribution
to a cesarean delivery risk model. Am J Obstet Gynecol.188:1579-85.
• Main, E.K. (1999). Reducing cesarean birth rates with data-driven quality improvement
activities. Peds. 103: 374-383.
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• Main E.K., Bloomfield, L., & Hunt, G. (2004). Development of a large-scale obstetric qualityimprovement program that focused on the nulliparous patient at term. Am J Obstet
Gynecol.190:1747-58.
• Main, E.K., Moore, D., Farrell, B., Schimmel, L.D., Altman, R.J., Abrahams, C., et al., (2006).
Is there a useful cesarean birth measure? Assessment of the nulliparous term singleton
vertex cesarean birth rate as a tool for obstetric quality improvement. Am J Obstet Gynecol.
194:1644-51.
• Menacker, F. (2005).Trends in cesarean rates for first births and repeat cesarean rates for
low-risk women: United States, 1990-2003. Nat Vital Stat Rep. 54(4): 1-5.
• Romano, P.S., Yasmeen, S., Schembri, M.E., Keyzer, J.M., & Gilbert, W.M. (2005). Coding of
perineal lacerations and other complications of obstetric care in hospital discharge data. Am J
Obstet Gynecol.106:717-25.
• U.S. Department of Health and Human Services. (2000). Healthy People 2010:
Understanding and Improving Health. 2nd ed. Washington, DC: U.S. Government Printing
Office. Measure 16-9.
• Yasmeen, S., Romano, P.S., Schembri, M.E., Keyzer, J.M., & Gilbert, W.M. (2006). Accuracy
of obstetric diagnoses and procedures in hospital discharge data. Am J Obstet Gynecol.
194:992-1001.
Original Performance Measure Source / Developer:
California Maternal Quality Care Collaborative
Measure Algorithm:
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**NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE**
Measure Information Form
Measure Set: Perinatal Care(PC)
Set Measure ID: PC-03
Performance Measure Name: Antenatal Steroids
Description: Patients at risk of preterm delivery at >=24 and <32 weeks gestation receiving
antenatal steroids prior to delivering preterm newborns
Rationale: The National Institutes of Health 1994 recommendation is to give a full course of
corticosteroids to all pregnant women between 24 weeks and 34 weeks of gestation who are at risk
of preterm delivery. Repeated corticosteroid courses should not be used routinely, because clinical
trials show decreased brain size, decreased birth weight, and adrenal insufficiency in newborns
exposed to repeated doses. Treatment should consist of two doses of 12 mg of betamethasone
given intramuscularly 24 hours apart or four doses of 6 mg dexamethasone given intramuscularly
every 12 hours. A full course of antenatal corticosteroids should be administered to women with
premature rupture of membranes (PROM) before 32 weeks of gestation to reduce the risks of
respiratory distress syndrome, prenatal mortality, and other morbidities. The efficacy of
corticosteroid use at 32-34 completed weeks of gestation is unclear based on available evidence,
but treatment may be beneficial, particularly if pulmonary immaturity is documented (Lockwood &
Lemons, 2007).
Type of Measure: Process
Improvement Noted As: Increase in the rate
Numerator Statement: Patients with antenatal steroid therapy initiated prior to delivering preterm
newborns
Included Populations: Antenatal steroid therapy initiated (refer to Appendix B, Table
11.0, antenatal steroid medications)
Excluded Populations: None
Data Elements:
• Antenatal Steroid Therapy Initiated
Denominator Statement: Patients delivering live preterm newborns with >=24 and <32 weeks
gestation completed
Included Populations:
• ICD-9-CM Principal or Other Diagnosis Codes for pregnancy as defined in
Appendix A, Tables 11.01, 11.02, 11.03 or 11.04
Excluded Populations:
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•
•
•
•
•
•
Less than 8 years of age
Greater than or equal to 65 years of age
Length of Stay >120 days
Enrolled in clinical trials
Documented Reason for Not Initiating Antenatal Steroid Therapy
ICD-9-CM Principal Diagnosis Code or ICD-9-CM Other Diagnosis Codes for fetal
demise as defined in Appendix A, Table 11.09.1
• Gestational Age < 24 or >= 32 weeks
Data Elements:
•
•
•
•
•
•
•
•
Admission Date
Birthdate
Clinical Trial
Discharge Date
Gestational Age
ICD-9-CM Other Diagnosis Codes
ICD-9-CM Principal Diagnosis Code
Reason for Not Initiating Antenatal Steroid Therapy
Risk Adjustment: No.
Data Collection Approach: Retrospective data sources for required data elements include
administrative data and medical records. Data are collected as weeks and days of gestation, but
the vendor converts to total days of gestation for data transmission and measure calculation.
Data Accuracy: Variation may exist in the assignment of ICD-9-CM codes; therefore, coding
practices may require evaluation to ensure consistency.
Measure Analysis Suggestions: In order to identify areas for improvement in antenatal steroid
administration rates, hospitals may wish to review documentation for reasons. Education efforts
can be targeted based on the specific reasons identified.
Sampling: Yes. For additional information see the Sampling Section.
Data Reported As: Aggregate rate generated from count data reported as a proportion.
Selected References:
• Lockwood, C.J., ed. & Lemons, J.A., ed. (2007). Guidelines for Perinatal Care, Sixth Edition,
American Academy of Pediatrics and the American College of Obstetricians and
Gynecologists, ISBN 978-1-58110-270-3; ISBN 978-1-932328-36-3, pp. 178-181.
• NIH Consensus Development Conference Statement: The Effect of Corticosteroids for Fetal
Maturation on Perinatal Outcomes. February 28-March 2, 1994.
Original Performance Measure Source / Developer:
Providence St Vincent’s Hospital/Council of Women and Infant’s Specialty Hospitals
Measure Algorithm:
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**NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE**
Measure Information Form
Measure Set: Perinatal Care(PC)
Set Measure ID: PC-04
Performance Measure Name: Health Care-Associated Bloodstream Infections in Newborns
Description: Staphylococcal and gram negative septicemias or bacteremias in high-risk newborns
Rationale: Health care-associated bacteremia is significant problem for infants admitted into
neonatal intensive care units (NICUs) and other hospital units. This is especially true for very low
birth weight infants who are at high risk for these infections due to their immature immune systems
and need for invasive monitoring and supportive care (Adams-Chapman & Stoll, 2002; Bloom et al.,
2003; Clark et al., 2004a; Clark et al., 2004b; Gaynes et al., 1996; Payne et al., 2004; Sohn et al.,
2001; Stoll et al., 2002). Reported health care-associated infection rates range from 6% to 33%, but
the rate varies widely among different centers (Adams-Chapman & Stoll, 2002; Bloom et al.,2003;
Clark et al.,2004b ; Sohn et al.,2001; Stoll et al.,2002). Mortality rates are high and infections result
in increased length of stay as well as increased hospital costs and charges (Adams-Chapman &
Stoll, 2002; Bloom et al.,2003; Clark et al., 2004b; Horbar et al., 2001; Kilbride et al., 2003a; Sohn
et al.,2001; Stoll et al., 2002).
The incidence of health care-associated bacteremia increases with decreasing birth weight. Other
risk factors include central venous catheter use, prolonged time using parenteral nutrition,
prolonged time on mechanical ventilation, use of H2-blocking agents, and overcrowding or heavy
staff loads (Adams-Chapman & Stoll, 2002; Barton et al., 1999; Gaynes et al., 1996; Stoll et al.,
2002). The most common causative organisms are coagulase-negative staphylococci,
Staphylococcus aureus, enterococci, Enterobacter sp, and Escherichia coli (Adams-Chapman &
Stoll, 2002; Clark et al., 2004b; Gaynes et al., 1996; Horbar et al., 2001; Payne et al., 2004; Sohn
et al., 2001; Stoll et al., 2002).
Effective preventive measures range from simple hand-washing protocols or closed medication
delivery systems to more elaborate multidisciplinary quality improvement plans involving handwashing, nutrition, skin care, respiratory care, vascular access, and diagnostic practices. All of
these interventions have been shown to substantially reduce infection rates, albeit in
nonrandomized studies using historical or concurrent control units (Adams-Chapman & Stoll, 2002;
Aly et al., 2005; Bloom et al., 2003; Clark et al., 2004a; Clark et al., 2004b; Horbar et al., 2001; Lam
et al., 2004; Kilbride et al., 2003a; Kilbride et al., 2003b; Ng et al., 2004; Schelonka et al., 2006).
For example, six Vermont Oxford Network NICUs reduced their rates of coagulase-negative
staphylococcus infections from 22.0% in 1994 to 16.6% in 1996 after implementing a quality
improvement model (versus a much smaller decrease from 15.4% to 14.5% at 66 comparison
NICUs) (Horbar et al., 2001). A similar reduction from 24.6% to 16.4% was achieved with a multimodality, multi-hospital intervention focusing on hand hygiene with an effective agent before and
after every patient contact, eliminating hand jewelry and artificial nails, using maximal barrier
precautions during central venous catheter insertion, decreasing the number of skin punctures,
reducing the duration of intravenous lipid and deep line use, and improving the diagnosis of health
care-associated infections. (Kilbride et al., 2003a; Kilbride et al., 2003b).
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Given the fragility and susceptibility of the patient population, a baseline level of health careassociated infections will be expected, even with good protocols in place. However, those centers
that have prevention protocols, and are able to encourage health care workers to adhere to these
protocols, will probably have success in reducing their rates of health care-associated bacteremia
in their neonatal population. Indeed, several quasi-experimental studies have demonstrated that
NICUs can lower their infection rates (based on positive blood cultures) from as high as 13.5 per
1,000 patient days to as low as 3.0 per 1,000 patient days( Adams-Chapman & Stoll, 2002; Aly et
al., 2005; Bloom et al. ,2003; Clark et al., 2004a; Clark et al., 2004b; Horbar et al., 2001; Lam et al.,
2004; Kilbride et al., 2003a; Kilbride et al., 2003b; Ng et al., 2004; Schelonka et al., 2006).
Type of Measure: Outcome
Improvement Noted As: Decrease in the rate
Numerator Statement: Newborns with septicemia or bacteremia
Included Populations:
• ICD-9-CM Other Diagnosis Codes for newborn septicemia or bacteremia as
defined in Appendix A, Table 11.10
OR
• ICD-9-CM Other Diagnosis Codes for sepsis as defined in Appendix A, Table
11.10.1
Excluded Populations: None
Data Elements:
• ICD-9-CM Other Diagnosis Codes
Denominator Statement: Liveborn newborns
Included Populations:
• ICD-9-CM Other Diagnosis Codes for birth weight between 500 and 1499g as
defined in Appendix A, Table 11.12, 11.13, 11.13.1 or 11.14 OR Birth Weight
between 500 and 1499g
OR
• ICD-9-CM Other Diagnosis Codes for birth weight ≥ 1500g as defined in Appendix
A, Table 11.15,11.16, 11.16.1 or 11.17 OR Birth Weight ≥ 1500g who experienced
one or more of the following:
◦ Experienced death
◦ ICD-9-CM Principal Procedure Code or ICD-9-CM Other Procedure Codes
for major surgery as defined in Appendix A, Table 11.18
◦ ICD-9-CM Principal Procedure Code or ICD-9-CM Other Procedure Codes
for mechanical ventilation as defined in Appendix A, Table 11.19
◦ Transferred in from another acute care hospital or health care setting within
2 days of birth
Excluded Populations:
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• ICD-9-CM Principal Diagnosis Code for septicemias or bacteremias as defined in
Appendix A, Table 11.10.2
• ICD-9-CM Other Diagnosis Codes for septicemias or bacteremias as defined in
Appendix A, Table 11.10.2 or ICD-9-CM Principal or Other Diagnosis Codes for
newborn septicemia or bacteremia as defined in Appendix A, Table 11.10 with a
Bloodstream Infection Present on Admission
• ICD-9-CM Other Diagnosis Codes for birth weight < 500g as defined in Appendix
A, Table 11.20 OR Birth Weight < 500g
• Enrolled in clinical trials
• Length of Stay < 2 days
Data Elements:
•
•
•
•
•
•
•
•
•
•
•
Admission Date
Birth Weight
Birthdate
Bloodstream Infection Present on Admission
Clinical Trial
Discharge Date
Discharge Disposition
ICD-9-CM Other Diagnosis Codes
ICD-9-CM Other Procedure Codes
ICD-9-CM Principal Diagnosis Code
ICD-9-CM Principal Procedure Code
Risk Adjustment: Yes. This section has been moved to the ORYX Risk Adjustment Guide. This
guide is available to the public on the Joint Commission’s website and, in addition, it is available to
performance measurement systems via the Joint Commission’s extranet site for measurement
systems (PET).
Data Elements:
•
•
•
•
Birth Weight
Discharge Disposition
ICD-9-CM Principal Diagnosis Code
ICD-9-CM Other Diagnosis Codes
Data Collection Approach: Retrospective data sources for required data elements include
administrative data and medical records.
Data Accuracy: * Variation may exist in the assignment of ICD-9-CM codes; therefore, coding
practices may require evaluation to ensure consistency.
• Since Birth Weight is a risk factor for hospital associated blood stream infections in newborns,
ICD-9-CM codes have been provided in Appendix A, Tables 11.12-11.17, 11.20 to assist in
identifying newborns with prematurity and fetal growth retardation with a fifth digit
subclassification to denote birth weight (less than 500 grams up to birth weight 2000-2499
grams). Therefore, newborns with birth weights greater than or equal to 2500 grams will need
to be captured using the data element Birth Weight.
• It is important to ensure that all weight conversions from pounds and ounces to grams are
accurate and concise. Birth Weight should not be rounded off i.e., when converting from
pounds and ounces to grams, do not round to the nearest pound before converting the weight
to grams.
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• Discrepancies can occur between Birth Weights obtained from labor and delivery vs. nursery
departments. Organizations should determine which is the most reliable source for this data
element value and consistently obtain it from that source.
Measure Analysis Suggestions: In order to identify areas for improvement, hospitals may want to
review results based on specific ICD-9 codes or patient populations. Data could then be analyzed
further determine specific patterns or trends to help reduce bloodstream infections.
Sampling: No. For additional information see the Sampling Section.
Data Reported As: Aggregate rate generated from count data reported as a proportion.
Selected References:
• Adams-Chapman, I. & Stoll, B.J. (2002). Prevention of nosocomial infections in the neonatal
intensive care unit. Current Opinion in Pediatrics.14 (2):157-64.
• Aly, H., Herson, V., Duncan, A., et al. (2005). Is bloodstream infection preventable among
premature infants? A tale of two cities. Pediatrics. 115(6):1513-8.
• Barton, L., Hodgman, J.E., & Pavlova, Z. (1999). Causes of death in the extremely low birth
weight infant. Pediatrics. 103(2):446-51.
• Bloom, B.T., Craddock, A., Delmore, P.M., et al. (2003). Reducing acquired infections in the
NICU: observing and implementing meaningful differences in process between high and low
acquired infection rate centers. Journal of Perinatology. 23(6):489-92.
• Clark, R., Powers, R., White, R., Bloom, B., Sanchez, P., & Benjamin, D.K., Jr. (2004a).
Prevention and treatment of nosocomial sepsis in the NICU. Journal of Perinatology. 4; 24
(7):446-53.
• Clark, R., Powers, R., White, R., Bloom, B., Sanchez, P., & Benjamin, D.K., Jr. (2004b).
Nosocomial infection in the NICU: a medical complication or unavoidable problem? Journal of
Perinatology. 24(6):382-8.
• Gaynes, R.P., Edwards, J.R., Jarvis, W.R., Culver, D.H., Tolson, J.S., & Martone, W.J.
(1996). Nosocomial infections among neonates in high-risk nurseries in the United States.
National Nosocomial Infections Surveillance System. Pediatrics. 98(3 Pt 1):357-61.
• Horbar, J.D., Rogowski, J., Plsek, P.E., et al. (2001). Collaborative quality improvement for
neonatal intensive care. NIC/Q Project Investigators of the Vermont Oxford Network.
Pediatrics. 107(1):14-22.
• Kilbride, H.W., Wirtschafter, D.D., Powers, R.J., & Sheehan, M.B. (2003a). Implementation of
evidence-based potentially better practices to decrease nosocomial infections. Pediatrics. 111
(4 Pt 2):e519-33.
• Kilbride, H.W., Powers, R., Wirtschafter, D.D., et al. (2003b). Evaluation and development of
potentially better practices to prevent neonatal nosocomial bacteremia. Pediatrics. 111(4 Pt
2):e504-18.
• Lam, B.C., Lee, J., & Lau, Y.L. (2004). Hand Hygiene Practices in a Neonatal Intensive Care
Unit: A Multimodal Intervention and Impact on Nosocomial Infection. Pediatrics.114 (5):e565.
• Ng, P.C., Wong, H.L., Lyon, D.J., et al. (2004). Combined use of alcohol hand rub and gloves
reduces the incidence of late onset infection in very low birthweight infants. Archives of
Disease in Childhood Fetal & Neonatal Edition. 89(4):F336-40.
• Payne, N.R., Carpenter, J.H., Badger, G.J., Horbar, J.D., & Rogowski, J. (2004). Marginal
increase in cost and excess length of stay associated with nosocomial bloodstream infections
in surviving very low birth weight infants. Pediatrics. 114(2):348-55.
• Schelonka, R.L., Scruggs, S., Nichols, K., Dimmitt, R.A., & Carlo, W.A. (2006). Sustained
reductions in neonatal nosocomial infection rates following a comprehensive infection control
intervention. Journal of Perinatology. 26(3):176-9.
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• Sohn, A.H., Garrett, D.O., Sinkowitz-Cochran, R.L., et al. (2001). Prevalence of nosocomial
infections in neonatal intensive care unit patients: Results from the first national pointprevalence survey. Journal of Pediatrics. 139(6):821-7.
• Stoll, B.J., Hansen, N., Fanaroff, A.A., et al. (2002). Late-onset sepsis in very low birth weight
neonates: the experience of the NICHD Neonatal Research Network. Pediatrics. 110(2 Pt
1):285-91.
Original Performance Measure Source / Developer:
Agency for Healthcare Research and Quality
Measure Algorithm:
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**NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE**
Measure Information Form
Measure Set: Perinatal Care(PC)
Set Measure ID: PC-05
Set Measure ID
Performance Measure Name
PC-05a
Exclusive Breast Milk Feeding Considering Mother's Choice
Performance Measure Name: Exclusive Breast Milk Feeding
Description:
• PC-05 Exclusive breast milk feeding during the newborn's entire hospitalization
• PC-05a Exclusive breast milk feeding during the newborn’s entire hospitalization considering
mother’s choice
The measure is reported as an overall rate which includes all newborns that were exclusively fed
breast milk during the entire hospitalization, and a second rate, a subset of the first, which includes
only those newborns that were exclusively fed breast milk during the entire hospitalization
excluding those whose mothers chose not to breast feed.
Rationale: Exclusive breast milk feeding for the first 6 months of neonatal life has long been the
expressed goal of World Health Organization (WHO), Department of Health and Human Services
(DHHS), American Academy of Pediatrics (AAP) and American College of Obstetricians and
Gynecologists (ACOG). ACOG has recently reiterated its position (ACOG, 2007). A recent
Cochrane review substantiates the benefits (Kramer et al., 2002). Much evidence has now focused
on the prenatal and intrapartum period as critical for the success of exclusive (or any) BF (Centers
for Disease Control and Prevention [CDC], 2007; Petrova et al., 2007; Shealy et al., 2005; Taveras
et al., 2004). Exclusive breast milk feeding rate during birth hospital stay has been calculated by
the California Department of Public Health for the last several years using newborn genetic disease
testing data. Healthy People 2010 and the CDC have also been active in promoting this goal.
Type of Measure: Process
Improvement Noted As: Increase in the rate
Numerator Statement:
• PC-05 Newborns that were fed breast milk only since birth
• PC-05a Newborns that were fed breast milk only since birth
Included Populations: Not applicable
Excluded Populations: None
Data Elements:
• Exclusive Breast Milk Feeding
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Denominator Statement:
• PC-05 Single term newborns discharged alive from the hospital
• PC-05a Single term newborns discharged alive from the hospital excluding those whose
mothers chose not to exclusively feed breast milk
Included Populations: Liveborn newborns with ICD-9-CM Principal Diagnosis Code for
single liveborn newborn as defined in Appendix A, Table 11.20.1
Excluded Populations:
• Admitted to the Neonatal Intensive Care Unit (NICU) at this hospital during the
hospitalization
• ICD-9-CM Other Diagnosis Codes for galactosemia as defined in Appendix A,
Table 11.21
• ICD-9-CM Principal Procedure Code or ICD-9-CM Other Procedure Codes for
parenteral infusion as defined in Appendix A, Table 11.22
• Experienced death
• Length of Stay >120 days
• Enrolled in clinical trials
• Documented Reason for Not Exclusively Feeding Breast Milk
• Patients transferred to another hospital
• ICD-9-CM Other Diagnosis Codes for premature newborns as defined in Appendix
A, Table 11.23
Data Elements:
•
•
•
•
•
•
•
•
•
•
•
Admission Date
Admission to NICU
Birthdate
Clinical Trial
Discharge Date
Discharge Disposition
ICD-9-CM Other Diagnosis Codes
ICD-9-CM Other Procedure Codes
ICD-9-CM Principal Diagnosis Code
ICD-9-CM Principal Procedure Code
Reason for Not Exclusively Feeding Breast Milk
Risk Adjustment: No.
Data Collection Approach: Retrospective data sources for required data elements include
administrative data and medical records.
Data Accuracy: Variation may exist in the assignment of ICD-9-CM codes; therefore, coding
practices may require evaluation to ensure consistency.
Measure Analysis Suggestions: In order to identify areas for improvement in breast milk feeding
rates, hospitals may wish to review documentation for reasons. Education efforts can be targeted
based on the specific reasons identified.
Sampling: Yes. For additional information see the Sampling Section.
Data Reported As: Aggregate rate generated from count data reported as a proportion.
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Selected References:
• American Academy of Pediatrics. (2005). Section on Breastfeeding. Policy Statement:
Breastfeeding and the Use of Human Milk. Pediatrics.115:496– 506.
• American College of Obstetricians and Gynecologists. (Feb. 2007). Committee on Obstetric
Practice and Committee on Health Care for Underserved Women.Breastfeeding: Maternal
and Infant Aspects. ACOG Committee Opinion 361.
• California Department of Public Health. (2006). Genetic Disease Branch. California InHospital Breastfeeding as Indicated on the Newborn Screening Test Form, Statewide, County
and Hospital of Occurrence: Available at:
http://www.cdph.ca.gov/data/statistics/Pages/BreastfeedingStatistics.aspx.
• Centers for Disease Control and Prevention. (Aug 3, 2007). Breastfeeding trends and
updated national health objectives for exclusive breastfeeding--United States birth years 2000
-2004. MMWR - Morbidity & Mortality Weekly Report. 56(30):760-3.
• Centers for Disease Control and Prevention. (2007). Division of Nutrition, Physical Activity
and Obesity. Breastfeeding Report Card. Available at:
http://www.cdc.gov/breastfeeding/data/report_card2.htm.
• Ip, S., Chung, M., Raman, G., et al. (2007). Breastfeeding and maternal and infant health
outcomes in developed countries. Rockville, MD: US Department of Health and Human
Services. Available at: http://www.ahrq.gov/downloads/pub/evidence/pdf/brfout/brfout.pdf
• Kramer, M.S. & Kakuma, R. (2002).Optimal duration of exclusive breastfeeding. [107 refs]
Cochrane Database of Systematic Reviews. (1):CD003517.
• Petrova, A., Hegyi, T., & Mehta, R. (2007). Maternal race/ethnicity and one-month exclusive
breastfeeding in association with the in-hospital feeding modality. Breastfeeding Medicine. 2
(2):92-8.
• Shealy, K.R., Li, R., Benton-Davis, S., & Grummer-Strawn, L.M. (2005).The CDC guide to
breastfeeding interventions. Atlanta, GA: US Department of Health and Human Services,
CDC. Available at: http://www.cdc.gov/breastfeeding/pdf/breastfeeding_interventions.pdf.
• Taveras, E.M., Li, R., Grummer-Strawn, L., Richardson, M., Marshall, R., Rego, V.H.,
Miroshnik, I., & Lieu, T.A. (2004). Opinions and practices of clinicians associated with
continuation of exclusive breastfeeding. Pediatrics. 113(4):e283-90.
• US Department of Health and Human Services. (2007). Healthy People 2010 Midcourse
Review. Washington, DC: US Department of Health and Human Services. Available at:
http://www.healthypeople.gov/data/midcourse.
• World Health Organization. (1991). Indicators for assessing breastfeeding practices. Geneva,
Switzerland: World Health Organization. Available at: http://www.who.int/child-adolescenthealth/new_publications/nutrition/who_cdd_ser_91.14.pdf.
Original Performance Measure Source / Developer:
California Maternal Quality Care Collaborative
Adopted for Stage 2 Medicare and Medicaid EHR Incentive Program
Measure Algorithm:
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Data Dictionary Introduction
Introduction
This section of the manual describes the data elements required to calculate category assignments and
measurements for The Joint Commission's National Quality Measures. It includes information necessary for
defining and formatting the data elements, as well as the allowable values for each data element. This information is
intended to assist in processing patient level data elements for The Joint Commission's National Quality Core
Measures.
It is of primary importance that all health care organizations using The Joint Commission's National Quality Core
Measures gather and utilize the data elements as defined in this section. This will ensure that the data are
standardized and comparable across organizations.
Regardless of which measure sets are selected by a hospital, certain general data elements must be collected by
the hospital and submitted for every patient that falls into any of the selected Initial Patient Populations. These data
elements are considered "general" to each patient's episode of care.
These data elements include:
Admission Date
Birthdate
Health Care Organization Identifier 2
Hispanic Ethnicity
Measure Set 1,2
Performance Measure Identifier 1,2
Race
Sample 1
Sex
Vendor Tracking ID 1,2
Data elements that are general for every patient that fall into measures that are reported at time of
discharge include:
Discharge Date
ICD-9-CM Other Diagnosis Codes
ICD-9-CM Other Procedure Codes (Optional for all HBIPS measures)
ICD-9-CM Other Procedure Dates (Optional for all HBIPS measures)
ICD-9-CM Principal Diagnosis Code
ICD-9-CM Principal Procedure Code (Optional for all HBIPS measures)
ICD-9-CM Principal Procedure Date (Optional for all HBIPS measures)
Payment Source
Data elements that are general for every patient that falls into measures that are reported at the time of
the event include:
Event Date (HBIPS measures only)
Event Type (HBIPS measures only)
Psychiatric Care Setting (HBIPS measures only)
Data elements that are general for every patient that falls into specific measures that are reported at the
time of discharge include:
Discharge Disposition (PC-04, PC-05, HBIPS-4, HBIPS-5, HBIPS-6, HBIPS-7)
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1
Transmission Data Element
These data elements are defined in the Transmission Data Dictionary within the Joint Commission National Quality Core Measures Data Transmission section of this
manual
2
Episode of Care
An Episode of Care (EOC) is defined as the health care services given during a certain period of time, usually
during a hospital stay (e.g., from the day of arrival or admission to the day of discharge). The medical record should
be abstracted as it was billed. In the event that there are multiple ED visits within the inpatient medical record, for
the same episode of care, it is recommended that the ED visit resulting in the admission to observation or inpatient
status be utilized for the purposes of abstraction.
If a patient is transferred from an acute care hospital to another acute care hospital, which is within the same
healthcare system and shares the same Joint Commission Health Care Organization Identifier (HCO ID), this
should be abstracted as one episode of care.
Data integrity
Editing Zero Values
Verification mechanisms are necessary to assure that zero is the intended data value rather than an initialization
value for those data elements which have an allowable value of zero (i.e., 0.0, 0000, 0).
Missing and Invalid Data
Each data element that is applicable per the algorithm for each of the measures within a topic must be “touched” by
the abstractor. While this is the expectation, it is recognized that in certain situations information may not be
available (e.g., dates, times, codes, etc.). After due diligence in reviewing all allowable data sources within the
medical record, if the abstractor determines that a value is not documented, i.e. “missing,” or is unable to determine
if a value is documented, the abstractor should select the “UTD - Unable to Determine,” value. The data elements
Admission Date, Discharge Date and Birthdate require an actual date for submission of discharge measure
information into the Joint Commission’s Data Warehouse, and “UTD” cannot be selected as an allowable value. For
Yes/No values the allowable value “No” incorporates the “UTD” into the definition. For data elements containing
more than two categorical values and for numerical data elements (i.e., dates, times, etc.), a “UTD” option is
included as an allowable value and is classified in the same category as not documented. Files that contain any
invalid and/or missing data will be rejected from the Joint Commission’s Data Warehouse. For additional details on
the proper handling of missing and/or invalid data, please refer to the Missing and Invalid Data section of this
manual.
Interpreting Data Element Definitions and Allowable Values
Every attempt has been made to comprehensively define The Joint Commission's National Quality Core Measure
data elements and allowable values in a manner that obviates the need for interpretation. If, after reviewing the
General Abstraction Guidelines, the data element definition, including the notes and guidelines for abstraction, an
abstractor cannot clearly assign an allowable value, refer to the Resource section of this manual for additional
contact information.
Interpretation of Data Dictionary Terms
Data elements fall into three broad categories in order to support a specific measure set. They include:
General Data Elements – data elements that must be collected by health care organizations for each patient
record
data elements required for each episode of care (EOC) record submitted
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data elements used to identify the health care organization on each patient record required for each
patient-level record submitted
patient demographic data required for each episode of care record submitted and used for risk
adjustment analysis (where applicable)
Measure-Specific Data Elements – data elements used by one specific measure or several measures in one
specific measure set, such as in the HBIPS measures
Algorithm Output Data Elements Refer to ORYX® Technical guide
Data Element Dictionary Terms
Term
Data Element Name:
Collected For:
Definition:
Suggested Data Collection
Question:
Format:
Allowable Values:
Notes for Abstraction:
Suggested Data Sources:
Guidelines for Abstraction:
Definition
A short phrase identifying the data element. For each of identification the data
element name is italicized.
Identifies the measure(s) that utilize this data element or specifies that the data
element is used for data transmission or verification.
A detailed explanation of the data element. A vendor may include this
information in data collection software.
A suggested wording for a data element question in a data abstraction tool.
Length = number of characters or digits allowed for the data element
Type = type of information the data element contains (e.g., numeric,
alphanumeric, date, character, or time)
Occurs = the number of times the data element occurs in a single episode of
care record
A list of acceptable responses for this data element
Provided to assist abstractor in the selection of appropriate value for a data
element
Source document from which data can be identified such as administrative or
medical record. Some data elements also list excluded data sources that are
unacceptable sources for collecting information.
Designed to assist abstractors in determining how a data element should be
answered
Note: Element specific notes and guidelines should take precedence over the
General Abstraction Guidelines.
General Abstraction Guidelines
The intent of abstraction is to use only documentation that was part of the medical record during the hospitalization
(is present upon discharge) and that is present at the time of abstraction. There are instances where an addendum
or late entry is added after discharge. This late entry or addendum can be used, for abstraction purposes, as long
as it has been added within 30 days of discharge, [Refer to the Medicare Conditions of Participation for Medical
Records, 42CFR482.24(c)(2)(viii)], unless otherwise specified in the data element. Documents containing
amendments, corrections, or delayed entries must employ the following widely accepted record keeping principles
(CMS “Medicare Program Integrity Manual” Chapter 3, Section 3.3.2.4):
Clearly and permanently identify any amendments, corrections or addenda;
Clearly indicate the date and author of any amendments, corrections, or addenda; and
Clearly identify all original content.
It is not the intent to have documentation added at the time of abstraction to ensure the passing of a measure.
Medical Record Documentation
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The intent of abstraction is to use only documentation that was part of the medical record during the hospitalization
(is present upon discharge) and that is present at the time of abstraction. There are instances where an addendum
or late entry is added after discharge. This late entry or addendum can be used, for abstraction purposes, as long
as it has been added within 30 days of discharge, unless otherwise specified in the data element. It is not the intent
to have documentation added at the time of abstraction to ensure the passing of a measure.
Important Note: There are several data elements where abstraction of data from documentation dated/timed after
discharge is restricted, and these exceptions are published on the respective data element pages of the data
dictionary. Data element specific notes and guidelines always take precedence over the General Abstraction
Guidelines.
All documentation in the medical record must be legible and must be timed, dated and authenticated. However,
documentation that is not timed, dated or authenticated may still be used for abstraction if not required by the
specific data element. When abstracting a medical record, if a handwritten document is determined to be not
legible, other documentation should be reviewed in an attempt to obtain the answer. If no other source document is
able to verify the handwritten documentation, only then is the abstractor to answer unable to determine from the
medical record documentation, unless otherwise specified in the data element. Authentication may include written
signatures, initials, computer key, or other codes.
Data element information should be retrieved from the current medical record, covering the admission and
discharge date, or reporting period for event measures being abstracted. Information ascertainable from previous
history (e.g., failed trials of monotherapy) AND determined to be part of the current medical record may be used in
abstraction. For example, if the patient had previously failed three or more trials of monotherapy and this
information is available in the current chart being abstracted (e.g., a note made in the continuing care plan), this
information should be used. Previous history information used in abstraction should be information that was part of
the medical record during hospitalization, when care was being delivered.
The medical record must be abstracted as documented (taken at “face value”). When the value documented is
obviously in error (not a valid format/range or outside of the parameters for the data element) and no other
documentation is found that provides this information, the abstractor should select “UTD.” Example:
Patient expires on 02-12-20XX and documentation indicates the Event Date was 03-12-20XX. Other
documentation in the medical record supports the date of death as being accurate. Since the Event Date is
after the Discharge Date (death), it is outside of the parameter of care and the abstractor should select
“UTD.”
Note: Hospitals should use abbreviations according to their policy. Frequently flow sheets or other documentation
contain a ‘key or legend’ that explains what the abbreviation or symbol stands for, especially if unique to that facility.
Suggested Data Sources
Suggested Data Sources are listed in alphabetical order, NOT priority order, unless otherwise specified in
the data element.
Suggested Data Sources are designed to provide guidance to the abstractor as to the locations/sources
where the information needed to abstract a data element will likely be found. However, the abstractor is not
limited to these sources for abstracting the information and must review the entire medical record unless
otherwise specified in the data element.
In some instances, a data element may restrict the sources that may be used to gain the information, list a
priority in which the sources should be used or may restrict documentation by only physician/advanced
practice nurse/physician assistant. If so, these sources will be identified and labeled as “Excluded Data
Sources.” "ONLY ACCEPTABLE SOURCES", "Priority Source", or "PHYSICIAN/APN/PA
DOCUMENTATION ONLY".
If, after due diligence, the abstractor determines that a value is not documented or is not able to determine the
answer value, the abstractor must select “Unable to Determine (UTD)” as the answer.
Hospitals often label forms and reports with unique names or titles. Suggested Data Sources are listed by
commonly used titles; however, information may be abstracted from any source that is equivalent to those
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listed.
Example:
If the “nursing admission assessment” is listed as a suggested source, an acceptable alternative might
be titled “nurses initial assessment” or “nursing data base.”
Note:
Element specific notes and guidelines should take precedence over the General Abstraction
Guidelines.
Inclusions/Exclusions
Inclusions are “acceptable terms” that should be abstracted as positive findings (e.g., “Yes”).
Inclusion lists are limited to those terms that are believed to be most commonly used in medical record
documentation. The list of inclusions should not be considered all-inclusive, unless otherwise
specified in the data element.
Exclusions are “unacceptable terms” that should be abstracted as negative findings (e.g., “No”).
Exclusion lists are limited to those terms an abstractor may most frequently question whether or not to
abstract as a positive finding for a particular element (e.g., “cardiomyopathy” is an unacceptable term for
heart failure and should be abstracted as "No"). The list of exclusions should not be considered allinclusive, unless otherwise specified in the data element.
When both an inclusion and exclusion are documented in a medical record, the inclusion takes precedence
over the exclusion and would be abstracted as a positive finding (e.g., answer “Yes”), unless otherwise
specified in the data element.
Physician/Advanced Practice Nurse/ Physician Assistant Documentation
Advanced Practice Nurse (APN, APRN) titles may vary among state and clinical specialties. Some common
titles that represent the advanced practice nurse role are:
Nurse Practitioner (NP)
Certified Registered Nurse Anesthetist (CRNA)
Clinical Nurse Specialist (CNS)
Certified Nurse Midwife (CNM)
When a physician/advanced practice nurse/ physician assistant (physician/APN/PA) signs a form or report
(e.g., ED sheet with triage and nursing information and a physician/APN/PA has signed somewhere on the
form), information on that form/report should be considered physician/APN/PA documentation.
“Rubber” stamped physician/advanced practice nurse/physician assistant (physician/APN/PA) signatures are
not acceptable on any document within the medical record. Handwritten, electronic signatures, facsimiles of
original written or electronic signatures are acceptable.
Resident and intern notes should be considered physician documentation. Medical student notes must be cosigned by a physician.
For the purposes of abstraction, telephone or verbal physician/APN/PA orders (TO/VO) in the medical record
are considered physician/APN/PA documentation at the time they were written regardless of whether or not
they were authenticated by the physician/APN/PA at the time of abstraction.
Pharmacist Documentation
Pharmacist titles may vary. Some common titles that represent the pharmacist role are:
Doctor of Pharmacy (Pharm.D. or D.Ph.)
Registered Pharmacist (R.Ph.)
Medications:
The approved medication tables contained in the dictionaries may not be inclusive lists of all available
therapeutic agents acceptable for a particular data element. Discrepancies must be reported. See Appendix
F (resource section) of this manual for contact information.
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Whether or not a medication has been administered to a patient is often clear when using medical record
sources such as medication administration records, but documentation can be more ambiguous in other
sources, namely, physician orders, ED records, and ambulance records. To make a determination using
these sources, use the following criteria:
For EHRs only accept documentation that reflects the actual administration of the medication in the
context of the chart.
If a medication in the physician orders has been initialed and signed off with a time, do NOT presume
that the medication was administered. The documentation MUST indicate that the medication was
actually given.
For an ED or ambulance record, there is no need for documentation indicating that the medication was
actually given.
Example:
If the ED or ambulance record reflects “ASA 325mg po 13:00” and no other documentation exists
indicating that the medication was actually given (e.g., “given” or “administered”), this is
acceptable documentation to abstract.
When determining whether or not a patient was discharged on a specific medication (e.g., antipsychotic
medication):
If discharge medications are noted using only references such as “continue home meds,” “continue
previous medications,” “resume other meds,” “same medications,” or “continue meds,” rather than lists
of the names of the discharge medications, the abstractor should include the medication in the count if
the patient was on the medication in question prior to arrival, unless documentation suggests otherwise.
If discharge medications are noted using only references such as “continue current medications” or
“continue present meds” rather than lists of the names of the discharge medications, the abstractor
should include the medication in the count if the medication in question was listed as a medication on
the day of discharge, unless documentation indicates it was to be discontinued at discharge or
suggests otherwise
If discharge medications are noted using general references such as “continue home meds,” “continue
previous medications,” “continue current meds,” “continue present meds,” “resume other meds,” or
“continue meds,” but a list of the names of the discharge medications also in the record gives conflicting
information about what medications the patient was actually discharged on, the abstractor should
consider the list most accurate and use only the list in determining whether or not a patient was
discharged on a specific medication.
Hospitals may allow a patient (or his or her caregiver/support person where appropriate) to self-administer
both hospital-issued medications and the patient’s own medications brought into the hospital. Hospitals must
document the administration of each medication, as reported by the patient (or the patient’s caregiver/support
person where appropriate), in the patient’s medical record [42CFR482.23(c)(6)].
Nursing Care Plans, Standing Orders and Protocols
Per Medicare Conditions of Participation [42CFR482.23(b)(4)] hospitals have the option of having a standalone nursing care plan or a single interdisciplinary care plan that addresses nursing and other disciplines.
Hospitals may use pre-printed and electronic standing orders, order sets, and protocols for patient orders if
such orders and protocols are dated, timed, and authenticated promptly in the patient’s medical record by the
ordering practitioner responsible for the care of the patient [42CFR482.24(c)(3)].
Diagnostic/Laboratory Tests
Whether or not a diagnostic or laboratory test has been done is usually clear when using medical record sources
such as diagnostic test reports, laboratory reports, or progress notes (where a physician might note test findings),
but documentation can be more ambiguous in other sources, namely, physician orders and ED records. To make a
determination using these sources, use the following criteria:
If a test in the physician orders has been initialed and signed off with a time, do NOT presume that the test
was done. The documentation MUST indicate that the test was actually done (e.g., accompanied by a word
such as “done”).
PC v2014A
54
For an ED record, there is no need for explicit documentation indicating that the test was actually done. For
example, if an ED record notes “Lipid profile,” and this is followed by a signature and/or a time, the abstractor
should presume the test was performed.
Grids
Instructions for reading values recorded on grids: Measure from the midpoint of the symbol, number and letter. If the
value falls between two lines on the grid, abstract the earliest value.
Alphabetical List of All Data Elements
Data Element Name
Admission Date
Admission to NICU
Antenatal Steroid Therapy Initiated
Appropriate Justification for Multiple
Antipsychotic Medications
Birth Weight
Birthdate
Collection Notes
Associated Measures
ACHF-01, ACHF-02, ACHF-03, ACHF-04,
ACHF-05, ACHF-06, CAH-01.1, CAH-02.1,
CAH-03, CAH-04, CAH-05, CAH-06, CAH08.1, CAH-09.1, CAH-10.1, CSTK, HBIPS,
Osteo, PBM, PC, PICU-03, PICU-06, PSCIP,
SCA-03, SUB, TOB
PC-05
PC-03
HBIPS-5
PC-04
ACHF, ACHFOP-01, ACHFOP-02,
ACHFOP-03, ACHFOP-04, ACHFOP-05,
ACHFOP-06, ACHFOP-07, CAH, CSTK,
HBIPS, Osteo, PBM, PC, PICU, PSCIP,
SCA, SUB, TOB
Bloodstream Infection Present on Admission
PC-04
CMS Certification Number
Hospital Clinical Data HBIPS, PC
File, Optional for All
Records
All Records
ACHF-01, ACHF-02, ACHF-03, CSTK-04,
Clinical Trial
CSTK-04a, CSTK-04b, CSTK-06, PC
Continuing Care Plan-Discharge Medications
HBIPS-6, HBIPS-7
Continuing Care Plan-Next Level of Care
HBIPS-6, HBIPS-7
Continuing Care Plan-Principal Discharge
HBIPS-6, HBIPS-7
Diagnosis
Continuing Care Plan-Reason for
HBIPS-6, HBIPS-7
Hospitalization
Discharge Date
All Records
ACHF-01, ACHF-02, ACHF-03, CAH-01.1,
CAH-02.1, CAH-03, CAH-04, CAH-05, CAH06, CAH-08.1, CAH-09.1, CAH-10.1, CSTK,
HBIPS-1, HBIPS-4, HBIPS-5, HBIPS-6,
HBIPS-7, Osteo, PBM, PC, PICU-03, PSCIP,
SCA, SUB, TOB
Discharge Disposition
HBIPS-4, HBIPS-5, HBIPS-6, HBIPS-7, PC04, PC-05
Event Date
Event Type
Exclusive Breast Milk Feeding
Gestational Age
Health Care Organization Identifier
PC v2014A
Risk Adjustment
All Records
All Records
All Records
All Records,
HBIPS-2, HBIPS-3
HBIPS-2, HBIPS-3
PC-05
PC-01, PC-02, PC-03
HBIPS, PC
55
Hispanic Ethnicity
ICD-9-CM Other Diagnosis Codes
ICD-9-CM Other Procedure Codes
ICD-9-CM Other Procedure Dates
ICD-9-CM Principal Diagnosis Code
ICD-9-CM Principal Procedure Code
ICD-9-CM Principal Procedure Date
Initial Patient Population Size – Medicare
Only
Initial Patient Population Size – NonMedicare Only
Labor
Measure Category Assignment
Measure Set
PC v2014A
Aggregate Data File,
Patient Population
Data File, Hospital
Clinical Data File
All Records
ACHF, AMI, CAC, CAH, CSTK, HBIPS, HF,
Osteo, PC, PN, PR, SCA, SCIP, STK
All Records
CAH-01, CAH-02.1, CAH-03, CAH-04, CAH05, CAH-06, CAH-08, CAH-09.1, CAH-10.1,
CSTK-05, CSTK-07a, HBIPS-1, HBIPS-4,
HBIPS-5, HBIPS-6, HBIPS-7, Osteo, PBM,
PC, PC-01, PC-02, PC-03, PC-04, PC-05,
PICU-03, PSCIP, SUB-03, SUB-04, TOB-02,
TOB-03
All Records
ACHF, ACHFOP-01, ACHFOP-02,
ACHFOP-03, ACHFOP-04, ACHFOP-05,
ACHFOP-06, ACHFOP-07, CAH-01.1, CAH02.1, CAH-03, CAH-04, CAH-05, CAH-06,
CAH-08.1, CAH-09.1, CAH-10.1, CSTK-01,
CSTK-02, CSTK-03, CSTK-05, CSTK-07,
HBIPS, PBM, PC, PICU, PSCIP, SUB-03,
SUB-04
All Records
CSTK-01, CSTK-02, CSTK-03, CSTK-05,
CSTK-07, HBIPS, PBM, PC
All Records
ACHF, ACHFOP-01, ACHFOP-02,
ACHFOP-03, ACHFOP-04, ACHFOP-05,
ACHFOP-06, ACHFOP-07, CAH, CSTK,
HBIPS-1, HBIPS-4, HBIPS-5, HBIPS-6,
HBIPS-7, Osteo, PBM, PC, PC-01, PC-02,
PC-03, PC-04, PC-05, PICU-03, PSCIP,
SUB-03, SUB-04, TOB-02, TOB-03
All Records
ACHF, ACHFOP-01, ACHFOP-02,
ACHFOP-03, ACHFOP-04, ACHFOP-05,
ACHFOP-06, ACHFOP-07, CAH-01.1, CAH02.1, CAH-03, CAH-04, CAH-05, CAH-06,
CAH-08.1, CAH-09.1, CAH-10.1, CSTK-01,
CSTK-02, CSTK-03, CSTK-05, CSTK-07,
HBIPS, IMM, PBM, PC, PICU-03, PSCIP,
SUB-03, SUB-04
All Records
ACHF-05a, ACHF-05b, ACHFOP-01,
ACHFOP-02, ACHFOP-03, ACHFOP-04,
ACHFOP-05, ACHFOP-06, ACHFOP-07,
CSTK-01, CSTK-02, CSTK-03, CSTK-05,
CSTK-07, HBIPS, PBM, PC
Transmission, Patient HBIPS, PC
Population Data File
Transmission, Patient HBIPS, PC
Population Data File
PC-01
Calculation,
HBIPS, PBM, PC
Transmission, Hospital
Clinical Data File
Transmission, Patient HBIPS, PC
Population Data File,
Hospital Clinical Data
File
56
Minutes of Physical Restraint
Minutes of Seclusion
National Provider Identifier
Number of Antipsychotic Medications
Prescribed at Discharge
Parity
Patient Referral to Next Level of Care
Provider
Patient Strengths
Payment Source
Predicted Value
Transmission
HBIPS-2
HBIPS-3
HBIPS, PC
HBIPS-4, HBIPS-5
PC-02
HBIPS-4, HBIPS-5, HBIPS-6, HBIPS-7
HBIPS-1
CSTK, HBIPS, PC
PC
All Records
Transmission, Risk
Adjustment, Hospital
Clinical Data File
Prior Uterine Surgery
Joint Commission
PC-01
Only
Psychiatric Care Setting
All Records
HBIPS-1, HBIPS-2, HBIPS-3, HBIPS-4,
HBIPS-5, HBIPS-6, HBIPS-7
HBIPS-2, HBIPS-3
Psychiatric Inpatient Days - Medicare Only
Psychiatric Inpatient Days-Non-Medicare Only
HBIPS-2, HBIPS-3
Psychological Trauma History
HBIPS-1
All Records
ACHF, AMI, CAC, CAH, CSTK, HBIPS, HF,
Race
Osteo, PC, PN, PR, SCA, SCIP, STK
Reason for Not Exclusively Feeding Breast
PC-05
Milk
Reason for Not Initiating Antenatal Steroid
PC-03
Therapy
Transmission,
HBIPS, PC
Sample
Aggregate Data File,
Hospital Clinical Data
File
Sample Size – Medicare Only
Transmission, Patient HBIPS, PC
Population Data File
Transmission, Patient HBIPS, PC
Sample Size – Non-Medicare Only
Population Data File
Sampling Frequency
Transmission, Patient HBIPS, PC
Population Data File
All Records
ACHF, BCC, BCS, CAH, CSTK, HBIPS,
Sex
Osteo, PBM, PC, PICU, PSCIP, SCA
Spontaneous Rupture of Membranes
PC-01
Substance Use
HBIPS-1
Total Leave Days - Medicare Only
HBIPS-2, HBIPS-3
Total Leave Days-Non-Medicare Only
HBIPS-2, HBIPS-3
Unique Blinded Case Identifier
All Records
ACHF, BCC, BCS, CAH, CSTK, Osteo, PC,
PICU, PSCIP, SCA
Transmission, HospitalHBIPS, PC
Vendor Tracking Identifier
Clinical Data File
Violence Risk to Others
HBIPS-1
Violence Risk to Self
HBIPS-1
PC v2014A
57
Data Element
Name:
Admission Date
Collected For:
ACHF-01, ACHF-02, ACHF-03, ACHF-04, ACHF-05, ACHF-06, CAH-01.1,
CAH-02.1, CAH-03, CAH-04, CAH-05, CAH-06, CAH-08.1, CAH-09.1, CAH
-10.1, CSTK, HBIPS, Osteo, PBM, PC, PICU-03, PICU-06, PSCIP, SCA03, SUB, TOB,
Definition:
Suggested Data
Collection
Question:
Format:
The month, day, and year of admission to acute inpatient care.
What is the date the patient was admitted to acute inpatient care?
Length: 10 – MM-DD-YYYY (includes dashes)
Type: Date
Occurs: 1
Allowable Values:
MM = Month (01-12)
DD = Day (01-31)
YYYY = Year (20xx)
Notes for
Abstraction:
• The intent of this data element is to determine the date that the
patient was actually admitted to acute inpatient care. Because this
data element is critical in determining the population for all measures,
the abstractor should NOT assume that the claim information for the
admission date is correct. If the abstractor determines through chart
review that the date is incorrect, for purposes of abstraction, she/he
should correct and override the downloaded value. If using claim
information, the ‘Statement Covers Period’ is not synonymous with
the ‘Admission Date’ and should not be used to abstract this data
element. These are two distinctly different identifiers:
◦ The Admission Date (Form Locator 12) is purely the date the
patient was admitted as an inpatient to the facility.
◦ The Statement Covers Period (“From” and “Through” dates in
Form Locator 6) identifies the span of service dates included in
a particular claim. The “From” Date is the earliest date of
service on the claim.
• For patients who are admitted to Observation status and
subsequently admitted to acute inpatient care, abstract the date that
the determination was made to admit to acute inpatient care and the
order was written. Do not abstract the date that the patient was
admitted to Observation.
Example: Medical record documentation reflects that the patient was
admitted to observation on 04-05-20xx. On 04-06-20xx the physician writes
an order to admit to acute inpatient effective 04-05-20xx. The Admission
Date would be abstracted as 04-06-20xx; the date the determination was
made to admit to acute inpatient care and the order was written.
PC v2014A
58
• If there are multiple inpatient orders, use the order that most
accurately reflects the date that the patient was admitted.
• For newborns that are born within this hospital, the admission date is
the date the baby was born.
• The admission date should not be abstracted from the earliest
admission order without regards to substantiating documentation. If
documentation suggests that the earliest admission order does not
reflect the date the patient was admitted to inpatient care, this date
should not be used.
Example: Preoperative Orders are dated as 04-06-20xx with an order to
admit to Inpatient. Postoperative Orders, dated 05-01-20xx, state to admit
to acute inpatient. All other documentation supports that the patient
presented to the hospital for surgery on 05-01-20xx. The admission date
would be abstracted 05-01-20xx.
Suggested Data
Sources:
ONLY ALLOWABLE SOURCES
• Physician orders
• Face sheet
• UB-04, Field Location: 12
Note: The physician order is the priority data source for this data element.
If there is not a physician order in the medical record, use the other only
allowable sources to determine the Admission Date.
Excluded Data Sources
• UB-04, Field Location: 06
Additional Notes:
Guidelines for Abstraction:
Inclusion
• None
PC v2014A
Exclusion
• Admit to observation
• Arrival date
59
Data Element
Name:
Admission to NICU
Collected For:
PC-05,
Definition:
Documentation that the newborn was admitted to the Neonatal Intensive
Care Unit (NICU) to receive critical care services at this hospital any time
during the hospitalization.
Suggested Data
Collection
Question:
Was the newborn admitted to the NICU to receive critical care services at
this hospital at any time during the hospitalization?
Format:
Allowable Values:
Length: 1
Type: Alphanumeric
Occurs: 1
Y (Yes) There is documentation that the newborn was admitted to the
NICU to receive critical care services at this hospital at any time
during the hospitalization.
N (No) There is no documentation that the newborn was admitted to the
NICU to receive critical care services at this hospital at any time
during the hospitalization or unable to determine from medical
record documentation.
Notes for
Abstraction:
A NICU is defined as a hospital unit providing critical care services which is
organized with personnel and equipment to provide continuous life support
and comprehensive care for extremely high-risk newborn infants and those
with complex and critical illness.
If the newborn is admitted to the NICU for observation or transitional care
following a cesarean section, select allowable value “no” unless he or she
is admitted to receive continuous life support and comprehensive care as
an extremely high-risk newborn or with a diagnosis of a complex and
critical illness.
Suggested Data
Sources:
• Nursing notes
• Discharge summary
• Physician progress notes
Additional Notes:
Guidelines for Abstraction:
Inclusion
• None
PC v2014A
Exclusion
• None
60
PC v2014A
61
Data Element
Name:
Antenatal Steroid Therapy Initiated
Collected For:
PC-03,
Definition:
Documentation that antenatal steroid therapy was initiated before delivery.
Initial antenatal steroid therapy is 12mg betamethasone IM or 6mg
dexamethasone IM.
Suggested Data
Collection
Question:
Format:
Allowable Values:
Is there documentation that antenatal steroid therapy was initiated before
delivery?
Length: 1
Type: Alphanumeric
Occurs: 1
Y (Yes) There is documentation that antenatal steroid therapy was
initiated before delivery.
N (No) There is no documentation that antenatal steroid therapy was
initiated before delivery OR unable to determine from medical record
documentation.
Notes for
Abstraction:
If there is documentation that antenatal steroid therapy was initiated prior to
current hospitalization in another setting of care, i.e., doctor's office, clinic,
birthing center, hospital before delivery, select allowable value "yes".
If antenatal steroid therapy was initiated in the hospital, the name of the
medication must be documented in the medical record in order to select
allowable value "yes".
Suggested Data
Sources:
•
•
•
•
History and physical
Progress notes
Medication administration record (MAR)
Prenatal forms
Additional Notes:
Guidelines for Abstraction:
Inclusion
Refer to Appendix B, Table 11.0 Antenatal
Steroid Medications
PC v2014A
Exclusion
None
62
Data Element
Name:
Birth Weight
Collected For:
PC-04, Risk Adjustment
Definition:
The weight (in grams) of a newborn at the time of delivery.
Note:
453.5 grams = 1 pound
28.35 grams = 1 ounce
It is recommended that each ORYX Vendor provide the ability to enter birth
weight in either grams or pounds. However, all birth weights must be
converted to grams prior to indicator calculation.
Suggested Data
Collection
Question:
Format:
What was the weight of the newborn at delivery?
Length: 4 or UTD
Type: Alphanumeric
Occurs: 1
Allowable Values:
150 through 8165 grams
UTD = Unable to Determine
Note:
When converting from pounds and ounces to grams, do not round to
the nearest pound before converting the weight to grams. Round to
the nearest whole number after the conversion to grams.
Notes for
Abstraction:
PC v2014A
• Newborns with birth weights less than 150 grams need to be verified
that the baby was live born and for data quality purposes. Birth
weights greater than 8165 grams need to be verified for data quality.
Abstractors should review all of the suggested data sources to verify
the accuracy of the data.
• If the birth weight is unable to be determined from medical record
documentation, enter "UTD".
• The medical record must be abstracted as documented (taken at
“face value”). When the value documented is not a valid
number/value per the definition of this data element and no other
documentation is found that provides this information, the abstractor
should select “UTD.”
Example:
Documentation indicates the Birth Weight was 0 grams. No other
documentation in the medical record provides a valid value. Since the
Birth Weight is not a valid value, the abstractor should select “UTD.”
Note:
Transmission of a case with an invalid value as described above will
63
be rejected from the Joint Commission’s Data Warehouse. Use of
“UTD” for Birth Weight allows the case to be accepted into the
warehouse.
• The NICU admission assessment or notes should be reviewed first
for the birth weight. In the absence of admission to the NICU, the
delivery record or operating room record should be reviewed next for
the birth weight. In cases where there is conflicting data, use the
document recording the birth weight closest to the time of delivery.
• It is acceptable to use data derived from vital records reports received
from state or local departments of public health if they are available
and are directly derived from the medical record with a process in
place to confirm their accuracy. If this is the case, these may be used
in lieu of the suggested data sources listed below.
Suggested Data
Sources:
In Order of Priority:
•
•
•
•
•
•
•
NICU admission assessment or notes
Delivery record
Operating room record
History and physical
Nursing notes
Nursery record
Physician progress notes
Additional Notes:
Guidelines for Abstraction:
Inclusion
• None
PC v2014A
Exclusion
• None
64
Data Element
Name:
Birthdate
Collected For:
All Records
Definition:
The month, day, and year the patient was born.
Note:
• Patient's age (in years) is calculated by Admission Date minus
Birthdate. The algorithm to calculate age must use the month and day
portion of admission date and birthdate to yield the most accurate
age.
• For HBIPS discharge measures, i.e., HBIPS-1, 4, 5, 6, 7, patient's
age (in years) is calculated by Discharge Date minus Birthdate. For
event measures, i.e., HBIPS-2, 3, patient's age at time of event (in
years) is calculated by Event Date minus Birthdate. The algorithm to
calculate age must use the month and day portion of birthdate, and
discharge date or event, as appropriate to yield the most accurate
age.
Suggested Data
Collection
Question:
Format:
What is the patient’s date of birth?
Length: 10 – MM-DD-YYYY (includes dashes)
Type: Date
Occurs: 1
Allowable Values:
MM = Month (01-12)
DD = Day (01-31)
YYYY = Year (1880-Current Year)
Notes for
Abstraction:
Suggested Data
Sources:
PC v2014A
Because this data element is critical in determining the population for all
measures, the abstractor should NOT assume that the claim information for
the birthdate is correct. If the abstractor determines through chart review
that the date is incorrect, she/he should correct and override the
downloaded value. If the abstractor is unable to determine the correct
birthdate through chart review, she/he should default to the date of birth on
the claim information.
• Emergency department record
• Face sheet
• Registration form
65
• UB-04, Field Location: 10
Additional Notes:
Guidelines for Abstraction:
Inclusion
• None
PC v2014A
Exclusion
• None
66
Data Element
Name:
Bloodstream Infection Present on Admission
Collected For:
PC-04,
Definition:
Documentation in the medical record within the first 48 hours after
admission that the patient had a bloodstream infection present on
admission. This includes both patients with positive blood cultures or
negative or inconclusive blood cultures when the patient is suspected of
having a bloodstream infection or septicemia and is being treated for the
condition. A blood culture can be defined as a culture of microorganisms
from specimens of blood to determine the presence and nature of
bacteremia.
Suggested Data
Collection
Question:
Is there documentation within the first 48 hours after admission that the
patient had a bloodstream infection present on admission or is receiving
treatment for a suspected bloodstream infection or septicemia on
admission?
Format:
Allowable Values:
Length: 1
Type: Alphanumeric
Occurs: 1
Y (Yes) There is documentation within the first 48 hours after admission
that the patient had a bloodstream infection present on admission or
is receiving treatment for a suspected bloodstream infection or
septicemia on admission.
N (No) There is no documentation within the first 48 hours after
admission that the patient had a bloodstream infection present on
admission or is receiving treatment for a suspected bloodstream
infection or septicemia present on admission or unable to determine
from medical record documentation.
Notes for
Abstraction:
Suggested Data
Sources:
PC v2014A
The admission assessment and the NICU admission assessment or notes
should be reviewed first for documentation of a suspected or confirmed
bloodstream infection present on admission. Documentation of the
suspected bloodstream infection being present on admission should be
taken at face value regardless of the blood culture results. Birth is
considered the same as admission for patients who were born in the
reporting hospital. If the present on admission (POA) indicator is present
with the ICD-9-CM diagnosis code for septicemia or bacteremia, answer
“yes” to bloodstream infection present on admission.
•
•
•
•
•
•
•
History and physical
Laboratory report
Nursing notes
Nursing admission assessment
Progress notes
Admission assessment
Microbiology report
67
• NICU admission assessment or notes
Additional Notes:
Guidelines for Abstraction:
Inclusion
• Suspected bloodstream infection
• Positive blood culture
• Negative or inconclusive blood culture
under treatment
• Staphylococcal septicemia
• Staphylococcal bacteremia
• Gram negative septicemia
• Gram negative bacteremia
PC v2014A
Exclusion
• None
68
Data Element
Name:
CMS Certification Number
Collected For:
HBIPS, PC, Hospital Clinical Data File, Optional for All Records
Definition:
Hospital's six digit acute care CMS Certification Number (CCN).
Note: This data element is optional. If data is transmitted in Hospital
Clinical Data (HCD) or Population and Sampling (PaS) all edits and rules
associated to this data element will be applied to the data.
Suggested Data
Collection
Question:
Format:
Allowable Values:
What is the hospital’s six digit acute care CMS Certification Number?
Length: 6
Type: Character
Occurs: 1
Any valid six digit CMS Certification Number.
The first two digits are the numeric state code. The third digit of zero
represents an acute facility. The third digit of “1” and fourth digit of
“3” represents a Critical Access Hospital (CAH).
Notes for
Abstraction:
None
Suggested Data
Sources:
None
Additional Notes:
None
Guidelines for Abstraction:
Inclusion
None
PC v2014A
Exclusion
None
69
Data Element
Name:
Clinical Trial
Collected For:
All Records
Definition:
Documentation that during this hospital stay the patient was enrolled in a
clinical trial in which patients with the same condition as the measure set
were being studied.
Suggested Data
Collection
Question:
During this hospital stay, was the patient enrolled in a clinical trial in which
patients with the same condition as the measure set were being studied?
Format:
Allowable Values:
Length: 1
Type: Alphanumeric
Occurs: 1
Y (Yes) There is documentation that during this hospital stay the
patient was enrolled in a clinical trial in which patients with the same
condition as the measure set were being studied.
N (No) There is no documentation that during this hospital stay the
patient was enrolled in a clinical trial in which patients with the same
condition as the measure set were being studied, or unable to
determine from medical record documentation.
Notes for
Abstraction:
PC v2014A
• To select “Yes” to this data element, BOTH of the following must be
true:
1. There must be a signed consent form for clinical trial. For
the purposes of abstraction, a clinical trial is defined as an
experimental study in which research subjects are recruited
and assigned a treatment/intervention and their outcomes are
measured based on the intervention received.
Treatments/interventions most often include use of drugs,
surgical procedures, and devices. Often a control group is used
to compare with the treatment/intervention. Allocation of
different interventions to participants is usually randomized.
2. There must be documentation on the signed consent form
that during this hospital stay the patient was enrolled in a
clinical trial in which patients with the same condition as
the measure set were being studied. Patients may either be
newly enrolled in a clinical trial during the hospital stay or
enrolled in a clinical trial prior to arrival and continued active
participation in that clinical trial during this hospital stay.
PC:
Only capture patients enrolled in clinical trials studying pregnant
patients or newborns. For Perinatal Care measures ONLY, it is
appropriate for the ORYX® Vendor to default the data element
to "No" unless the ICD-9-CM diagnosis code of V70.7,
"Examination of participant in a clinical trial" is present. If this
code is present, or the organization knows via some other
70
electronic method that the patient is participating in a clinical
trial, default the data element to "Yes". Hospital abstractors may
change defaulted value of "No" based on hospital participation
in clinical trial.
• In the following situations, select "No":
1. There is a signed patient consent form for an observational
study only. Observational studies are non-experimental and
involve no intervention (e.g., registries). Individuals are
observed (perhaps with lab draws, interviews, etc.), data is
collected, and outcomes are tracked by investigators. Although
observational studies may include the assessment of the effects
of an intervention, the study participants are not allocated into
intervention or control groups.
2. It is not clear whether the study described in the signed
patient consent form is experimental or observational.
3. It is not clear which study population the clinical trial is
enrolling. Assumptions should not be made if it is not specified.
Suggested Data
Sources:
ONLY ACCEPTABLE SOURCES:
• Signed consent form for clinical trial
FOR PC ONLY
• UB-04, Field Locations: 67A-Q
Additional Notes:
Guidelines for Abstraction:
Inclusion
• None
PC v2014A
Exclusion
• None
71
Data Element
Name:
Discharge Date
Collected For:
All Records , Not collected for HBIPS-2 and HBIPS-3
Definition:
Suggested Data
Collection
Question:
Format:
The month, day, and year the patient was discharged from acute care, left
against medical advice, or expired during this stay.
What is the date the patient was discharged from acute care, left against
medical advice (AMA), or expired?
Length: 10 – MM-DD-YYYY (includes dashes)
Type: Date
Occurs: 1
Allowable Values:
MM = Month (01-12)
DD = Day (01-31)
YYYY = Year (20xx)
Notes for
Abstraction:
Because this data element is critical in determining the population for many
measures, the abstractor should NOT assume that the claim information for
the discharge date is correct. If the abstractor determines through chart
review that the date is incorrect, she/he should correct and override the
downloaded value. If the abstractor is unable to determine the correct
discharge date through chart review, she/he should default to the discharge
date on the claim information.
For HBIPS only, if the patient was in an acute-care hospital and had
multiple admissions to the psychiatric unit during his or her hospitalization,
this information should be abstracted only once at the time of discharge
from the hospital.
Suggested Data
Sources:
•
•
•
•
•
•
•
Face sheet
Progress notes
Physician orders
Discharge summary
Nursing discharge notes
Transfer note
UB-04, Field Location: 6
Additional Notes:
Guidelines for Abstraction:
PC v2014A
72
Inclusion
• None
PC v2014A
Exclusion
• None
73
Data Element
Name:
Discharge Disposition
Collected For:
HBIPS-4, HBIPS-5, HBIPS-6, HBIPS-7, PC-04, PC-05,
Definition:
Suggested Data
Collection
Question:
Format:
Allowable Values:
The final place or setting to which the patient was discharged on the day of
discharge.
What was the patient’s discharge disposition on the day of discharge?
Length: 1
Type: Alphanumeric
Occurs: 1
1 Home
2 Hospice - Home
3 Hospice – Health Care Facility
4 Acute Care Facility
5 Other Health Care Facility
6 Expired
7 Left Against Medical Advice/AMA
8 Not Documented or Unable to Determine (UTD)
Notes for
Abstraction:
• Only use documentation written on the day prior to discharge
through 30 days after discharge when abstracting this data
element.
• The medical record must be abstracted as documented (taken at
“face value”). Inferences should not be made based on internal
knowledge.
• If there is documentation that further clarifies the level of care that
documentation should be used to determine the correct value to
abstract. If documentation is contradictory, use the latest
documentation.
Examples:
•
PC v2014A
◦ Discharge summary dictated 2 days after discharge states
patient went “home”. Physician note on day of discharge further
clarifies that the patient will be going "home with hospice”.
Select value “2” (“Hospice - Home”).
◦ Discharge planner note from day before discharge states “XYZ
Nursing Home”. Discharge order from day of discharge states
74
•
•
•
•
•
•
Suggested Data
Sources:
PC v2014A
•
•
•
•
•
•
•
•
“Discharge home”. Contradictory documentation, use latest.
Select value “1” (“Home”).
◦ Physician order on discharge states “Discharge to ALF”.
Discharge instruction sheet completed after the physician order
states patient discharged to “SNF”. Contradictory
documentation, use latest. Select value “5” (“Other Health Care
Facility”).
If documentation is contradictory, and you are unable to determine
the latest documentation, select the disposition ranked highest (top to
bottom) in the following list. See Inclusion lists for examples.
◦ Acute Care Facility
◦ Hospice – Health Care Facility
◦ Hospice – Home
◦ Other Health Care Facility
◦ Home
Hospice (values “2” and “3”) includes discharges with hospice
referrals and evaluations.
If the medical record states only that the patient is being discharged
to another hospital and does not reflect the level of care that the
patient will be receiving, select value “4” (“Acute Care Facility”).
If the medical record identifies the facility the patient is being
discharged to by name only (e.g., “Park Meadows”), and does not
reflect the type of facility or level of care, select value “5” (“Other
Health Care Facility”).
If the medical record states only that the patient is being “discharged”
and does not address the place or setting to which the patient was
discharged, select value “1” (“Home”).
When determining whether to select value “7” (“Left Against Medical
Advice/AMA”):
◦ Explicit “left against medical advice” documentation is not
required. E.g., “Patient is refusing to stay for continued care” –
Select value “7”.
◦ Documentation suggesting that the patient left before discharge
instructions could be given does not count.
◦ A signed AMA form is not required, for the purposes of this data
element.
◦ Do not consider AMA documentation and other disposition
documentation as “contradictory”. If any source states the
patient left against medical advice, select value “7”, regardless
of whether the AMA documentation was written last. E.g., AMA
form signed and discharge instruction sheet states “Discharged
home with belongings” – Select “7”.
Progress notes
Physician orders
Discharge summary
Discharge instruction sheet
Discharge planning notes
Nursing discharge notes
Social service notes
Transfer record
75
Excluded Data Sources
• Any documentation prior to the last two days of hospitalization
• Coding documents
• UB-04
Additional Notes:
Guidelines for Abstraction:
Inclusion
Home (Value 1):
Exclusion
None
• Assisted Living Facilities (ALFs) –
Includes ALFs and assisted living care at
nursing home, intermediate care, and
skilled nursing facilities
• Court/Law Enforcement – includes
detention facilities, jails, and prison
• Home – includes board and care, foster
or residential care, group or personal
care homes, retirement communities,
and homeless shelters
• Home with Home Health Services
• Outpatient Services including outpatient
procedures at another hospital,
Outpatient Chemical Dependency
Programs and Partial Hospitalization
Hospice – Home (Value 2):
• Hospice in the home (or other “Home”
setting as above in Value 1)
Hospice – Health Care Facility (Value 3):
• Hospice - General Inpatient and Respite
• Hospice - Residential and Skilled
Facilities
• Hospice - Other Health Care Facilities
Acute Care Facility (Value 4):
• Acute Short Term General and Critical
Access Hospitals
• Cancer and Children’s Hospitals
• Department of Defense and Veteran’s
Administration Hospitals
Other Health Care Facility (Value 5):
• Extended or Intermediate Care Facility
(ECF/ICF)
PC v2014A
76
• Long Term Acute Care Hospital (LTACH)
• Nursing Home or Facility including
Veteran’s Administration Nursing Facility
• Psychiatric Hospital or Psychiatric Unit of
a Hospital
• Rehabilitation Facility including Inpatient
Rehabilitation Facility/Hospital or
Rehabilitation Unit of a Hospital
• Skilled Nursing Facility (SNF), Sub-Acute
Care or Swing Bed
• Transitional Care Unit (TCU)
• Veterans Home
PC v2014A
77
Data Element
Name:
Exclusive Breast Milk Feeding
Collected For:
PC-05,
Definition:
Documentation that the newborn was exclusively fed breast milk during the
entire hospitalization.
Exclusive breast milk feeding is defined as a newborn receiving only breast
milk and no other liquids or solids except for drops or syrups consisting of
vitamins, minerals, or medicines.
Suggested Data
Collection
Question:
Format:
Allowable Values:
Is there documentation that the newborn was exclusively fed breast milk
during the entire hospitalization?
Length: 1
Type: Alphanumeric
Occurs: 1
Y (Yes) There is documentation that the newborn was exclusively fed
breast milk during the entire hospitalization.
N (No) There is no documentation that the newborn was exclusively fed
breast milk during the entire hospitalization OR unable to determine
from medical record documentation.
Notes for
Abstraction:
If the newborn receives any other liquids including water during the entire
hospitalization, select allowable value "No".
Exclusive breast milk feeding includes the newborn receiving breast milk
via a bottle or other means beside the breast.
Sweet-Ease® or a similar 24% sucrose and water solution given to the
newborn for the purpose of reducing discomfort during a painful procedure
is classified as a medication and is not considered a supplemental feeding.
If the newborn receives donor breast milk, select allowable value "Yes".
If breast milk fortifier is added to the breast milk, select allowable value
"Yes".
In cases where there is conflicting documentation and both exclusive
breast milk feeding and formula supplementation is documented, select
allowable value "No".
Suggested Data
Sources:
PC v2014A
•
•
•
•
Discharge summary
Feeding flow sheets
Individual treatment plan
Intake and output sheets
78
• Nursing notes
• Physician progress notes
Additional Notes:
Guidelines for Abstraction:
Inclusion
None
PC v2014A
Exclusion
None
79
Data Element
Name:
Gestational Age
Collected For:
PC-01, PC-02, PC-03,
Definition:
The weeks of gestation completed at the time of delivery.
Gestational age is defined as the number of weeks that have elapsed
between the first day of the last normal menstrual period (not presumed
time of conception) and the date of delivery, irrespective of whether the
gestation results in a live birth or a fetal death.
Suggested Data
Collection
Question:
Format:
Allowable Values:
How many weeks of gestation were completed at the time of delivery?
Length: 3 or UTD
Type: Alphanumeric
Occurs: 1
1-50
UTD=Unable to Determine
Notes for
Abstraction:
Gestational age should be rounded off to the nearest completed week, not
the following week. For example, an infant born on the 5th day of the 36th
week (35 weeks and 5/7 days) is at a gestational age of 35 weeks, not 36
weeks.
The delivery or operating room record should be reviewed first for
gestational age. If gestational age is not recorded in the delivery or
operating room record, then continue to review the data sources in the
following order: history and physical, prenatal forms,clinician admission
progress note and discharge summary until a positive finding for
gestational age is found. In cases where there is conflicting data, the
gestational age found in the first document according to the order listed
above should be used. The phrase "estimated gestational age" is an
acceptable descriptor for gestational age.
If the patient has not received prenatal care, estimated gestational age
(EGA) may be used to answer gestational age.
When the admission date is different from the delivery date, use
documentation of the gestational age completed closest to the delivery
date.
Gestational age should be documented by the clinician as a numeric value
between 1-50. The clinician, not the abstractor, should perform the
calculation to determine gestational age based on the first day of the last
normal menstrual period (not presumed time of conception) and the date of
PC v2014A
80
delivery. Ultrasound-based dating is also an acceptable method of
determining gestational age.
If the gestational age entered by the clinician in the first document listed
above is obviously incorrect (in error) but it is a valid number and the
correct number can be supported with other documentation in the other
acceptable data sources in the medical record, the correct number may be
entered.
Documentation in the acceptable data sources may be written by the
following clinicians: physician, certified nurse midwife (CNM), advanced
practice nurse/physician assistant (APN/PA) or registered nurse (RN).
It is acceptable to use data derived from vital records reports received from
state or local departments of public health if they are available and are
directly derived from the medical record with a process in place to confirm
their accuracy. If this is the case, these may be used in lieu of the
acceptable data sources listed below.
Suggested Data
Sources:
ONLY ACCEPTABLE SOURCES IN ORDER OF PREFERENCE:
•
•
•
•
•
•
Delivery room record
Operating room record
History and physical
Prenatal forms
Admission clinician progress notes
Discharge summary
Additional Notes:
Guidelines for Abstraction:
Inclusion
None
PC v2014A
Exclusion
None
81
Data Element
Name:
Health Care Organization Identifier
Collected For:
All Records, Aggregate Data File, Patient Population Data File, Hospital
Clinical Data File
Definition:
Suggested Data
Collection
Question:
Format:
Allowable Values:
Notes for
Abstraction:
Suggested Data
Sources:
A unique number, assigned by The Joint Commission, to identify the health
care organization that is accredited by The Joint Commission. This number
is used to identify and group a health care organization's HCO-Level
performance measure data.
What is the Joint Commission’s unique identification number for the
provider?
Length: 6
Type: Numeric
Occurs: 1
1 – 999,999
None
Does not apply, assigned by The Joint Commission.
Additional Notes:
Guidelines for Abstraction:
Inclusion
None
PC v2014A
Exclusion
None
82
Data Element Name:
Collected For:
Definition:
Suggested Data Collection
Question:
Format:
Allowable Values:
Hispanic Ethnicity
All Records
Documentation that the patient is of Hispanic ethnicity or Latino.
Is the patient of Hispanic ethnicity or Latino?
Length: 1
Type: Character
Occurs: 1
Y
(Yes) Patient is of Hispanic ethnicity or Latino.
N (No) Patient is not of Hispanic ethnicity or Latino or
unable to determine from medical record documentation.
Notes for Abstraction:
Suggested Data Sources:
The data element, Race , is required in addition to this data
element.
•
•
•
•
•
Emergency department record
History and physical
Face sheet
Nursing admission assessment
Progress notes
Additional Notes:
Guidelines for Abstraction:
Inclusion
A person of Cuban, Mexican, Puerto Rican,
South or Central American, or other Spanish
culture or origin, regardless of race. The term
“Spanish origin” can be used in addition to
“Hispanic or Latino.”
Examples:
•
•
•
•
•
•
•
•
•
PC v2014A
Exclusion
• None
Black-Hispanic
Chicano
H
Hispanic
Latin American
Latino/Latina
Mexican-American
Spanish
White-Hispanic
83
Data Element
Name:
ICD-9-CM Other Diagnosis Codes
Collected For:
All Records , Optional for HBIPS-2, HBIPS-3 and PBM; Used in algorithm
for PC-01, 02, 03, 04, and 05
Definition:
Suggested Data
Collection
Question:
Format:
Allowable Values:
Notes for
Abstraction:
Suggested Data
Sources:
The International Classification of Diseases, Ninth Revision, Clinical
Modification (ICD-9-CM) codes associated with the diagnosis for this
hospitalization.
What were the ICD-9-CM other diagnosis codes selected for this medical
record?
Length: 6 (implied decimal point)
Type: Alphanumeric
Occurs: 24
Any valid ICD-9-CM diagnosis code
None
• Face sheet
• Discharge summary
• UB-04, Field Locations: 67A-Q
NOTE: Medicare will only accept codes listed in fields A-H
Additional Notes:
Guidelines for Abstraction:
Inclusion
• None
PC v2014A
Exclusion
• None
84
Data Element
Name:
ICD-9-CM Other Procedure Codes
Collected For:
All Records , Optional for All HBIPS Records; Used in algorithm for PC-01,
02, 04 and 05;
Definition:
The International Classification of Diseases, Ninth Revision, Clinical
Modification (ICD-9-CM) codes identifying all significant procedures other
than the principal procedure.
Note: If transmitted for the HBIPS measure set, all applicable edits (e.g.,
valid value, ICD-9-CM Other Procedure Date exists, etc.) will apply.
Suggested Data
Collection
Question:
Format:
Allowable Values:
Notes for
Abstraction:
Suggested Data
Sources:
What were the ICD-9-CM code(s) selected as other procedure(s) for this
record?
Length: 5 (with or without decimal point)
Type: Alphanumeric
Occurs: 24
Any valid ICD-9-CM procedure code
None
•
•
•
•
Face sheet
Discharge summary
UB-04, Field Location: 74A-E
Outpatient medical record
Additional Notes:
Guidelines for Abstraction:
Inclusion
• None
PC v2014A
Exclusion
• None
85
Data Element
Name:
ICD-9-CM Other Procedure Dates
Collected For:
All Records , Optional for All HBIPS and PBM Records
Definition:
The month, day, and year when the associated procedure(s) was (were)
performed.
Note: If transmitted for the HBIPS measure set, all applicable edits (e.g.,
valid value, ICD-9-CM Other Procedure Codes exists, etc.) will apply.
Suggested Data
Collection
Question:
Format:
What were the date(s) the other procedure(s) were performed?
Length: 10 – MM-DD-YYYY (includes dashes) or UTD
Type: Date
Occurs: 24
Allowable Values:
MM = Month (01-12)
DD = Day (01-31)
YYYY = Year (20xx)
Leave Blank if Unable to Determine
Notes for
Abstraction:
PC v2014A
• If the procedure date for the associated procedure is unable to be
determined from medical record documentation, enter UTD.
• The medical record must be abstracted as documented (taken at
“face value”). When the date documented is obviously in error (not a
valid format/range or outside of the parameters of care [after
Discharge Date ]) and no other documentation is found that provides
this information, the abstractor should leave blank.
Examples:
◦ Documentation indicates the ICD-9-CM Other Procedure Dates
was 02- 42 -2008. No other documentation in the medical
record provides a valid date. Since the ICD-9-CM Other
Procedure Dates is outside of the range listed in the Allowable
Values for “Day,” it is not a valid date and the abstractor should
select “UTD.”
◦ Patient expires on 02-12-2008 and documentation indicates the
ICD-9-CM Other Procedure Dates was 03-12-2008. Other
documentation in the medical record supports the date of death
as being accurate. Since the ICD-9-CM Other Procedure Dates
is after the Discharge Date (death), it is outside of the
parameters of care and the abstractor should leave blank.
Note:
Transmission of a case with an invalid date as described above
will be rejected from the Joint Commission’s Data Warehouse.
86
Suggested Data
Sources:
•
•
•
•
•
•
•
•
Consultation notes
Face sheet
Progress notes
Discharge summary
Operative report
Procedure notes
Diagnostic test reports
UB-04, Field Locations: 74A-E
Additional Notes:
Guidelines for Abstraction:
Inclusion
• None
PC v2014A
Exclusion
• None
87
Data Element
Name:
ICD-9-CM Principal Diagnosis Code
Collected For:
All Records , Optional for HBIPS-2 and HBIPS-3; Used in algorithm for PC01, 02, 03, 04, 05 and PBM-03
Definition:
The International Classification of Diseases, Ninth Revision, Clinical
Modification (ICD-9-CM) code associated with the diagnosis established
after study to be chiefly responsible for occasioning the admission of the
patient for this hospitalization.
Suggested Data
Collection
Question:
What was the ICD-9-CM code selected as the principal diagnosis for this
record?
Format:
Allowable Values:
Notes for
Abstraction:
Suggested Data
Sources:
Length: 6 (implied decimal point)
Type: Alphanumeric
Occurs: 1
Any valid ICD-9-CM diagnosis code
The principal diagnosis is defined in the Uniform Hospital Discharge Data
Set (UHDDS) as “that condition established after study to be chiefly
responsible for occasioning the admission of the patient to the hospital for
care.”
•
•
•
•
Face sheet
Discharge summary
UB-04, Field Location: 67
Outpatient medical record
Additional Notes:
Guidelines for Abstraction:
Inclusion
• Refer to Appendix A, for ICD-9-CM Code
Tables.
PC v2014A
Exclusion
• Refer to Appendix A, for ICD-9-CM Code
Tables.
88
Data Element
Name:
ICD-9-CM Principal Procedure Code
Collected For:
All Records , Optional for All HBIPS Records; Used in algorithm for PC-01,
02, 04 and 05
Definition:
The International Classification of Diseases, Ninth Revision, Clinical
Modification (ICD-9-CM) code that identifies the principal procedure
performed during this hospitalization. The principal procedure is the
procedure performed for definitive treatment rather than diagnostic or
exploratory purposes, or which is necessary to take care of a complication.
Note: If transmitted for the HBIPS measure set, all applicable edits (e.g.,
valid value, ICD-9-CM Principal Procedure Date exists, etc.) will apply.
Suggested Data
Collection
Question:
Format:
Allowable Values:
Notes for
Abstraction:
Suggested Data
Sources:
What was the ICD-9-CM code selected as the principal procedure for this
record?
Length: 5 (with or without decimal point)
Type: Alphanumeric
Occurs: 1
Any valid ICD-9-CM procedure code.
The principal procedure as described by the Uniform Hospital Discharge
Data Set (UHDDS) is one performed for definitive treatment rather than
diagnostic or exploratory purposes, or which is necessary to take care of a
complication.
•
•
•
•
Face sheet
Discharge summary
UB-04, Field Location: 74
Outpatient medical record
Additional Notes:
Guidelines for Abstraction:
Inclusion
• None
PC v2014A
Exclusion
• None
89
Data Element
Name:
ICD-9-CM Principal Procedure Date
Collected For:
All Records , Optional for All HBIPS and PBM Records
Definition:
The month, day, and year when the principal procedure was performed.
Note: If transmitted for the HBIPS measure set, all applicable edits (e.g.,
valid value, ICD-9-CM Principal Procedure Code exists, etc.) will apply.
Suggested Data
Collection
Question:
Format:
What was the date the principal procedure was performed?
Length: 10 – MM-DD-YYYY (includes dashes)
Type: Date
Occurs: 1
Allowable Values:
MM = Month (01-12)
DD = Day (01-31)
YYYY = Year (20xx)
Leave Blank if Unable to Determine
Notes for
Abstraction:
PC v2014A
• If the principal procedure date is unable to be determined from
medical record documentation, leave blank.
• The medical record must be abstracted as documented (taken at
“face value”). When the date documented is obviously in error (not a
valid date/format or is outside of the parameters of care [after
Discharge Date ]) and no other documentation is found that provides
this information, the abstractor should leave blank.
Examples:
◦ Documentation indicates the ICD-9-CM Principal Procedure
Date was 02- 42 -2008. No other documentation in the medical
record provides a valid date. Since the ICD-9-CM Principal
Procedure Date is outside of the range listed in the Allowable
Values for “Day,” it is not a valid date and the abstractor should
leave blank.
◦ Patient expires on 02-12-2008 and documentation indicates the
ICD-9-CM Principal Procedure Date was 03-12-2008. Other
documentation in the medical record supports the date of death
as being accurate. Since the ICD-9-CM Principal Procedure
Date is after the Discharge Date (death), it is outside of the
parameter of care and the abstractor should leave blank.
Note:
Transmission of a case with an invalid date as described above
will be rejected from the Joint Commission’s Data Warehouse.
90
Suggested Data
Sources:
•
•
•
•
•
•
•
•
•
Consultation notes
Face sheet
Progress notes
Discharge summary
Diagnostic test reports
Operative notes
Procedure notes
UB-04, Field Location: 74
Outpatient medical record
Additional Notes:
Guidelines for Abstraction:
Inclusion
• None
PC v2014A
Exclusion
• None
91
Data Element
Name:
Initial Patient Population Size – Medicare Only
Collected For:
HBIPS, PC, Transmission, Patient Population Data File , Used in
transmission of the Hospital Initial Patient Population Data file.
Note:
Refer to the Hospital Initial Patient Population Data XML File Layout in the
Transmission section of this manual.
Definition:
Indicates the number of episode of care (EOC) records identified for a
hospital with Medicare listed as a payment source prior to the application of
data integrity filters, measure exclusions, and/or sampling methodology for
the specified time period.
The data element is based on the hospital's initial identification of Medicare
EOC records for a measure set, stratum, or sub-population. Initial Patient
Population Size – Medicare Only includes all patients that are billed under
Medicare or Title 18. Medicare can be listed as a primary, secondary,
teritary or lower on the list of payment sources for the patient. In addition,
patients who are participating as a member of a Medicare HMO/Medicare
Advantage are included in the Medicare counts, e.g., Medicare Blue,
Humana Gold, Secure Horizons, AARP, Coventry Advantra, etc. This initial
data pull utilizes administrative data such as ICD-9-CM diagnosis and
procedure codes, admission date, and birthdate.
For the discharge measures (eg. HBIPS-1, 4, PC-01), refer to the Initial
Patient Population discussion in the Measure Information section of this
manual for more information.
For the HBIPS event measures (HBIPS-2 and 3), the Initial Patient
Population Size – Medicare Only is equal to those EOC records in the
census data identified as being Medicare EOC records. The HBIPS census
data are calculated by (Psychiatric Inpatient Days-Medicare Only - Total
Leave Days-Medicare Only). Initial Patient Population Size – Medicare
Only is not derived from those cases that pass through the Initial Patient
Population algorithm.
Note:
If the hospital’s data has been sampled, this field contains the population
from which the sample was originally drawn, NOT the sample size.
Suggested Data
Collection
Question:
Format:
Not Applicable
Length: 6
Type: Numeric
Occurs:
Non-stratified Measure Sets:
One Initial Patient Population Size – Medicare Only per
hospital’s measure set (e.g., AMI, HF, PN, and STK).
PC v2014A
92
Stratified Measure Sets:
One Initial Patient Population Size – Medicare Only per
measure set stratum or sub-population the hospital is
participating in:
* The PC measure set has three occurrences, one for the
mother sub-population and two for the newborn subpopulations.
* The HBIPS measure set has four occurrences, one for each
age stratum.
Note:
Refer to the appropriate version of the Specifications Manual for
National Quality Inpatient Measures for the number of
occurrences for the CAC, VTE, and SCIP measure sets.
Allowable Values:
Notes for
Abstraction:
Suggested Data
Sources:
0 through 999,999
Initial Patient Population Size-Medicare Only must contain the actual
number of patients in the population even if the hospital has five or fewer
discharges (both Medicare and non-Medicare combined) in a quarter and
has decided to not submit patient level data.
Not Applicable
Additional Notes:
Guidelines for Abstraction:
Inclusion
None
PC v2014A
Exclusion
None
93
Data Element
Name:
Initial Patient Population Size – Non-Medicare Only
Collected For:
HBIPS, PC, Transmission, Patient Population Data File , Used in
transmission of the Hospital Initial Patient Population Data file.
Note:
Refer to the HBIPS Hospital Initial Patient Population Data XML File Layout
in the Transmission section of this manual.
Definition:
Indicates the number of episode of care (EOC) records identified for a
hospital with Medicare NOT listed as a payment source prior to the
application of data integrity filters, measure exclusions, and/or sampling
methodology for the specified time period.
The data element is based on the hospital's initial identification of nonMedicare EOC records for a measure set, stratum, or sub-population. This
initial data pull utilizes administrative data such as ICD-9-CM diagnosis and
procedure codes, admission date, and birthdate.
For the discharge measures (eg. HBIPS-1, 4, PC-01), refer to the Initial
Patient Population discussion in the Measure Information section of this
manual for more information.
For the HBIPS event measures (HBIPS-2 and 3), the Initial Patient
Population Size – Non-Medicare Only is equal to those EOC records in the
census data identified as not having Medicare listed as a payment source.
The HBIPS census data are calculated by (Psychiatric Inpatient Day-NonMedicare Only - Total Leave Days-Non-Medicare Only). Initial Patient
Population Size – Non-Medicare Only is not derived from those cases that
pass through the Initial Patient Population algorithm.
Note:
If the hospital’s data has been sampled, this field contains the population
from which the sample was originally drawn, NOT the sample size.
Suggested Data
Collection
Question:
Format:
Not Applicable
Length: 6
Type: Numeric
Occurs:
Non-stratified Measure Sets:
One Initial Patient Population Size – Non-Medicare Only per
hospital’s measure set (e.g., AMI, HF, PN, and STK).
Stratified Measure Sets:
One Initial Patient Population Size – Non-Medicare Only per
measure set stratum or sub-population the hospital is
participating in:
PC v2014A
94
* The PC measure set has three occurrences, one for the
mother sub-population and two for the newborn subpopulations.
* The HBIPS measure set has four occurrences, one for each
age stratum.
Note:
Refer to the appropriate version of the Specifications Manual for
National Quality Inpatient Measures for the number of
occurrences for the CAC, VTE, and SCIP measure sets.
Allowable Values:
Notes for
Abstraction:
Suggested Data
Sources:
0 through 999,999
Initial Patient Population Size-Non-Medicare Only must contain the actual
number of patients in the population even if the hospital has five or fewer
discharges (both Medicare and non-Medicare combined) in a quarter and
has decided to not submit patient level data.
Not Applicable
Additional Notes:
Guidelines for Abstraction:
Inclusion
None
PC v2014A
Exclusion
None
95
Data Element
Name:
Labor
Collected For:
PC-01,
Definition:
Suggested Data
Collection
Question:
Format:
Allowable Values:
Documentation by the clinician that the patient was in labor.
Is there documentation by the clinician that the patient was in labor?
Length: 1
Type: Alphanumeric
Occurs: 1
Y (Yes) There is documentation by the clinician that the patient was in
labor.
N (No) There is no documentation by the clinician that the patient was in
labor OR unable to determine from medical record documentation.
Notes for
Abstraction:
Suggested Data
Sources:
• A clinician is defined as a physician, certified nurse midwife (CNM),
advanced practice nurse/physician assistant (APN/PA) or registered
nurse (RN).
• Documentation of labor by the clinician should be abstracted at face
value. No additional documentation of regular contractions or cervical
change is required in order to answer yes to labor.
• History and physical
• Nursing notes
• Physician progress notes
Additional Notes:
Guidelines for Abstraction:
Inclusion
The following are acceptable descriptors for
labor:
• Active
• Early
• Spontaneous
PC v2014A
Exclusion
The following are not acceptable descriptors
for labor:
• Latent
• Prodromal
96
Data Element
Name:
Measure Category Assignment
Collected For:
HBIPS, PBM, PC, Calculation, Transmission, Hospital Clinical Data File ,
Used in calculation of the Joint Commission’s aggregate data and in the
transmission of the Hospital Clinical Data file. Informational ONLY for PBM.
Notes:
• Episode of care records that calculate with a Measure Category
Assignment of ”X” (missing data) for one or more measures will be
rejected by the Joint Commission’s Data Warehouse. Refer to the
Missing and Invalid Data section in this manual for more information.
• All hospital measures use this data element. The ORYX Vendor's
calculated Measure Category Assignment will be transmitted to The
Joint Commission on a quarterly basis with the associated hospital
clinical data. These measure results will be used in the Joint
Commission’s data quality analysis and continuous measure
verification process. ORYX Vendors can refer to the Joint
Commission’s ORYX Data Quality Manual for more information.
Definition:
Calculated measures results for each episode of care (EOC) that is
processed through a measure algorithm.
Used to summarize the outcome for an EOC that is processed through a
specific measure algorithm.
Suggested Data
Collection
Question:
Format:
Allowable Values:
Not Applicable
Length: 1
Type: Character
Occurs: One Measure Category Assignment per EOC is expected for
every measure that a hospital is participating in.
B
Category B - Not in Measure Population
For rate-based and continuous variable measures:
EOC record is not a member of a measure's population.
For rate-based-ratio measures:
Does not apply.
D
Category D - In Measure Population
For rate-based measures:
EOC record is a member of the measure's population and there has
not been an occurrence of the measure.
For rate-based-ratio measures:
Does not apply.
PC v2014A
97
For continuous variable measures:
EOC record is a member of the measure's population and has
sufficient accurate and valid data to compute the measurement.
Note:
For continuous variable measures, EOC records that have a
Measure Category Assignment of “D” will have an associated
Measurement Value.
E
Category E - In Numerator Population
For rate-based measures:
EOC record is a member of the measure's population and there has
been an occurrence of the measure.
For rate-based-ratio measures:
Event record is a member of the measure's population and there has
been an occurrence of the measure.
For continuous variable measures:
Does not apply.
U
Category U – Not In Numerator Population
For rate-based-proportion measures:
Does not apply
For rate-based-ratio measures:
Event record is a member of the measure's population; however, it
contains a data element whose allowable value excludes it from the
numerator.
For continuous variable measures:
Does not apply.
X
Category X – Data Are Missing
For rate-based and continuous variable measures:
Data are missing that is required to calculate the measure. The
record will be rejected by the QIO Clinical Warehouse and the Joint
Commission’s Data Warehouse.
Y
Category Y – UTD Allowable Value Does Not Allow Calculation
of The Measure
For rate-based measures:
Does not apply.
For rate-based-ratio measures: Event record contains a Date, Time,
or Numeric data element with a value of ‘UTD’.
For continuous variable measures:
EOC record contains a Date, Time, or Numeric data element with a
value of ‘UTD’.
Note:
For continuous variable measures, EOC records that have a
PC v2014A
98
Measure Category Assignment of “Y” will not have an associated
_Measurement Value_
Notes for
Abstraction:
Suggested Data
Sources:
None
Not Applicable
Additional Notes:
Guidelines for Abstraction:
Inclusion
• None
PC v2014A
Exclusion
• None
99
Data Element
Name:
Measure Set
Collected For:
HBIPS, PC, Transmission, Patient Population Data File, Hospital Clinical
Data File
Definition:
Suggested Data
Collection
Question:
Format:
Allowable Values:
Notes for
Abstraction:
Suggested Data
Sources:
Indicates which measure set (topic) is being transmitted for a hospital.
Not Applicable
Length: 10
Type: Character
Occurs: Hospital Clinical Data file: 1
Hospital Initial Patient Population Data file: 1 – 9
Refer to the Hospital Clinical Data XML File Layout and the Hospital
Initial Patient Population Data XML File Layout in the Transmission
section of this manual.
None
Not Applicable
Additional Notes:
Guidelines for Abstraction:
Inclusion
None
PC v2014A
Exclusion
None
100
Data Element
Name:
National Provider Identifier
Collected For:
HBIPS, PC, Transmission , Optional for All Records
Definition:
Suggested Data
Collection
Question:
Format:
Allowable Values:
All Health Insurance Portability and Accountability Act of 1996 (HIPAA)
covered healthcare providers must obtain a National Provider Identifier
(NPI). The NPI may be provided in addition to the Medicare provider
number.
What is the NPI for this provider?
Length: 10
Type: Character
Occurs: 1
Any valid 10 digit NPI number.
The 10th digit is a numeric check digit based off the first 9 digits.
Notes for
Abstraction:
Suggested Data
Sources:
None
UB-04, Field Location: 56
Additional Notes:
Guidelines for Abstraction:
Inclusion
None
PC v2014A
Exclusion
None
101
Data Element
Name:
Parity
Collected For:
PC-02,
Definition:
Suggested Data
Collection
Question:
Format:
Allowable Values:
The number of live deliveries the patient experienced prior to current
hospitalization.
How many live deliveries did the patient experience prior to current
hospitalization?
Length: 2 or UTD
Type: Alphanumeric
Occurs: 1
0-50
UTD=Unable to Determine
Notes for
Abstraction:
The delivery or operating room record should be reviewed first for parity. If
parity is not recorded in the delivery or operating room record, then
continue to review the data sources in the following order: history and
physical, prenatal forms,clinician admission progress note and discharge
summary until a positive finding for parity is found. In cases where there is
conflicting data, parity found in the first document according to the order
listed above should be used.
If parity entered by the clinician in the first document listed above is
obviously incorrect (in error) but it is a valid number and the correct number
can be supported with other documentation in the other acceptable data
sources in the medical record, the correct number may be entered.
If parity is not documented and GTPAL terminology is documented where
G= Gravida, T= Term, P= Preterm, A= Abortions and L= Living, all previous
term and preterm deliveries prior to this hospitalization should be added
together to determine parity.
If parity is not documented and gravidity is documented as one, parity
should be considered zero.
The previous delivery of twins or any multiple gestation is considered one
parous event.
Documentation in the acceptable data sources may be written by the
following clinicians: physician, certified nurse midwife (CNM), advanced
practice nurse/physician assistant (APN/PA) or registered nurse (RN).
It is acceptable to use data derived from vital records reports received from
state or local departments of public health if they are available and are
directly derived from the medical record with a process in place to confirm
PC v2014A
102
their accuracy. If this is the case, these may be used in lieu of the
acceptable data sources listed below.
Suggested Data
Sources:
ONLY ACCEPTABLE SOURCES IN ORDER OF PREFERENCE:
•
•
•
•
•
•
Delivery room record
Operating room record
History and physical
Prenatal forms
Admission clinician progress note
Discharge summary
Additional Notes:
Guidelines for Abstraction:
Inclusion
The following descriptor must precede the
number when determining parity:
• Parity
• P
Examples: parity=2 or g3p2a1
PC v2014A
Exclusion
A string of three or more numbers without the
alpha designation of "p" preceding the second
number can not be used to determine parity.
Example: 321
When GTPAL terminology is documented, G=
Gravida, T= Term, P= Preterm, A= Abortions,
L= Living, P does not equal parity.
103
Data Element
Name:
Payment Source
Collected For:
All Records , Optional for HBIPS-2 and HBIPS-3
Definition:
The source of payment for this episode of care.
Suggested Data
Collection
Question:
Format:
Allowable Values:
What is the patient's source of payment for this episode of care?
Length: 1
Type: Alphanumeric
Occurs: 1
1 Source of payment is Medicare.
2 Source of payment is NonMedicare.
Notes for
Abstraction:
Suggested Data
Sources:
• If Medicare is listed as the primary, secondary, tertiary, or even lower
down on the list or payers, select "1".
• If the patient has Medicaid only or Medicaid and another insurance
type, other than Medicare, select "2". If the patient has Medicaid and
Medicare, select "1".
• If the patient is an Undocumented Alien or Illegal immigrant select "1".
Undocumented Alien: Section 1011 of the Medicare Modernization
Act of 2003 allows for reimbursement for services rendered to
patients who are: Undocumented or illegal aliens (immigrants), Aliens
who have been paroled into a United States port of entry and
Mexican citizens permitted to enter the United States on a laser visa.
• Face sheet
• UB-04, Field Location: 50A, B or C
Additional Notes:
Guidelines for Abstraction:
PC v2014A
104
Inclusion
Medicare includes, but is not limited to:
• Medicare Fee for Service (includes DRG
or PPS)
• Black Lung
• End Stage Renal Disease (ESRD)
• Railroad Retirement Board (RRB)
• Medicare Secondary Payer
• Medicare HMO/Medicare Advantage
PC v2014A
Exclusion
• None
105
Data Element
Name:
Predicted Value
Collected For:
PC, Transmission, Risk Adjustment, Hospital Clinical Data File , Used in
the calculation of the Joint Commission’s aggregate data for Risk Adjusted
Measures (PC-02, PC-04) and in the Transmission section of the Hospital
Clinical Data file.
Note:
• The ORYX Vendor’s calculated Predicted Value will be transmitted to
The Joint Commission on a quarterly basis with the associated
hospital clinical data. These measure results will be used in the Joint
Commission’s data quality analysis and continuous measure
verification process. ORYX Vendors can refer to the Joint
Commission’s ORYX Data Quality Manual and ORYX Risk
Adjustment Guide for more information.
Definition:
This data element is used to store the calculated predicted value that
results from applying the appropriate Joint Commission risk model to the
data.
Note:
Used in conjunction with Measure Category Assignment when its allowable
value = “D” (In Measure Population) or “E” (In Numerator Population).
Suggested Data
Collection
Question:
Format:
Allowable Values:
Not Applicable
Length: 2-9 (including decimal)
Type: Numeric
Occurs: One Predicted Value is expected per EOC for every riskadjusted measure that a hospital is participating in.
0.00000001 – 0.99999999
JOINT COMMISSION NOTE TO PROGRAMMERS:
• Round to 8 decimal places.
• Use only the twenty four ICD-9-CM Diagnosis Codes that are
transmitted as part of the patient record when evaluating the patient
against the risk model. Do not use additional ICD-9-CM Diagnosis
Codes that may be available in the medical record or from the UB
download.
Notes for
Abstraction:
PC v2014A
None
106
Suggested Data
Sources:
Not Applicable
Additional Notes:
Guidelines for Abstraction:
Inclusion
None
PC v2014A
Exclusion
None
107
Data Element
Name:
Prior Uterine Surgery
Collected For:
PC-01, Joint Commission Only
Definition:
Documentation that the patient had undergone prior uterine surgery.
Suggested Data
Collection
Question:
Is there documentation that the patient had undergone prior uterine
surgery?
Format:
Allowable Values:
Length: 1
Type: Alphanumeric
Occurs: 1
Y (Yes) The medical record contains documentation that the patient had
undergone prior uterine surgery.
N (No) The medical record does not contain documentation that the
patient had undergone a prior uterine surgery OR unable to
determine from medical record documentation.
Notes for
Abstraction:
Suggested Data
Sources:
•
•
•
•
•
History and physical
Nursing admission assessment
Progress notes
Physician’s notes
Prenatal forms
Additional Notes:
Guidelines for Abstraction:
Inclusion
The only prior uterine surgeries considered for
the purposes of the measure are:
• Prior classical cesarean section which is
defined as a vertical incision into the
upper uterine segment
• Prior myomectomy
• Prior uterine surgery resulting in a
perforation of the uterus due to an
accidental injury
• History of a uterine window or thinning of
the uterine wall noted during prior uterine
surgery or during ultrasound
• History of uterine rupture requiring
surgical repair
PC v2014A
Exclusion
• Prior low transverse cesarean section
• Prior cesarean section without specifying
prior classical cesarean section
108
PC v2014A
109
Data Element
Name:
Race
Collected For:
All Records
Definition:
Suggested Data
Collection
Question:
Format:
Documentation of the patient’s race.
What is the patient’s race?
Length: 1
Type: Character
Occurs: 1
Allowable Values:
Select one:
Notes for
Abstraction:
PC v2014A
1
White: Patient’s race is White or the patient has origins in Europe,
the Middle East, or North Africa.
2
Black or African American: Patient’s race is Black or African
American.
3
American Indian or Alaska Native: Patient’s race is American
Indian/Alaska Native.
4
Asian: Patient’s race is Asian.
5
Native Hawaiian or Pacific Islander: Patient’s race is Native
Hawaiian/Pacific Islander.
6
RETIRED VALUE (effective 07-01-05 discharges)
7
UTD: Unable to determine the patient’s race or not stated (e.g., not
documented, conflicting documentation or patient unwilling to
provide).
• The data element Hispanic Ethnicity is required in addition to this data
element.
• If documentation indicates the patient has more than one race (e.g.,
Black-White, Indian-White), select the first listed race.
• Although the terms “Hispanic” and “Latino” are actually descriptions of
the patient’s ethnicity, it is not uncommon to find them referenced as
race. If the patient’s race is documented only as Hispanic/Latino,
select “White.” If the race is documented as mixed Hispanic/Latino
with another race, use whatever race is given (e.g., Black-Hispanic –
select “Black”). Other terms for Hispanic/Latino include Chicano,
Cuban, H (for Hispanic), Latin American, Latina, Mexican, MexicanAmerican, Puerto Rican, South or Central American, and Spanish.
110
Suggested Data
Sources:
•
•
•
•
•
Emergency department record
History and physical
Face sheet
Nursing admission assessment
Progress notes
Additional Notes:
Guidelines for Abstraction:
Inclusion
Black or African American
A person having origins in any of the black
racial groups of Africa. Terms such as
“Haitian” or “Negro” can be used in addition to
“Black or African American.”
Exclusion
• None
American Indian or Alaska Native
A person having origins in any of the original
peoples of North and South America (including
Central America) and who maintains tribal
affiliation or community attachment (e.g., any
recognized tribal entity in North and South
America [including Central America], Native
American.)
Asian
A person having origins in any of the original
peoples of the Far East, Southeast Asia, or the
Indian subcontinent including, for example,
Cambodia, China, India, Japan, Korea,
Malaysia, Pakistan, the Philippine Islands,
Thailand, and Vietnam.
White
A person having origins in any of the original
peoples of Europe, the Middle East, or North
Africa (e.g., Caucasian, Iranian, White).
Native Hawaiian or Pacific Islander
A person having origins in any of the other
original peoples of Hawaii, Guam, Samoa, or
other Pacific Islands.
PC v2014A
111
Data Element
Name:
Reason for Not Exclusively Feeding Breast Milk
Collected For:
PC-05,
Definition:
Reasons for not exclusively feeding breast milk during the entire
hospitalization are clearly documented in the medical record. These
reasons are due to a maternal medical condition for which feeding breast
milk should be avoided or due to mother’s choice to not exclusively feed
breast milk upon admission.
Exclusive breast milk feeding is defined as a newborn receiving only breast
milk and no other liquids or solids except for drops or syrups consisting of
vitamins, minerals, or medicines.
Suggested Data
Collection
Question:
Format:
Allowable Values:
Was there documentation of a reason for not exclusively feeding breast
milk during the entire hospitalization?
Length: 1
Type: Alphanumeric
Occurs: 1
1.) There is documentation by physician/advanced practice nurse
(APN)/physician assistant (PA)/certified nurse midwife
(CNM) /lactation consultant of a reason for not exclusively feeding
breast milk during the entire hospitalization due to a maternal
medical condition with which breast milk feeding should be avoided.
2.) There is documentation by physician/APN/PA/CNM/lactation
consultant/RN that the newborn’s mother chose to not exclusively
feed breast milk upon admission.
3.) There is no documentation by physician/APN/PA/CNM/lactation
consultant/RN of a reason for not exclusively feeding breast milk
during the entire hospitalization due to a maternal medical condition
with which breast milk feeding should be avoided OR newborn's
mother's choice to not exclusively feed breast milk OR unable to
determine from medical record documentation.
Notes for
Abstraction:
PC v2014A
When determining whether there is a reason due to a medical maternal
condition documented by a physician/APN/PA/CNM or lactation consultant
for not exclusively feeding breast milk, reasons must be explicitly
documented (e.g., "mother is HIV positive - newborn will not be breast fed")
or clearly implied (e.g., "mother is currently abusing alcohol - newborn will
be fed formula"). If reasons are not mentioned in the context of newborn
feeding, do not make inferences (e.g., do not assume that the newborn is
not receiving breast milk because of the medications the mother is currently
taking).
112
A mother’s choice to not exclusively feed breast milk upon admission must
be clearly documented in the newborn’s medical record in the context of
the newborn feeding method in order to select allowable value “2”. Do not
assume that the newborn was not exclusively fed breast milk due to
maternal choice in the absence of such documentation.
If the mother's choice is to feed both formula and breast milk upon
admission select allowable value "2".
RN documentation of the mother's choice to not exclusively feed breast
milk upon admission may be used only if there is additional documentation
during the hospitalization from the physician/APN/PA/CNM/lactation
consultant that they are aware of the mother's decision to not exclusively
breast milk feed the newborn.
Suggested Data
Sources:
PHYSICIAN/APN/CNM/LACTATION CONSULTANT DOCUMENTATION
ONLY
•
•
•
•
Clinician progress notes
History and physical
Physician progress notes
Physician's orders
Additional Notes:
Guidelines for Abstraction:
Inclusion
These are the only acceptable maternal
medical conditions for which breast milk
feeding should be avoided which includes
one or more of the following medical
conditions:
•
•
•
•
•
•
•
•
•
PC v2014A
Exclusion
None
HIV infection
Human t-lymphotrophic virus type I or II
Substance abuse and/or alcohol abuse
Active, untreated tuberculosis
Taking certain medications, i.e.,
prescribed cancer chemotherapy,
radioactive isotopes, antimetabolites,
antiretroviral medications and other
medications where the risk of morbidity
outweighs the benefits of breast milk
feeding
Undergoing radiation therapy
Active, untreated varicella
Active herpes simplex virus with breast
lesions
Admission to Intensive Care Unit (ICU)
post-partum
113
• Adoption or foster home placement of
newborn
• Previous breast surgery, i.e., bilateral
mastectomy, bilateral breast reduction or
augmentation where the mother is
unable to produce breast milk
• Breast abnormality, i.e., hypoplasia,
tumor, etc. where the mother is unable to
produce breast milk
• Surrogate delivery resulting in placement
of the newborn with another person who
will assume care of the newborn after
discharge
PC v2014A
114
Data Element
Name:
Reason for Not Initiating Antenatal Steroid Therapy
Collected For:
PC-03,
Definition:
Reasons for not initiating antenatal steroid therapy before delivery are
clearly documented in the medical record. Reasons for not initiating
antenatal steroid therapy may include fetal distress, imminent delivery or
other reasons documented by physician/advanced practice nurse
(APN)/physician assistant (PA)/certified nurse midwife (CNM).
Initial antenatal steroid therapy is 12mg betamethasone IM or 6mg
dexamethasone IM.
Suggested Data
Collection
Question:
Format:
Allowable Values:
Is there documentation in the medical record of reasons for not initiating
antenatal steroid therapy before delivery?
Length: 1
Type: Alphanumeric
Occurs: 1
Y (Yes) There is documentation by physician/APN/PA/CNM that the
patient has one or more reasons for not initiating antenatal steroid
therapy before delivery.
N (No) There is no documentation by physician/APN/PA/CNM of a
reason for not initiating antenatal steroid therapy before delivery or
unable to determine from medical record documentation.
Notes for
Abstraction:
Suggested Data
Sources:
When determining whether there is a reason documented by a
physician/APN/PA or CNM for not initiating antenatal steroid therapy,
reasons must be explicitly documented (e.g., "patient had an adverse
reaction to the medication in the past - unable to initiate antenatal steroid
therapy") or clearly implied (i.e., there is documentation the delivery
occurred before antenatal steroid therapy could be initiated, there is
documentation the fetus has anomalies which are not compatible with life,
there is documentation that the patient has chorioamnionitis). If reasons are
not mentioned in the context of antenatal steroid administration, do not
make inferences.
PHYSICIAN/APN/PA/CNM DOCUMENTATION ONLY
• History and physical
• Physician progress notes
• Prenatal forms
Additional Notes:
PC v2014A
115
Guidelines for Abstraction:
Inclusion
None
PC v2014A
Exclusion
None
116
Data Element
Name:
Sample
Collected For:
HBIPS, PC, Transmission, Aggregate Data File, Hospital Clinical Data File ,
(Used in transmission of the Joint Commission’s aggregate data file and
the Hospital Clinical Data file.)
Notes:
• Required for transmission of aggregate data to The Joint
Commission. Refer to the ORYX Technical Implementation Guide for
more information.
Definition:
Suggested Data
Collection
Question:
Format:
Allowable Values:
Indicates if the data being transmitted for a hospital has been sampled, or
represent an entire population for the specified time period.
Does this case represent part of a sample?
Length: 1
Type: Alphanumeric
Occurs: 1
Y
(Yes) The data represents part of a sample.
N (No) The data is not part of a sample; this indicates the hospital is
performing 100 percent of the discharges eligible for this topic.
Notes for
Abstraction:
Suggested Data
Sources:
When Sampling Frequency equals '3' (No, the hospital is not sampling) or
'4' (N/A, submission of patient level data is not required), then abstract
Sample as "No".
Not Applicable
Additional Notes:
Guidelines for Abstraction:
Inclusion
• None
PC v2014A
Exclusion
• None
117
Data Element
Name:
Sample Size – Medicare Only
Collected For:
HBIPS, PC, Transmission, Patient Population Data File , Used in
transmission of the Hospital Initial Patient Population Data file.
Note:
For more information refer to the Population and Sampling Specifications
section and Hospital Initial Patient Population Data XML File Layout in the
Transmission section of this manual.
Definition:
Indicates the number of episode of care (EOC) records identified for a
hospital with Medicare listed as a payment source for a hospital to perform
data abstraction on. This count is after the appropriate sampling
methodology, if any, has been applied for the specific time period.
Notes for discharge measures (eg. HBIPS-1, 4, PC-01):
• If the hospital is sampling the discharge measures, then the Sample
Size – Medicare Only should be equal or less than the Initial Patient
Population Size – Medicare Only for the set, stratum, or subpopulation.
• If the hospital is not sampling the discharge measures, then the
Sample Size – Medicare Only will equal the Initial Patient Population
Size – Medicare Only for the set, stratum, or sub-population.
Notes for HBIPS event measures (HBIPS-2 and 3):
• Hospitals may not sample the HBIPS event measures. For these two
measures, the Sample Size – Medicare Only equals the Initial Patient
Population Size – Medicare Only for the set, stratum, or subpopulation.
Suggested Data
Collection
Question:
Format:
Not Applicable
Length: 6
Type: Numeric
Occurs:
Non-stratified Measure Sets:
One Sample Size – Medicare Only per hospital’s measure set
(e.g., AMI, HF, PN, and STK).
Stratified Measure Sets:
One Sample Size – Medicare Only per measure set stratum or
sub-population the hospital is participating in:
* The PC measure set has three occurrences, one for the
mother sub-population and two for the newborn subpopulations.
* The HBIPS measure set has four occurrences, one for each
PC v2014A
118
age stratum.
Note:
Refer to the appropriate version of the Specifications Manual for
National Quality Inpatient Measures for the number of
occurrences for the CAC, VTE, and SCIP measure sets.
Allowable Values:
Notes for
Abstraction:
Suggested Data
Sources:
0 through 999,999
For Discharge measures (eg. HBIPS-1,PC-01), when Sampling Frequency
= ‘N/A’ because the hospital has five or fewer discharges (both Medicare
and non-Medicare combined) in a quarter and has decided to not submit
patient level data, Sample Size – Medicare Only should equal zero.
Not Applicable
Additional Notes:
Guidelines for Abstraction:
Inclusion
None
PC v2014A
Exclusion
None
119
Data Element
Name:
Sample Size – Non-Medicare Only
Collected For:
HBIPS, PC, Transmission, Patient Population Data File , Used in
transmission of the Hospital Initial Patient Population Data file.
Note:
• For more information, refer to the Population and Sampling
Specifications section and Hospital Initial Patient Population Data
XML File Layout in the Transmission section of this manual.
Definition:
Indicates the number of episode of care (EOC) records identified for a
hospital with Medicare NOT listed as a payment source for a hospital to
perform data abstraction on. This count is after the appropriate sampling
methodology, if any, has been applied for the specific time period.
Notes for discharge measures (eg HBIPS-1, 4, PC-01):
• If the hospital is sampling the HBIPS discharge measures, then the
Sample Size – Non-Medicare Only should be equal or less than the
Initial Patient Population Size – Non-Medicare Only for the set,
stratum, or sub-population.
• If the hospital is not sampling the discharge measures, then the
Sample Size – Non-Medicare Only will equal the Initial Patient
Population Size – Non-Medicare Only for the set, stratum, or subpopulation.
Notes for HBIPS event measures (HBIPS-2 and 3):
• Hospitals may not sample the HBIPS event measures. For these two
measures, the Sample Size – Non-Medicare Only equals the Initial
Patient Population Size – Non-Medicare Only for the set, stratum, or
sub-population.
Suggested Data
Collection
Question:
Format:
Not Applicable
Length: 6
Type: Numeric
Occurs:
Non-stratified Measure Sets:
One Sample Size – Non Medicare Only per hospital’s measure
set (e.g., AMI, HF, PN, and STK).
Stratified Measure Sets:
One Sample Size – Non Medicare Only per measure set
stratum or sub-population the hospital is participating in:
* The PC measure set has three occurrences, one for the
PC v2014A
120
mother sub-population and two for the newborn subpopulations.
* The HBIPS measure set has four occurrences, one for each
age stratum.
Note:
Refer to the appropriate version of the Specifications Manual for
National Quality Inpatient Measures for the number of
occurrences for the CAC, VTE, and SCIP measure sets.
Allowable Values:
Notes for
Abstraction:
Suggested Data
Sources:
0 through 999,999
For Discharge measures (eg. HBIPS-1, 4, PC-01), when Sampling
Frequency = ‘N/A’ because the hospital has five or fewer discharges (both
Medicare and non-Medicare combined) in a quarter and has decided to not
submit patient level data, Sample Size – Non-Medicare Only should equal
zero.
Not Applicable
Additional Notes:
Guidelines for Abstraction:
Inclusion
None
PC v2014A
Exclusion
None
121
Data Element
Name:
Sampling Frequency
Collected For:
HBIPS, PC, Transmission, Patient Population Data File , Used in
transmission of the Hospital Initial Patient Population Data file.
Note:
Refer to the Population and Sampling Specifications section and Hospital
Initial Patient Population Data XML File Layout in the Transmission section
of this manual.
Definition:
Suggested Data
Collection
Question:
Format:
Indicates if the data being transmitted for a hospital has been sampled
(either monthly or quarterly), or represents an entire population for the
specified time period.
Not Applicable
Length: 1
Type: Character
Occurs:
Non-stratified Measure Sets:
One Sample Size – Medicare Only per hospital’s measure set
(e.g., AMI, HF, PN, and STK).
Stratified Measure Sets:
One Sample Size – Medicare Only per measure set stratum or
sub-population the hospital is participating in:
* The PC measure set has three occurrences, one for the
mother sub-population and two for the newborn subpopulations.
* The HBIPS measure set has four occurrences, one for each
age stratum.
Note:
Refer to the appropriate version of the Specifications Manual for
National Quality Inpatient Measures for the number of
occurrences for the CAC, VTE, and SCIP measure sets.
Allowable Values:
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1
Yes, the hospital is sampling data monthly.
2
Yes, the hospital is sampling data quarterly.
3
No, the hospital is not sampling.
4
N/A, submission of patient level data is not required.
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Notes for
Abstraction:
• Sampling Frequency must be consistent across a discharge time
period.
Example:
If the Sampling Frequency for April is monthly, then the Sampling
Frequency for May and June must be monthly.
• For Discharge measures (e.g., HBIPS-1, 4, PC-01): Hospitals with
five or fewer discharges (both Medicare and Non-Medicare
combined) in a quarter are not required to submit patient level data.
• For Event measures (eg., HBIPS-2 and 3): This data element will
always be equal to ‘3’ (No, the hospital is not sampling) for the HBIPS
event measures (HBIPS-2 and 3).
Suggested Data
Sources:
Not Applicable
Additional Notes:
Guidelines for Abstraction:
Inclusion
None
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Exclusion
None
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Data Element
Name:
Sex
Collected For:
All Records
Definition:
Suggested Data
Collection
Question:
Format:
The patient's documented sex on arrival at the hospital.
What is the patient’s sex?
Length: 1
Type: Character
Occurs: 1
Allowable Values:
M = Male
F = Female
U = Unknown
Notes for
Abstraction:
Suggested Data
Sources:
• Collect the documented patient’s sex at admission or the first
documentation after arrival.
• Consider the sex to be unable to be determined and select
“Unknown” if:
◦ The patient refuses to provide their sex.
◦ Documentation is contradictory.
◦ Documentation indicates the patient is a Transexual.
◦ Documentation indicates the patient is a Hermaphrodite.
•
•
•
•
•
•
•
Consultation notes
Emergency department record
History and physical
Face sheet
Progress notes
UB-04 Field Location: 11
Nursing admission notes
Additional Notes:
Guidelines for Abstraction:
Inclusion
• None
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Exclusion
• None
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Data Element
Name:
Spontaneous Rupture of Membranes
Collected For:
PC-01,
Definition:
Suggested Data
Collection
Question:
Format:
Allowable Values:
Documentation that the patient had spontaneous rupture of membranes
(SROM) before medical induction and/or cesarean section.
Is there documentation that the patient had spontaneous rupture of
membranes before medical induction and/or cesarean section?
Length: 1
Type: Alphanumeric
Occurs: 1
Y (Yes) There is documentation that the patient had spontaneous rupture
of membranes before medical induction and/or cesarean section.
N (No) There is no documentation that the patient had spontaneous
rupture of membranes before medical induction and/or cesarean
section OR unable to determine from medical record documentation.
Notes for
Abstraction:
If the patient's spontaneous rupture of membranes is confirmed before
medical induction and/or cesarean section by one of the following methods,
select allowable value "Yes":
•
•
•
•
•
Suggested Data
Sources:
Positive ferning test
Positive nitrazine test
Positive pooling (gross fluid in vagina)
Positive Amnisure® ROM test or equivalent
Patient report of SROM prior to hospital arrival
• History and physical
• Nursing notes
• Physician progress notes
Additional Notes:
Guidelines for Abstraction:
Inclusion
None
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Exclusion
None
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Data Element
Name:
Unique Blinded Case Identifier
Collected For:
All Records , All Records (Used in transmission of anonymous patient-level
data to the Joint Commission)
Definition:
Suggested Data
Collection
Question:
Format:
Allowable Values:
An identifier that is assigned to each patient by the hospital that uniquely
identifies the patient for the episode of care. It is a fictitious identifier used
to differentiate between individual patient records.
What number has been assigned to identify the patient?
Length: 9
Type: Numeric
Occurs: 1
Any valid positive number up to nine digits
• This identifier should not be derived from or related to information
about the patient in such a way that it is possible to identify the
patient via a review or manipulation of the data.
• Since a unique identifier is used for each medical record that is
abstracted for the Joint Commission pilot, hospitals need to link this
tracking identifier to the original patient record. This link will be
important in the event that data quality issues arise and it is
requested that the episode of care data be reviewed or if the patient
is chosen to be included in the data reliability study.
Notes for
Abstraction:
Suggested Data
Sources:
Additional Notes:
Does not apply, determined by the hospital.
Guidelines for Abstraction:
Inclusion
None
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Exclusion
None
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Data Element
Name:
Vendor Tracking Identifier
Collected For:
HBIPS, PC, Transmission, Hospital Clinical Data File
Definition:
An ORYX Vendor® -generated identifier that uniquely identifies this
patient’s stay or episode of care. It is a fictitious identifier generated by the
ORYX Vendor to differentiate between individual patient records in each
hospital.
This identifier cannot be derived from or related to information about the
patient in such a way that it is possible to identify the patient via a review or
manipulation of the data.
Since this identifier is transmitted to The Joint Commission, ORYX Vendors
must be able to link this tracking identifier to the original record (patient) in
the event that data quality issues arise. Any data that require correction
and re-transmission must use the same tracking identifier as that used in
the original transmission or a duplication of data within the Joint
Commission’s database will occur.
This identifier is linked to a patient’s episode of care, not to a specific event
that occurs during the episode of care. The Vendor Tracking ID must be the
same each time data for a unique patient’s episode of care is transmitted;
regardless of whether this is the second or thirty-second record being
transmitted for the patient.
Suggested Data
Collection
Question:
Format:
Allowable Values:
Not applicable, this data element is not data entered.
Length: 100
Type: Character
Occurs: 1
Up to 100 letters, numbers, and/or special characters can be entered.
NOTE: Only the following special characters will be allowed: ~ ! @ # $ %
^ * ( ) _ + { } | : ? ` - = [ ] ; ‘ . , / and space
The identifier cannot be left blank or be the patient’s social security
number, Medicare number, driver license number, medical record
number, account number, or other identifier assigned to the patient
for purposes other than transmission of data to The Joint
Commission. In addition, this identifier cannot be a combination of
data in which one portion of the data directly identifies the patient or
the combination of data identifies the patient.
Notes for
Abstraction:
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For each patient episode of care, the Vendor Tracking ID should match for
each Measure Set that is submitted. For example, if the hospital submits a
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separate XML file for PC, ED, and TOB, the Vendor Tracking ID should be
the same in each XML file.
Suggested Data
Sources:
Unique ORYX Vendor generated identifier
NOTE TO PROGRAMMERS:
• An ORYX Vendor may have its own case identifier. We are not
requesting that ORYX Vendors change their internal processes;
rather, this tracking identifier is needed for transmission of the
hospital clinical data to The Joint Commission.
Additional Notes:
Guidelines for Abstraction:
Inclusion
None
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Exclusion
None
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Missing and Invalid Data
Introduction
Missing data refers to data elements, required for calculating a national hospital quality measure, that have no
values present for one or more episodes of care (EOC) or event records. Invalid data refers to data element values,
required for calculating a national hospital quality measure, that fall outside of the range of allowable values defined
by The Joint Commission for that data element.
Reducing missing and invalid data minimizes the bias to a measure rate, because episodes of care with missing or
invalid data cannot be included in the calculation of the observed measure rate. A measure’s observed rate may not
accurately reflect the patient population, if the excluded EOC and event records differ significantly from the EOCs
and events with no missing data that were included in the measure calculation.
Data Collection and the Unable to be Determined (UTD) Allowable Value
Abstractors must ‘touch’ and provide an answer to every data element that is applicable per the combined skip
logic of all of the measures in a topic. While there is an expectation that all data elements are collected, it is
recognized that in certain situations information may not be available (dates, times, codes, etc.). If, after due
diligence, the abstractor determines that a value is not documented or is not able to determine the answer value,
the abstractor must select “Unable to Determine (UTD)” as the answer. The “UTD” allowable value is used as
follows:
Admission Date, Birthdate, Discharge Date, Event Date, Event Type, ICD-9-CM Principal and Other
Diagnosis Codes, ICD-9-CM Principal and Other Procedure Codes, Psychiatric Care Setting, Psychiatric
Inpatient Days-Medicare Only, Psychiatric Inpatient Days-Non-Medicare Only, Total Leave Days-Medicare
Only, and Total Leave Days-Non-Medicare Only do not have an “UTD” allowable value for transmission to
The Joint Commission. EOC and event records containing “UTD” for any of these data elements are rejected
when submitted to the Joint Commission’s Data Warehouse.
Date, time, and numeric data elements, other than those listed above have an “UTD” allowable value option.
Rate-based proportion algorithms evaluate EOC records to a Measure Category Assignment = “D” or
"E" (failed) depending on the desired direction improvement of the associated measure when a date,
time, or numeric data element containing an allowable value of “UTD” is evaluated. When the direction
of the improvement is an increase in rate, the algorithm will evaluate the EOC records to a Measure
Category Assignment = "D". When the direction of improvement is a decrease in rate, the algorithm will
evaluate the EOC record to a Measure Category Assignment = "E".
Continuous variable and rate-based ratio algorithms evaluate EOC records to a Measure Category
Assignment = “Y” (UTD value exists) when a date, time, or numeric data element containing an
allowable value of “UTD” is evaluated.
The method by which data collection software collects “UTD’ information is determined by each
software vendor; except the software cannot automatically default an “UTD” answer. The decision
to enter an “UTD” for each data element is up to the abstractor, not the software.
There are specific requirements pertaining to the transmission of this value. Refer to the Transmission
section in this manual for more information.
Yes/No data elements: The allowable value “No” incorporates “UTD” into the definition. Refer to the measure
algorithms in which each Yes/No data element is used to determine how the EOC and event records are
treated.
Data elements containing two or more categorical values: The “UTD” value is either classified as a separate
allowable value or included in the same category as “None of the above/Not documented”. Refer to the
measure algorithms in which each categorical data element is used to determine how the EOC record is
treated.
Missing and Invalid Episode of Care (EOC) and Event Data
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The Joint Commission’s Data Warehouse evaluates patient data using the missing, invalid and data integrity edits.
Refer to the Edit Feedback Messages documents located on the Upload/Download page in the HCD section on
PET for Joint Commission, for a complete listing of all critical and informational edits.
Rejected data must be corrected and resubmitted before the transmission deadline in order for it to be accepted by
the Joint Commission’s Data Warehouse.
The majority of general data elements that are missing data cause the EOC and event records to be rejected.
These data elements for Discharge measure include but not limited to Admission Date, Birthdate, Discharge
Date, and ICD-9-CM Principal Diagnosis Codes. For Event measures such general data elements include
but not limited to event-type, event-date, Admission Date, and Birthdate. Refer to the Introduction to the Data
Dictionary in this manual for the complete list of general data elements.
Not all patients have an ICD-9-CM Other Diagnosis Code. Records will be accepted with missing data
for this data element.
Measure-specific data elements that are missing data cause the EOC and event records to be rejected if any
measure algorithm results in a Measure Category Assignment = “X” (missing data). If no measure evaluates
to a category assignment of “X”, the EOC record will be accepted.
General and measure specific data elements that contain invalid data cause the EOC and events record to
be rejected.
Abstraction Software Skip Logic and Missing Data
Skip logic allows hospitals and vendors to minimize abstraction burden by using vendor software edit logic to
bypass abstraction of data elements not utilized in the measure algorithm. However, these bypassed elements also
negatively impact data quality when elements are incorrectly abstracted and subsequent data elements are
bypassed and left blank.
The use of skip logic by hospitals and ORYX vendors is optional and not required by The Joint Commission.
Hospitals should be aware the potential impact of skip logic on data quality and abstraction burden. Vendors and
hospitals utilizing skip logic should closely monitor the accuracy rate of abstracted data elements, particularly data
elements placed higher in the algorithm flow.
Note:
*A missing value occurs when the abstractor does not select an answer for a data element (leaves it blank) or the
software incorrectly transmits a “null” instead of the correct value for a data element. An “UTD” allowable value is not
considered missing data.
Missing, Invalid, UTD Data Summary:
Missing Data
Invalid Data
UTD
No data element value is
present. (blank or “null”)
The data element value falls outside of the
range of defined allowable values.
The allowable value of “UTD” is
present for the data element.
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Population and Sampling Specifications
Introduction
Population
Defining the population is the first step to estimate a hospital’s performance. A population is generally defined as a
collection of patients sharing a common set of universally measured characteristics, such as an ICD-9-CM Principal
Diagnosis or Procedure Code. The Initial Patient Population and diagnosis codes meet this description for the
national quality measures. For the purpose of measuring national quality core measures, the term “Initial Patient
Population” is defined below:
An “Initial Patient Population” refers to all patients (Medicare and non-Medicare) who share a common set of
specified, administratively derived data elements. This may include ICD-9-CM diagnosis codes or other
population characteristics such as age. For example, the population for the HBIPS discharge measures (e.g.,
HBIPS-1, 4, 5, 6, and 7) includes all patients having a principal or secondary psychiatric diagnosis code from
Appendix A, Table 10.1.
Cases identified as being in the Initial Patient Population for the measure set, or strata (e.g., HBIPS), or sampling
group (e.g., PC) are eligible to be sampled. For the definition of the Initial Patient Population(s) for each measure
set, refer to the appropriate Initial Patient Population discussion in the Measure Information section of this manual.
Sampling
Sampling is a process of selecting a representative part of a population in order to estimate the hospital’s
performance, without collecting data for its entire population. Using a statistically valid sample, a hospital can
measure its performance in an effective and efficient manner. Sampling is a particularly useful technique for
performance measures that require primary data collection from a source such as the medical record. Sampling
should not be used unless the hospital has a large number of cases in the Initial Patient Population because a fairly
large number of sample cases are needed to achieve a representative sample of the population. For the purpose of
sampling national quality measures, the terms “sample” and “case​
are defined as below:
The “sample” is the fraction of the population that is selected for further study.
A “case” refers to a single record (or an episode of care [EOC] or event) within the population. For example,
during the first quarter a hospital may have 100 patients who had principal or secondary psychiatric diagnosis
code associated to the HBIPS-1, 4, 5, 6, and 7 measures. The hospital’s Initial Patient Population would
include 100 cases or 100 patient records for these measures during the first quarter.
To obtain statistically valid sample data, the sample size should be carefully determined and the sample cases
should be randomly selected in such a way that the individual cases in the population have an equal chance of
being selected. Only when the sample data truly represent the whole population can the sample-based performance
measure data be meaningful and useful.
Each hospital is ultimately responsible that sampling techniques applied for their hospital adhere to the sampling
requirements outlined in this manual. ORYX® Vendors are responsible for ensuring that the sampling techniques
are applied consistently across their client hospitals.
Sampling is done by national quality inpatient measure set; however, for Perinatal Care (PC), and Hospital-Based
Inpatient Psychiatric Services (HBIPS) are done by strata or sampling group. For measures requiring medical
record abstraction, sampling must be done using available databases that contain all discharges for the
transmission quarter.
Note:
Hospitals are NOT required to sample their data. If sampling offers minimal benefit (i.e., a hospital has 80
cases for the quarter and must select a sample of 76 cases) the hospital may choose to use all cases.
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Order of Data Flow
The sampling methodology defined in the Specifications Manual for National Hospital Inpatient Quality Measures
requires hospitals submitting data for any measure set, except HBIPS, that utilizes the Global Initial Patient
Population to use the associated sampling methodology for all measure sets being submitted. This requirement
includes the PC measure set. Hospitals submitting data for HBIPS are not required to utilize Global sampling
methodology even if they are submitting Global measure sets.
If the hospital is submitting data to both the QIO Clinical Warehouse and the Joint Commission’s Data
Warehouse, use sampling methodology number one.
If the hospital is submitting data to only The Joint Commission:
If the hospital is submitting at least one measure set that uses the Global Initial Patient Population, use
sampling methodology number one.
If the hospital is not submitting any of the measure sets that uses the Global Initial Patient Population,
sample each measure set independently using sampling methodology number two.
If the hospital is submitting HBIPS, sample independently using sampling methodology number two
1. Hospitals Submitting Measure Sets Under the Global Initial Patient Population to Both the QIO Clinical
Warehouse and The Joint Commission’s Data Warehouse
For the submission of the Global Initial Patient Population and associated measure sets (i.e., ED, IMM, TOB, and/or
SUB) the following data flow or process steps should be used to identify the data for all measure sets or stratum
that are transmitted to the Joint Commission’s Data Warehouse, including PC, however excluding HBIPS. These
process steps are:
Identify Global Cases To Be Abstracted (ED, IMM, SUB, TOB)
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Identify the Global Initial Patient Population. The Global Initial Patient Population is used for the ED, IMM,
TOB, and SUB measure sets. This data pull utilizes administrative data such as admission date and
discharge date. This identification process must be completed prior to the application of data integrity filter,
measure exclusions, and the application of sampling methodology. For specific Global Initial Patient
Population definitions, refer to the Global Initial Patient Population discussion in the Measure Information
section of the Specifications Manual for National Hospital Inpatient Quality Measures. This data pull is
completed once for each hospital. This is not performed for each measure set that utilizes the Global
population.
If the hospital is sampling, use the Global Initial Patient Population identified above and pull the sample
of medical records for the ED, IMM, TOB, and/or SUB measure sets using the Sample Size
Requirements defined in the Global Initial Patient Population Information section of the Specifications
Manual for National Hospital Inpatient Quality Measures. Note: This is completed once for each
hospital. This is not performed for each measure set that utilizes the Global population.
Collect or abstract from the identified medical records the general and measure specific data elements that
are needed for the measure set. Run the data through the algorithms for the measure sets under the Global
Initial Patient Population (ED, IMM, SUB and/or TOB). The count of the number of cases used in this step is
collected in the Global Initial Patient Population and Sample Size data elements.
If the hospital is only submitting the measure sets under the Global Initial Patient Population (i.e., ED, IMM,
SUB or TOB), the process is complete.
Identify Cases To Be Abstracted For The Remaining Measure Sets, Strata, and Sub-populations (PC,
AMI, CAC, HF, PN, SCIP, STK, VTE)
Identify the Initial Patient Population for the other measure sets (AMI, HF, PN, STK) strata or sub-populations
(PC, SCIP, CAC, VTE). This data pull utilizes administrative data such as ICD-9-CM diagnosis and
procedure codes, admission date, and birthdate. All ICD-9-CM diagnosis and procedure codes included in
the Initial Patient Population definition must be applied. This identification process must be completed prior to
the application of data integrity filter, measure exclusions, and the application of sampling methodology. For
specific PC measure set definitions, refer to the Initial Patient Population discussion in the Measure
Information section of this manual. For all other measures, refer to the Initial Patient Population discussion in
the Measure Information section of the Specifications Manual for National Hospital Inpatient Quality
Measures. The number of cases in the Initial Patient Population of each measure set, strata, and subpopulation are collected in the appropriate Initial Patient Population Size data elements.
If the hospital is not sampling, collect or abstract from the identified medical records the general and
measure specific data elements that are needed for the measure set(s), strata or sub-populations. The
count of the number of cases used in this step is collected in the Sample Size data elements.
If the hospital is sampling, use the Initial Patient Population (N) identified above and pull the sample of
medical records for the measure set, strata or sub-population using the “Sample Size Requirements” in
the appropriate sampling discussion in the Measure Information section of this manual for PC. For all
other measures, refer to the “Sample Size Requirements” in the appropriate sampling discussion in the
Measure Information section of the Specifications Manual for National Hospital Inpatient Quality
Measures.
Using the Global Initial Patient Population identified above, identify and count the number of cases that are
also in the other Measure Sets (e.g., AMI, HF, PN, and STK), strata, or sub-populations (e.g., PC, SCIP,
CAC, or VTE) Initial Patient Population(s).Determine the number of cases that need to be sampled (n) from
the cases in the other measure set(s) or stratum(s) Initial Patient Population (N). Use the “Sample Size
Requirements” in the appropriate sampling discussion in the Measure Information section of this manual for
PC and HBIPS. For all other measures, refer to the “Sample Size Requirements” in the appropriate sampling
discussion in the Measure Information section of the Specifications Manual for National Hospital Inpatient
Quality Measures.
If there are enough Initial Patient Population cases in the Global sample pull to meet the specific initial
patient population and sampling requirements for the measure set(s), strata, or sub-populations, then no
additional sampling is required. Collect or abstract from the identified medical records the general and
measure specific data elements that are needed for the measure set(s), strata, or sub-populations. The
count of the number of cases used in this step is collected in the Sample Size data elements.
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If there are not enough Initial Patient Population cases in the Global sample pull to meet the specific
initial patient population and sampling requirements for the measure set(s), strata or sub-populations,
complete the sample by pulling additional cases from the other measure set(s), strata or subpopulations Initial Patient Population(s). Use the “Sample Size Requirements” in the appropriate
Sampling discussion in the Measure Information section of this manual for PC. For all other measures,
refer to the “Sample Size Requirements” in the appropriate sampling discussion in the Measure
Information section of the Specifications Manual for National Hospital Inpatient Quality Measures.
Collect or abstract from the identified medical records the general and measure specific data elements
that are needed for the measure set(s). The count of the number of cases used in this step is collected
in the Sample Size data elements.
Example: For 4th quarter the Global Initial Patient Population is 1550, 100 for AMI, 250 for PC-Mothers, and 300 for
PC-Newborns with Breast Feeding. If the hospital is sampling, the minimum number of cases that would be
required to be sampled would be 306 for Global (ED, IMM, TOB, and/or SUB), 78 for AMI, 75 for PC-Mothers, and
37 for PC-Newborns with Breast Feeding.
The hospital would pull 306 cases for the Global sample. From those 306 cases the hospital would determine how
many of those cases were also AMI, PC-Mothers, PC-Newborns with Breast Feeding cases that met the initial
patient population criteria for the specific measure set. If there are enough AMI, PC-Mothers, and PC-Newborns
with Breast Feeding cases in the Global sample pull to meet the minimum sampling requirements for those
measure sets, then no additional sample pull is needed.
If there are not enough cases in the Global sample pull to meet the other measure sets minimum sampling
requirements then an additional sample pull is needed. For example, from the Global sample pull there were 72
AMI, 20 PC-Mothers, and 5 PC-Newborns with Breast Feeding cases identified that met the initial population
criteria for the specific measure set. As the minimum sample requirements for AMI is 78, 6 additional AMI cases
would need to be pulled from the AMI Initial Patient Population. As the minimum sample requirements for PCMothers is 75, an additional 55 cases would need to be pulled from the PC-Mothers Initial Patient Population. As
the minimum sample requirements for PC-Newborns with Breast Feeding is 37, an additional 32 cases would need
to be pulled from the PC-Newborns with Breast Feeding Initial Patient Population.
Note: PC-Newborns with BSI are not eligible for sampling and will use the entire Initial Patient sampling group, as
appropriate, for reporting.
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2. Hospitals Submitting HBIPS or Hospitals Not Submitting the Measure Sets Under the Global Initial
Patient Population to The Joint Commission Only
For hospitals submitting HBIPS or hospitals not submitting the measure sets under the Global Initial Patient
Population to The Joint Commission only, an independent sample pull should be used to pull the sample for the
applicable measure sets (i.e., PC, HBIPS, AMI, CAC, HF, PN, SCIP, STK and VTE).
Each measure set, stratum, or sub-population has a unique definition of Initial Patient Population and sample size
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requirement. However, the same data flow or process steps can be used to identify the data that is transmitted to
the Joint Commission's Data Warehouse. These process steps are:
First, identify the Initial Patient Population for the measure set. An Initial Patient Population is defined for each
measure set, stratum, and sampling group and the count is collected in the Initial Patient Population Size data
elements.
All data elements in the appropriate Initial Patient Population definition, including ICD-9-CM Diagnosis Codes when
appropriate, must be applied. This identification process must be completed prior to the application of data
integrity filter, measure exclusions, and the application of sampling methodology.
For specific measure set, stratum, and sampling group definitions, refers to the appropriate Initial Patient
Population discussion in the Measure Information section of this manual for PC and HBIPS. For all other measures,
refer to the “Sample Size Requirements” in the appropriate sampling discussion in the Measure Information section
of the Specifications Manual for National Hospital Inpatient Quality Measures.
Second, if the measure allows sampling and the hospital is sampling, use the Initial Patient Population
identified above and pull the sample of medical records for each measure set, stratum, or sub-population
using the Sample Size Requirements defined in the appropriate Measure Information section of this manual
for PC and HBIPS. For all other measures, refer to the “Sample Size Requirements” in the appropriate
sampling discussion in the Measure Information section of the Specifications Manual for National Hospital
Inpatient Quality Measures.
Third, collect or abstract from the identified medical records the general and measure specific data elements
that are needed for the measure set. The count of the number of cases used in this step is collected in the
Sample Size data elements.
If the hospital is not sampling, use the medical records identified in the first data pull.
If the measure allows sampling and the hospital is sampling, use the medical records from the cases in
the identified sample.
Sample Size Requirements
Hospitals that choose to sample have the option of sampling quarterly or sampling monthly. The sample size
requirements for each of these options are described in turn. Hospitals need to use the next highest whole number
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when determining their required sample size. See below for rounding examples. For each measure sets sample
size requirements, refer to the appropriate measure set’s Measure Information section in this manual.
Hospitals selecting sample cases for measure sets that are not stratified must ensure that it's Initial Patient
Population(s) and sample size(s) meet the conditions stated in the measure set’s Sample Size Requirements.
For hospitals selecting sample cases for stratified measure sets or measure sets with sampling groups (e.g.,
HBIPS and PC), a modified sampling procedure is required. Hospitals selecting samples cases for these sets
must ensure that each individual stratum's Population/sampling group and sample size meets the conditions stated
in the measure set's Sample Size Requirements.
Regardless of the option used, hospital samples must be monitored to ensure that sampling procedures
consistently produce statistically valid and useful data. Due to exclusions and contraindications, hospitals selecting
sample cases MUST submit AT LEAST the minimum required sample size. The sample size tables for each option
automatically build the number of cases needed to obtain the required sample sizes.
Hospitals that sample, should sample by their Joint Commission’s Health Care Organization Identifier. All data that
are sampled must be transmitted to The Joint Commission.
A hospital may choose to use a larger sample size than is required. Hospitals whose Initial Patient
Population size is less than the minimum number of cases per quarter/month for the stratum cannot
sample. For the Discharge measures (e.g., HBIPS-1, 4, 5, 6, 7, and PC), hospitals that have five or fewer
discharges (both Medicare and non-Medicare combined) are not required to submit patient level data to
the Joint Commission's Data Warehouse. For the event measures (e.g., HBIPS-2, and 3), hospitals must
submit patient level data to The Joint Commission regardless of the number of discharges or events
they have each quarter. Refer to the Sample Size Requirement tables provided in the Measure
Information section to determine the minimum number of cases that need to be sampled for each HBIPS
measure set.
Quarterly Sampling Examples
Quarterly Example 1: Measure set is Not Stratified
Hospitals selecting sample cases for measure set ABC, which is not stratified, must ensure that its Initial Patient
Population and quarterly sample size meet the following conditions:
Quarterly Sample Size
Based on Initial Patient Population for the ABC Measure set
Hospital's Measures
Average Quarterly
Initial Patient
Population
“N”
Minimum Required
Sample Size
“n”
≥ 1551
311
391 - 1550
20% of the Initial Patient Population
78-390
78
6 - 77
No sampling; 100% of the Initial Patient Population is required
0-5
Submission of patient level data is not required; if submission occurs, 100% Initial Patient
Population required.
Examples
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A hospital’s ABC Initial Patient Population is 77 patients during the first quarter. Using the above table, no
sampling is allowed – 100% of the population is required.
A hospital’s ABC Initial Patient Population is 100 patients during the second quarter. Using the above table,
the required sample size is seen to be a minimum of 78 ABC patients for this quarter.
A hospital’s ABC Initial Patient Population is 401 patients during the third quarter. Using the above table, the
required sample size is seen to be 20% of the population, or 81 cases for the quarter (twenty percent of 401
equals 80.2 rounded to the next whole number = 81).
A hospital’s ABC Initial Patient Population is 5 patients during the first quarters. Using the above table,
submission of patient level data is not required. If the hospital chooses to submit patient level data, the
required quarterly sample size would be 100% of the patient population or 5 cases for the quarter.
Quarterly Example 2: Measure set is stratified
For hospitals selecting sample cases for measure set XYZ which contains 8 strata, a modified sampling procedure
is required. Hospitals selecting sample cases for these sets must ensure that each individual stratum’s population
and quarterly sample size meets the following conditions.
Select within each of the seven individual measure stratum and the 8th XYZ stratum.
Quarterly Sample Size
Based on Initial Patient Population for the XYZ measure set
Hospital's Measures
Average Quarterly Stratum
Initial Patient Population
“N”
Minimum Required
Stratum Sample Size
“n”
≥ 471
48
161 - 470
10% of the Initial Patient Population
16 - 160
16
< 16
No sampling; 100% of the Initial Patient Population is required
Example
The XYZ Initial Patient Population sizes for a hospital is 5, 50, 15, 140, 35, 201, 3, and 481 patients
respectively per stratum for the quarter. Since the total Initial Patient Population for XYZ is 930, the hospital
must submit patient level data. The required quarterly sample sizes for each stratum would be 5, 16, 15, 16,
16, 21, 3, and 48.
The 1st, 3rd, and 7th strata are less than the minimum required quarterly sample size, so 100% of each
of these strata are sampled.
The 2nd, 4th, and 5th strata each require 16 cases to be sampled.
The 6th stratum has 201 patients per quarter, which requires a 10% sample size, or 21 cases (twenty
percent of 201 equals 20.1 rounded to the next whole number = 21).
The 8th stratum is more than the maximum required quarterly sample size, so this stratum requires 48
cases to be sampled.
The XYZ Initial Patient Population sizes for a hospital 1, 1, 0, 0, 1, 0, 1, and 1 patients respectively per stratum
for the quarter. Since the total Initial Patient Population for XYZ is 5, the hospital may choose to not submit
patient level data. If the hospital chooses to submit patient level data, the required quarterly sample sizes for
each stratum would be 1, 1, 0, 0, 1, 0, 1, and 1.
The 1st, 2nd, 5th, 7th, and 8th strata are less than the minimum required quarterly sample size, so 100% of
each of these strata are sampled.
There is no data to sample for the 3rd, 4th, and 6th strata.
Quarterly Example 3: Measure set has sub-populations
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For hospitals selecting sample cases for measure set DEF which contains 3 independent sub-populations a
modified sampling procedure is required. The three sub-populations must be sampled independently from each
other.
1-Hospitals selecting sample cases for sub-population 1 must ensure that the Initial Patient Population and sample
size for the sub-population 1 meet the following conditions:
Quarterly Sample Size
Based on Initial Patient Population for the Patient Sub-Population 1
Hospital's Measures
Average Quarterly
Initial Patient SubPopulation Size
“N”
Minimum Required
Sub-Population Sample Size
“n”
≥ 896
180
226 - 895
20% of the Initial Patient Population Size
45 - 225
45
< 45
No sampling; 100% of the Initial Patient Population required
0 - 45
Submission of patient level data is not required; if submission occurs, 100% Initial
Patient Population required.
2 - Hospitals selecting sample cases for sub-population 2 must ensure that the initial Patient Population and
sample size for sub-population 2 meet the following conditions:
Quarterly Sample Size
Based on Initial Patient Population Size for the
Patient Sub-Population 2
Hospital's Measures
Average Quarterly
Initial Patient Sub-Population Size
“N”
Minimum Required
Sub-Population Sample Size
“n”
≥ 1796
360
451 - 1795
20% of the Initial Patient Population
90 - 450
90
< 90
No sampling; 100% of the Initial Patient Population required
3 - Sub-population 3 is not eligible for sampling and will use the entire Initial Patient Population for reporting.
Example
1. Quarterly sampling for sub-population 1:
A hospital's sub-population 1 is 752 during the second quarter. Using the quarterly sampling table for subpopulation 1, the sample size required is 20% of this sub-population, or 151 cases for the quarter (twenty
percent of 752 equals 150.4 rounded up to the next whole number = 151).
A hospital's sub-population 1 is 5 during the first quarter. Using the quarterly sampling table for sub-population
1, the sample size is less than the minimum required quarterly sample size, so 100% of this sub-population is
sampled.
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A hospital's sub-population 1 is 99 during the third quarter. The required quarterly sample is 45 cases.
2. Quarterly sampling for sub-population 2:
A hospital's sub-population 2 is 511 during the second quarter. Using the quarterly sampling table for subpopulation 2, the sample size required is 20% of this sub-population, or 103 cases for the quarter (twenty
percent of 511 equals 102.2 rounded up to the next whole number = 103).
A hospital's sub-population 2 is 3 during the first quarter. Using the quarterly sampling table for sub-population
2, the sample size is less than the minimum required quarterly sample size, so 100% of this sub-population is
sampled.
A hospital's sub-population 2 is 300 during the third quarter. The required quarterly sample is 90 cases.
3. Quarterly sampling for sub-population 3:
Sub-population is not eligible for sampling and will use the entire initial Patient Sub-Population for reporting.
Quarterly Example 4: Measure set has Sampling Groups
For hospitals selecting sample cases for measure set HGI which contains 3 independent sampling groups a
modified sampling procedure is required. The three sampling groups are sampled independently from each other.
A patient falls into multiple sampling groups but may not actually be sampled for all the groups for chich the patient
is eligible.
1-Hospitals selecting sample cases for sampling group 1 must ensure that the Initial Patient Population and sample
size for the sampling group 1 meet the following conditions:
Quarterly Sample Size
Based on Initial Patient Population Size for the
Patient Sampling Group 1
Hospital's Measures
Average Quarterly
Initial Patient
Sampling Group Size
“N”
Minimum Required
Sampling Group Sample Size
“n”
≥ 801
161
201 - 800
20% of the Initial Patient Population Size
40 - 200
40
< 40
No sampling; 100% Initial Patient Population required
2 - Hospitals selecting sample cases for sampling group 2 must ensure that the initial Patient Population and
sample size for the sampling group 2 meet the following conditions:
Quarterly Sample Size
Based on Initial Patient Population Size for the
Patient Sampling Group 2
Hospital's Measures
Average Quarterly
Initial Patient
Sampling Group Size
“N”
Minimum Required
Sampling Group Sample Size
“n”
≥ 2001
401
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501 - 2000
20% of the Initial Patient Population
100 - 500
100
< 100
No sampling; 100% Initial Patient Population required
3 - Hospitals selecting sample cases for sampling group 3 must ensure that the Initial Patient Population and
sample size for the sampling group 3 meet the following conditions:
Quarterly Sample Size
Based on Initial Patient Population Size for the
Patient Sampling Group 3
Hospital's Measures
Average Quarterly
Initial Patient
Sampling Group Size
“N”
Minimum Required
Sampling Group Sample Size
“n”
≥ 2001
401
501 - 2000
20% of the Initial Patient Population
100 - 500
100
< 100
No sampling; 100% Initial Patient Population required
Example
1. A Hospital's sampling group 1 size 347 during the second quarter. The required sample size is 20% of the
patient population or 70 cases for the quarter (twenty percent of 347 equals 69.4 rounded up to the next
highest whole number is 70.)
2. A Hospital's sampling group 2 size is 250 patients during the second quarter. The required sample size is
seen to be 100 patients for this quarter.
3. A Hospital's sampling group 3 size is 700 patients during the second quarter. The required sample size is
seen to be 140 patients for this quarter.
Monthly Sampling Examples
Monthly Example 1: Measure set is Not Stratified
Hospitals selecting sample cases for ABC measure set must ensure that its Initial Patient Population and effective
monthly sample size meet the following conditions:
Monthly Sample Size
Based on Initial Patient Population for the ABC measure set
Hospital's Measures
Average Monthly
Initial Patient Population
“N”
Minimum Required
Sample Size
“n”
≥ 516
104
131 – 515
20% of the Initial Patient Population
26 – 130
26
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< 26
No sampling; 100% of the Initial Patient Population is required
Examples
A hospital’s ABC Initial Patient Population is 25 patients during January. Using the above table, no sampling
is allowed – 100% of the population is required.
A hospital’s ABC Initial Patient Population is 130 patients during February. Using the above table, the
required sample size is seen to be a minimum of 26 ABC patients for this month.
A hospital’s ABC Initial Patient Population is 301 patients during March. Using the above table, the required
sample size is seen to be 20% of the population, or 61 cases for the month (twenty percent of 301 equals =
60.2 rounded to the next whole number = 61.
A hospital’s ABC Initial Patient Population is 516 patients during April. Using the above table, the required
sample size is seen to be a minimum of 104 ABC patients for this month.
Monthly Example 2: Measure set is Stratified
For hospitals selecting sample cases for the XYZ measure set, a modified sampling procedure is required.
Hospitals selecting sample cases for this set must ensure that each individual strata population and effective
monthly sample size meets the following conditions:
Select within each of the seven individual measure stratum and the 8th XYZ stratum.
Monthly Sample Size
Based on Initial Patient Population for the XYZ measure set
Hospital's Measures
Average Monthly Stratum
Initial Patient Population
“N”
Minimum Required
Stratum Sample Size
“n”
≥ 151
16
61 - 150
10% of the Initial Patient Population
6 - 60
6
<6
No sampling; 100% of the Initial Patient Population is required
Example
The XYZ Initial Patient Population sizes for a hospital is 5, 50, 15, 141, 35, 201, 3, and 481 patients
respectively in June. The required monthly sample sizes would be 5, 6, 6, 15, 6, 16, 3, and 16.
The 1st and 7th strata are less than the minimum required monthly sample size, so 100% of each of
these strata are sampled.
The 2nd, 3rd, and 5th strata each require 6 cases to be sampled.
The 4th stratum has 141 patients per month, which requires a 10% sample size, or 15 cases (twenty
percent of 141 equals 14.1 rounded to the next whole number = 15).
The 6th and 8th strata are each more than the maximum required monthly sample size, so this stratum
requires 16 cases to be sampled.
Monthly Example 3: Measure set has sub-populations
For hospitals selecting sample cases for measure set DEF which contains 3 independent sub-populations a
modified sampling procedure is required. The three sub-populations must be sampled independently from each
other.
1 - Hospitals selecting sample cases for sub-population 1 must ensure that the Initial Patient Population and sample
size for sub-population and sample size for sub-population 1 meet the followind conditions:
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Monthly Sample Size
Based on Initial Patient Population Size for the
Patient Sub-Population 1
Hospital's Measures
Average Monthly
Initial Patient
Sub-Population Size
“N”
Minimum Required
Sub-Population Sample Size
“n”
≥ 296
60
76 - 295
20% of the Initial Patient Population
15 - 75
15
< 15
No sampling; 100% of the Initial Patient Population is required
2 - Hospitals selecting sample cases for sub=population 2 must ensure that the Initial Patient Population and
sample size for sub-population and sample size for sub-population 2 meet the following conditions:
Monthly Sample Size
Based on Initial Patient Population Size for the
Patient Sub-Population 2
Hospital's Measures
Average Monthly
Initial Patient
Sub-Population Size
“N”
Minimum Required
Sub-Population Sample Size
“n”
≥ 596
120
151 - 595
20% of the Initial Patient Population
30 - 150
30
< 30
No sampling; 100% of the Initial Patient Population is required
3 - Sub-population 3 is not eligible for sampling and will use the entire Initial Patient Sub-Population for reporting.
Example
1. Monthly sampling for sub-population 1:
A hospital's sub-population 1 is 81 during March. Using the monthly sampling table for sub-population 1, the
sample size required is 20% of this sub-population, or 17 cases for the month (twenty percent of 81 equals
16.2 rounded up to the next whole number = 17).
A hospital's sub-population 1 is 5 during February. Using the monthly sampling table for sub-population 1, the
sample size is less than the minimum required monthly sample size, so 100% of this sub-population is
sampled.
A hospital's sub-population 1 is 45 during January. The required monthly sample is 15 cases.
2. Monthly sampling for sub-population 2:
A hospital's sub-population is 387 during March. Using the monthly sampling table for sub-population 2, the
sample size required is 20% of this sub-population, or 78 cases for the month (twenty percent of 387 equals
77.4 rounded up to the next whole number = 78).
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A hospital's sub-population 2 is 3 during February. Using the monthly sampling table for sub-population 2, the
sample size is less than the minimum required monthly sample size, so 100% of this sub-population is
sampled.
A hospital's sub-population 2 is 47 during January. The required monthly sample is 30 cases.
3. Monthly sampling for sub-population 3:
Sub-population 3 is not eligible for sampling and will use the entire initial Patient Sub-Population for
reporting.
Monthly Example 4: Measure set has Sampling Groups
1 - Hospitals selecting sample cases for sampling group 1 must ensure that the Initial Patient Population and
sample size for the sampling group 1 meet the following conditions:
Monthly Sample Size
Based on Initial Patient Population Size for the
Patient Sampling Group 1
Hospital's Measures
Average Monthly
Initial Patient
Sampling Group Size
“N”
Minimum Required
Sampling Group Sample Size
“n”
≥ 201
41
51 - 200
20% of the Initial Patient Population Size
10 - 50
10
< 50
No sampling; 100% Initial Patient Population required
2 - Hospitals selecting sample cases for sampling group 2 must ensure that the initial Patient Population and
sample size for the sampling group 2 meet the following conditions:
Monthly Sample Size
Based on Initial Patient Population Size for the
Patient Sampling Group 2
Hospital's Measures
Average Monthly
Initial Patient
Sampling Group Size
“N”
Minimum Required
Sampling Group Sample Size
“n”
≥ 501
101
126 - 500
20% of the Initial Patient Population
25 - 125
25
< 25
No sampling; 100% Initial Patient Population required
3 - Hospitals selecting sample cases for sampling group 3 must ensure that the Initial Patient Population and
sample size for the sampling group 3 meet the following conditions:
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Monthly Sample Size
Based on Initial Patient Population Size for the
Patient Sampling Group 3
Hospital's Measures
Average Monthly
Initial Patient
Sampling Group Size
“N”
Minimum Required
Sampling Group Sample Size
“n”
≥ 501
101
126 - 500
20% of the Initial Patient Population
25 - 125
25
< 25
No sampling; 100% Initial Patient Population required
Example
1. Monthly sampling for sampling group 1:
A hospital's sampling group 1 is 81 during March. Using the monthly sampling table for sampling group 1, the
sample size required is 20% of this sampling group, or 17 cases for the month (twenty percent of 81 equals
16.2 rounded up to the next whole number = 17).
A hospital's sampling group 1 is 5 during February. Using the monthly sampling table for sub-population 1, the
sample size is less than the minimum required monthly sample size, so 100% of this sampling group is
sampled.
A hospital's sampling group 1 is 45 during January. The required monthly sample is 10 cases.
2. Monthly sampling for sampling group 2:
A hospital's sampling group is 2 is 387 during March. Using the monthly sampling table for sampling group 2,
the sample size required is 20% of this sampling group, or 78 cases for the month (twenty percent of 387
equals 77.4 rounded up to the next whole number = 78).
A hospital's sampling group 2 is 3 during February. Using the monthly sampling table for sampling group 2,
the sample size is less than the minimum required monthly sample size, so 100% of this sampling group is
sampled.
A hospital's sampling group 2 is 47 during January. The required monthly sample is 25 cases.
3. Monthly sampling for sampling group 3:
A hospital's sampling group 3 is 125 during January. The required monthly sample is 25 cases.
Sampling Approaches
As previously stated in this section, hospitals have the option to sample from their population, or submit their entire
population. Hospitals that choose to sample must ensure that the sampled data represent their Initial Patient
Population by using either the simple random sampling or systematic random sampling methods and that the
sampling techniques are applied consistently within a quarter. For example, monthly samples for a measure set,
stratum, or sampling group must use consistent sampling techniques across the quarterly submission period.
Simple random sampling - selecting a sample size (n) from a population of size (N) in such a way that every
case has the same chance of being selected.
Systematic random sampling - selecting every kth record from a population of size N in such a way that a
sample size of n is obtained, where k ≤ N/n. The first sample record (i.e., the starting point) must be randomly
selected before taking every kth record. This is a two-step process: a) Randomly select the starting point by
choosing a number between one and k using a table of random numbers or a computer-generated random
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number; and a) Then select every kth record thereafter until the selection of the sample size is completed.
Each hospital is ultimately responsible that sampling techniques applied for their hospital adhere to the sampling
requirements outlined in this manual. ORYX Vendors are responsible for ensuring that the sampling techniques are
applied consistently across their client hospitals.
Sampling Approach Examples
For a hospital with an Initial Patient Population size of 350 ABC measure set discharges per quarter, the sample
size would be 78. To select a random sample of 78 ABC patients:
Simple random sampling:
1. Generate random numbers for individual ABC patient records from a random number function using a
statistical software package or computer programming language.
2. Sort data by the random numbers either in an increasing or decreasing order.
3. Select the first 78 ABC patient records as the random sample.
Systematic random sampling:
1. In this example, the hospital’s Initial Patient Population size= 350 and the sample size = 78. Divide the
Initial Patient Population size by the sample size and take the quotient (i.e., the integer portion) as the
sampling interval k. The sampling interval k = 350/78 = 4.5. Thus, every 4th ABC patient record will be
selected from the Initial Patient Population until 78 cases are selected.
2. To ensure that each ABC patient has an equal chance of being selected, the “starting point” must be
randomly determined before selecting every 4th ABC patient record. This can be done using a
computer random number generator or a random number table to randomly choose a number between
1 and 4 as the starting point.
Transmission of Initial Patient Population and Sample Data Elements
The Joint Commission requires transmission of Initial Patient Population and sample count data. Transmission of
Initial Patient Population and sample count data elements are used to assist in evaluating completeness of
submission in accordance with The Joint Commission sampling requirements.
The Initial Patient Population Size refers to all patients (Medicare and non-Medicare) who share common payment
sources which can be identified by utilizing administrative data such as the UB-04. All ICD-9-CM diagnosis and
procedure codes included in the appropriate Initial Patient Population definition must be applied. This identification
process must be completed prior to the application of data integrity filter, measure exclusions, and the application
of sampling methodology. For specific measure set and strata definitions, refer to the appropriate Initial Patient
Population discussion in the Measure Information section of this manual.
The Initial Patient Population and sample data elements are:
ICD Population Size *
Initial Patient Population Size – Medicare Only **
Initial Patient Population Size – Non-Medicare Only **
Sample *
Sampling Frequency **
Sample Size – Medicare Only **
Sample Size – Non-Medicare Only **
Sample indicates whether or not the hospital has sampled data for the specified time period. Sampling Frequency
indicates if the hospital has sampled using the monthly or quarterly methodology, or whether the entire population
was used for the specified time period or the hospital had five or fewer discharges for the discharge quarter and
did not submit patient level data.
Initial Patient Population Size – Medicare Only includes all patients that are billed under Medicare or Title 18.
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Medicare can be listed as a primary, secondary, tertiary or lower on the list of payment sources for the patient. In
addition, patients who are participating as a member of a Medicare HMO/Medicare Advantage are included in the
Medicare counts, e.g., Medicare Blue, Humana gold, Secure Horizons, AARP, Coventry Advantra, etc.
* Transmitted in the aggregate data file. Refer to the ORYX Technical Implementation Guide for more information.
** Transmitted in the Hospital Initial Patient Population data file. Refer to the Hospital Initial Patient Population
Data XML File Layout in the Transmission section of this manual.
Initial Patient Population and Sample Size Examples
Example 1 – Hospital does not sample
A hospital uses the Initial Patient Population(s) for the ABC measure set to identify 120 cases in the ABC Initial
Patient Population during the second quarter. The hospital does not sample the ABC measure set, so data for all
120 cases are collected and used to calculate the hospital’s rate for each ABC measure. 40 of the 120 cases in the
ABC Initial Patient Population are Medicare patients.
Note: Sampling Frequency = 3 (not sampling) is the only valid value for HBIPS event measures (HBIPS-2 and 3).
The breakdown of data by month and Medicare / Non-Medicare is:
April May June Total
Initial Patient Population – Medicare patients
10
15
15
40
Initial Patient Population – Non-Medicare patients
20
30
30
80
Total Initial Patient Population Size
30
45
45
120
Sample Size – Medicare patients
10
15
15
40
Sample Size – Non-Medicare patients
20
30
30
80
Total Sample Size
30
45
45
120
The following is transmitted for each month in the quarter:
April May June
ICD Population Size (Initial Patient Population Size – Medicare Only + Initial Patient
Population Size – Non-Medicare Only)
30
45
45
Initial Patient Population Size – Medicare Only
10
15
15
Initial Patient Population Size – Non-Medicare Only
20
30
30
Sample
N
N
N
Sampling Frequency (3 = not sampling)
3
3
3
Sample Size – Medicare Only
10
15
15
Sample Size – Non-Medicare Only
20
30
30
Example 2 – Hospital samples monthly
A hospital uses the Initial Patient Population(s) for the ABC measure set to identify 120 cases in the ABC Initial
Patient Population during the second quarter. From these 120 cases, the hospital uses the monthly sample size
requirements and randomly selects a sample of 26 cases for each month. Data for these 26 cases are collected
and used to calculate the hospital’s rate for each ABC measure. 40 of the 120 cases in the ABC Initial Patient
Population are Medicare patients and 24 of these cases were included in the sample.
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Note: Sampling Frequency = 1 (sampling data monthly) is not valid for HBIPS event measures (HBIPS-2 and 3).
The breakdown of data by month and Medicare / Non-Medicare is:
April May June Total
Initial Patient Population – Medicare patients
10
15
15
40
Initial Patient Population – Non-Medicare patients
20
30
30
80
Total Initial Patient Population Size
30
45
45
120
Sample Size – Medicare patients
8
9
7
24
Sample Size – Non-Medicare patients
18
17
19
54
Total Sample Size
26
26
26
78
The following is transmitted for each month in the quarter:
April May June
ICD Population Size (Initial Patient Population Size – Medicare Only + Initial Patient
Population Size – Non-Medicare Only)
30
45
45
Initial Patient Population Size – Medicare Only
10
15
15
Initial Patient Population Size – Non-Medicare Only
20
30
30
Sample
Y
Y
Y
Sampling Frequency (1 = sampling data monthly)
1
1
1
Sample Size – Medicare Only
8
9
7
Sample Size – Non-Medicare Only
18
17
19
Example 3 – Hospital samples quarterly
A hospital uses the Initial Patient Population(s) for the ABC measure set to identify 120 cases in the ABC Initial
Patient Population during the second quarter. From these 120 cases, the hospital uses the quarterly sample size
requirements and randomly selects a sample of 78 cases. Data for these 78 cases are collected and are then used
to calculate the hospital’s rate for each ABC measure. 40 of the 120 cases in the ABC Initial Patient Population are
Medicare patients and 20 of these cases were included in the sample.
Note: Sampling Frequency = 2 (sampling data quarterly) is not valid for HBIPS event measures (HBIPS-2 and 3).
The breakdown of data by month and Medicare / Non-Medicare is:
April May June Total
Initial Patient Population – Medicare patients
10
15
15
40
Initial Patient Population – Non-Medicare patients
20
30
30
80
Total Initial Patient Population Size
30
45
45
120
Sample Size – Medicare patients
5
10
5
20
Sample Size – Non-Medicare patients
10
20
28
58
Total Sample Size
15
30
33
78
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The following is transmitted for each month in the quarter:
April May June
ICD Population Size (Initial Patient Population Size – Medicare Only + Initial Patient
Population Size – Non-Medicare Only)
30
45
45
Initial Patient Population Size – Medicare Only
10
15
15
Initial Patient Population Size – Non-Medicare Only
20
30
30
Sample
Y
Y
Y
Sampling Frequency (2 = sampling data quarterly)
2
2
2
Sample Size – Medicare Only
5
10
5
Sample Size – Non-Medicare Only
10
20
28
Example 4 – Hospital has five or fewer discharges and chooses not to submit patient level data
Note: This example is only valid for the HBIPS Discharge measures (HBIPS-1, 4, 5, 6, 7, and 8). This is not valid for
the HBIPS Event measures (HBIPS-2 and 3) since all data must be submitted for these measures regardless of the
number of discharges or events that occur during the quarter.
A hospital uses the Initial Patient Population(s) for the ABC measure set to identify 5 cases in the ABC Initial
Patient Population for the entire measure set during the second quarter. Since the total Initial Patient Population for
ABC is 5, the hospital chooses to not submit patient level data.
Note: Sampling Frequency = 4 (N/A, submission of patient level data is not required) is not valid for HBIPS event
measures (HBIPS-2 and 3).
The breakdown of data by month and Medicare / Non-Medicare is:
April May June Total
Initial Patient Population – Medicare patients
1
0
2
3
Initial Patient Population – Non-Medicare patients
0
1
1
2
Total Initial Patient Population Size
1
1
3
5
Sample Size – Medicare patients
0
0
0
0
Sample Size – Non-Medicare patients
0
0
0
0
Total Sample Size
0
0
0
0
The following is transmitted for each month in the quarter:
April May June
ICD Population Size (Initial Patient Population Size – Medicare Only + Initial Patient
Population Size – Non-Medicare Only)
1
1
3
Initial Patient Population Size – Medicare Only
1
0
2
Initial Patient Population Size – Non-Medicare Only
0
1
1
Sample (clinical XML file)
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N/A
Sample (Joint Commission's HCO-level file)
N
N
N
Sampling Frequency (2 = sampling data quarterly)
4
4
4
149
Sample Size – Medicare Only
0
0
0
Sample Size – Non-Medicare Only
0
0
0
Example 5 – Hospital has five or fewer discharges and chooses to submit patient level data
Note: This example is only valid for the HBIPS Discharge measures (HBIPS-1, 4, 5, 6, 7, and 8). This is not valid for
the HBIPS Event measures (HBIPS-2 and 3) since all data must be submitted for these measures regardless of the
number of discharges or events that occur during the quarter.
A hospital uses the Initial Patient Population(s) for the ABC measure set to identify 5 cases in the ABC Initial
Patient Population for the entire measure set during the second quarter. Even though the total Initial Patient
Population for ABC is 5, the hospital chooses to submit patient level data.
Note: Sampling Frequency = 4 (N/A, submission of patient level data is not required) is not valid for HBIPS event
measures (e.g., HBIPS-2 and 3).
The breakdown of data by month and Medicare / Non-Medicare is:
April May June Total
Initial Patient Population – Medicare patients
1
0
2
3
Initial Patient Population – Non-Medicare patients
0
1
1
2
Total Initial Patient Population Size
1
1
3
5
Sample Size – Medicare patients
1
0
2
3
Sample Size – Non-Medicare patients
0
1
1
2
Total Sample Size
1
1
3
5
The following is transmitted for each month in the quarter:
April May June
ICD Population Size (Initial Patient Population Size – Medicare Only + Initial Patient
Population Size – Non-Medicare Only)
1
1
3
Initial Patient Population Size – Medicare Only
1
0
2
Initial Patient Population Size – Non-Medicare Only
0
1
1
Sample
N
N
N
Sampling Frequency (2 = sampling data quarterly)
3
3
3
Sample Size – Medicare Only
1
0
2
Sample Size – Non-Medicare Only
0
1
1
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The Joint Commission National Quality Core
Measures
Data Transmission
Introduction
This section of the manual is provided to highlight the unique data transmission specifications for The Joint
Commission national quality core measure data.
This section is divided into four parts: National Quality Core Measure Data Transmission, Guidelines for
Submission of Data, Transmission Alphabetical Data Dictionary, and Transmission Data Processing Flows.
The Data Transmission section provides information related to the transmission of national quality core measure
data to the Joint Commission’s Data Warehouse.
The Guidelines for Submission of Data includes an overview of the data required to be submitted to the Joint
Commission’s Data Warehouse, as well as the Hospital Clinical Data XML file layout and the Hospital Initial Patient
Population Data XML file Layout.
The Transmission Alphabetical Data Dictionary describes the data elements that are either used to identify the
hospital and measure set associated to the transmitted data or are calculated by the vendor using the hospital’s
patient-level data and measure results. These data elements are not used in the Initial Patient Population
Algorithms or Measure Algorithms.
The Transmission Data Processing Flows contain information regarding the order in which the Joint Commission’s
Data Warehouse evaluates the national hospital quality measures and the associated population and sampling
data. In addition, it highlights the decision points as to when cases are rejected from the warehouse. Refer to the
Edit Message documents located on the Upload/Download page in the HCD section of PET for The Joint
Commission for a complete listing of all critical and informational edits.
The Joint Commission National Quality Core Measure Data Transmission
Overview
The Joint Commission requires three different data transmissions related to the national quality core measure data.
All of these transmissions are submitted by ORYX® Vendors and follow the same data transmission schedule used
to submit ORYX data to The Joint Commission. The most significant items related to the transmission of national
quality core measure data are listed here, but this is not an exhaustive list. Refer to the appropriate documents as
detailed below for more information.
Download File Layouts
Download Hospital Clinical Data XML File Layout (MS Excel)
Download ICD Population XML File Layout (MS Excel)
Hospital Initial Patient Population Data
The Joint Commission collects Initial Patient Population and sampling information by Measure Set. This data is
required to be submitted to The Joint Commission on a quarterly basis. All Initial Patient Population and sampling
data will be submitted in an XML file that adheres to the Hospital Initial Patient Population Data XML File Layout
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specifications and guidelines provided later in this section. Each file may contain data for only one provider.
Hospital Clinical Data
Hospital clinical data is required to be submitted to The Joint Commission no less than on a quarterly basis. All
HBIPS and PC patient-level data submitted to The Joint Commission must adhere to the Hospital Clinical Data
XML File Layout specifications and guidelines provided later in this section. The hospital clinical data submitted to
The Joint Commission is anonymous because no direct patient identifiers are included in the Hospital Clinical
Data XML File.
If a patient has also been sampled for a different national hospital quality measure set, then a separate XML file
must be created for the additional measure set. Refer to the applicable version of the Specifications Manual for
National Hospital Inpatient Quality Measures for information on how to create and transmit the data for the other
measure set.
Each HBIPS discharge case and event case must have a separate XML file. For example:
Example #1: During the quarter, 10 patients are discharged (Discharge Date) and no restraint or seclusion events
occurred for any patient (not just those discharged). Ten (10) separate XML files are created and transmitted, one
for each discharged patient.
Example #2: During the quarter, no patients are discharged (Discharge Date) and 4 unique patients have restraint
or seclusion events for a total of 11 events. Eleven (11) separate XML files are created and transmitted, one for
each event (Event Date). Multiple events (Event Date) for a patient cannot be combined into one XML file. If the
same patient is restrained and seclude (Event Type) on the same day (Event Date), the two events must be
transmitted in separate XML files.
Example #3: During the quarter, 1 patient is discharged (Discharge Date) and 1 unique patient has a restraint
event and a seclusion event (Event Date) for a total of 2 events. The patient with the events is the same patient that
was discharged. Three (3) separate XML files are created and transmitted, one for the patient’s discharge
information (Discharge Date) and one for each event (Event Date and Event Type). A patient’s discharge
information and event information cannot be combined into the same XML file.
Additional information:
For more information concerning the Performance Measurement System Identifier, refer to the ORYX Technical
Implementation Guide . For more information concerning the Vendor Tracking ID and Health Care Organization
Identifier, refer to the Transmission Alpha Data Dictionary in this manual.
Unique Key Identifier for Discharge Measures (e.g., HBIPS-1, HBIPS-4, PC-01):
Performance Measurement System Identifier – not part of the file, captured at the point the file is
uploaded to The Joint Commission
Vendor Tracking ID – fictitious identifier generated by the measurement system to differentiate
between individual patient records from each hospital
Admission Date
Discharge Date
Measure Set
Health Care Organization Identifier
Unique Key Identifier for Event Measures (e.g., HBIPS-2 and HBIPS-3):
Performance Measurement System Identifier – not part of the file, captured at the point the file is
uploaded to The Joint Commission
Vendor Tracking ID – fictitious identifier generated by the ORYX Vendor to differentiate between
individual patient records from each hospital
Admission Date
Event Date
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Event Type
Measure Set
Health Care Organization Identifier
Transaction Processing: Data can be added, replaced, and deleted during the current reporting quarter
using the Action-Code in the XML file. In order to replace or delete an existing file at The Joint Commission,
the files must match on the unique key data elements as defined above. In order to update a key element in an
existing file, the file must be deleted and a new file must be submitted. If the element to update is not a key
element, then the file can be resubmitted using the ‘Add’ Action-Code; there is no need to delete the file first
as long as the file matches on the unique key data elements.
Measure Selection: Data that passes all edits and contains all data required to calculate the measures will
be accepted as long as the hospital (identified by the Health Care Organization Identifier) has selected the
measure set for the reporting quarter with the ORYX Vendor that is submitting the data.
Sample: All EOC and event records included in the sample, or if the hospital is not sampling the Initial Patient
Population, must be transmitted to The Joint Commission. This is true regardless of whether or not any
measure for the record calculates to a Measure Category Assignment = “X”. Note – the HBIPS event
measures (HBIPS-2 and 3) do not allow sampling, all data in the Initial Patient Population of these two
measures must be transmitted.
Data Elements Not Accepted by The Joint Commission: The following data elements may be
transmitted to the Centers for Medicare and Medicaid Services (CMS) for the aligned national hospital quality
measures but cannot be transmitted to The Joint Commission for any measure because the data transmitted
to The Joint Commission are anonymous. For information concerning these data elements, refer to the
applicable version of the Specifications Manual for National Hospital Inpatient Quality Measures. Files
transmitted to The Joint Commission that contain the following data will be rejected:
Patient Identifier
Patient HIC #
First Name
Last Name
Postal Code
Data Elements Required by The Joint Commission: In order to support the Joint Commission’s data
quality analysis and continuous measure verification process the following data elements are required to be
transmitted for each measure in the HBIPS measure set.
Measure Category Assignment
Measurement Value
Predicted Value
A fictitious identifier is generated by the ORYX Vendor to differentiate between individual patient records from
each hospital because the Joint Commission’s data are blinded as to whom the patient is. The following data
element is used to transmit this fictitious identifier.
Vendor Tracking ID
This identifier is unique to a patient.
For each patient episode of care the following patient identifiers should match for each Measure Set that is
submitted for Discharge Measures (e.g., HBIPS-1, HBIPS-4, PC-01).
Vendor Tracking ID
Admission Date
Discharge Date
Birthdate
Health Care Organization Identifier
For example, if the hospital submits a separate XML file for AMI, PC, HBIPS, and TOB, the above
identifiers should be the same in each of the discharge XML files.
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For HBIPS records, if the patient has multiple events(e.g., HBIPS-2 and HBIPS-3), the following patient
identifiers should match for each event record transmitted.
Vendor Tracking ID
Admission Date
Birthdate
Health Care Organization Identifier
In addition, the discharge record must also be transmitted with the same identifiers.
HBIPS Specific Data Elements Not Accepted by The Joint Commission As Part of HCD: The following
data elements will not be transmitted to The Joint Commission in the Hospital Clinical Data (HCD) file. These
data are aggregated at the hospital level and are not patient specific data. Performance measurement
systems will reference the applicable version of the ORYX Technical Implementation Guide for instructions
on how to use the data elements to calculate the HCO-level aggregate data (see below). Files transmitted to
The Joint Commission that contain the following data will be rejected:
Psychiatric Inpatient Days - Medicare Only
Psychiatric Inpatient Days - Non-Medicare Only
Total Leave Days - Medicare Only
Total Leave Days - Non-Medicare Only
Aggregate Data
Aggregate hospital data is required to be submitted to The Joint Commission no less than on a quarterly basis.
Include in the HCO-level statistical aggregate data (e.g., Observed Rate and Number of Cases) only those
cases which process through the patient-level edits without being rejected and do not receive a Measure
Category Assignment = X for any measure in the set. Refer to the “HCO-Level Data Elements” and
“Electronic Data Interchange” sections of the ORYX Technical Implementation Guide for a complete set of
definitions, allowable values, and edits related to the data elements “Observed Rate”, “Number of Cases”,
and “Number of Rejected Cases”. In addition, refer to the data element “Number of Rejected Cases” for
information on how to report the number of cases excluded from the HCO-level statistical aggregate data due
to data quality and missing data issues.
Technical Manual: ORYX Vendors will reference the applicable version of the ORYX Technical
Implementation Guide for instructions and data element definitions that pertain to the transmission of
aggregate data for national hospital quality core measure data, including how to calculate the HCO-level
aggregate data.
Stratified national quality core measures and Sub-Measures: Although a stratified measure or submeasures will often be referred to as a single measure (such as measure HBIPS-1), the overall rate, submeasures, and the individual strata measures and will actually be transmitted to The Joint Commission in the
aggregate HCO-level data as a series of measures, using a number of pre-determined transmission ID
numbers.
Missing and Invalid Data: The following data elements are required for national hospital quality measures
and must be included in the health care organization (HCO)-level data transmission file. These will not be
used for traditional ORYX data. The data elements include:
Number of Rejected Cases
Number of Cases with UTD Allowable Values
ICD Population Size
Sample
Refer to the “HCO-Level Data Elements” and “Electronic Data Interchange” sections of the ORYX
Technical Implementation Guide for a complete set of definitions, allowable values, and edits related
to these data elements.
Five or fewer cases: The following HCO-level aggregate data elements are still required for hospital
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electronic to not report data for the quarter because they have five or fewer discharges (both Medicare and
non-Medicare combined) for the set. The data elements include:
ICD Population Size
Sample
Data Received for Health Care Organization
Note: Hospitals may choose to not report data when they have five or fewer discharges for Discharge
measures only (e.g., HBIPS-1, 4, PC-01). Hospitals must report all data for Event measures regardless
of the number of discharges or events that occur during the quarter. Refer to the “HCO-Level Data
Elements” and “Electronic Data Interchange” sections of the ORYX Technical Implementation Guide
for a complete set of definitions, allowable values, and edits related to these data elements.
Identifiers used to transmit national quality core measure data: The performance measure identifiers
used to transmit aggregate HCO-level data to The Joint Commission are maintained within the ORYX
Technical Implementation Guide. ORYX Vendors have access to the ORYX Technical Implementation
Guide through the Performance Measurement System Extranet Track (PET).
ORYX data re-transmission: The Joint Commission acknowledges that it is appropriate to allow ORYX
data to be updated. We are interested in assuring the best possible data quality, especially in light of public
reporting. With each regularly scheduled transmission deadline, we routinely accept retransmission of up to
seven quarters of aggregate national quality core measures. In addition, we accept retransmission of up to
seven quarters of aggregate non-core measure data. The purposes of the accepting the retransmitted data is
to update the data for the ORYX Performance Measure Reports, national comparison group data, and the
health care organization Quality Report postings. These retransmitted data may be inclusive of updated data
previously submitted and/or data that may have been erroneously omitted.
ORYX Vendors are required to correct their recognized data integrity issues and retransmit up to seven
quarters of updated aggregate national quality core measures and aggregate non-core measure data (due to
the rolling quarters of the ORYX Performance Measure Reports that display up to 24 months of data) by the
next regularly scheduled quarterly transmission deadline. Retransmission of corrected aggregate data from
issues emanating at the client health care organization-level is encouraged whenever feasible. It is the
responsibility of the ORYX Vendor to notify their clients that updated data were retransmitted to The Joint
Commission, and that the subsequent Quality Report posting and future ORYX Performance Measure
Reports will reflect these data. It is important to note, these retransmitted data will refresh the following
quarter’s ORYX Performance Measure Reports and Quality Report (core only), and update the national
comparison group rates (core only).
Refer to the ORYX Performance Measurement System Agreement, ORYX Data Retransmission Process, for
further details and associated fees that apply. ORYX Vendor inquires related to the retransmission of ORYX
data should be directed to http://manual.jointcommission.org.
Information The Joint Commission Provides To Core ORYX Vendors
Risk Adjustment: The Joint Commission will provide ORYX Vendors with risk adjustment model information for
the active national quality core measures (e.g., PC) that require risk adjustment. ORYX Vendors must apply the risk
model information to their patient-level data and generate aggregate risk adjustment data for submission to The
Joint Commission as a part of HCO-level data elements. Additional specifics include:
ORYX Vendors will have access to current national quality core measure risk model information files through
the Performance Measurement System Extranet Track (PET).
Details related to the risk model information file, its usage by ORYX Vendors and a list of significant risk
factors are provided in the ORYX Risk Adjustment Guide. This guide is available to the public on the Joint
Commission’s website and, in addition, it is available to ORYX Vendors via the Joint Commission’s extranet
site for ORYX Vendors (PET).
National quality core measure risk models must not be used for any purposes other than calculating riskadjusted data elements.
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For assistance with the national quality core measure risk model information, please contact the ORYX
statistical support staff at http://manual.jointcommission.org and click on Statistical Support.
National Comparison Group: The Joint Commission will provide ORYX Vendors participating in the ORYX
national quality core measure initiative with national comparison group data. ORYX Vendors may use this
information to prepare feedback reports for client organizations. Additional details in regard to this process include:
ORYX Vendors will have access to national comparison group data through the Performance Measurement
System Extranet Track (PET).
Refer to the ORYX Data Quality Manual for the list of national comparison group data elements, how ORYX
Vendors may utilize this data, and related information.
For assistance with the national quality core measure national comparison group, please contact the ORYX
statistical support staff at http://manual.jointcommission.org and click on Statistical Support.
Joint Commission Guidelines for Submission of Data
Overview
The below guidelines are for the submission of Hospital Clinical Data and Hospital Initial Patient Population Data to
The Joint Commission. Additionally, for the Joint Commission’s Hospital Clinical Data Edit and Algorithm Error
Feedback Messages, please refer to the Joint Commission’s extranet for measurement systems (PET).
Error Messages provide feedback regarding submitted data, file structure and data integrity that either cause
the case to be rejected from the warehouse (Critical) or ask for further verification (Informational). Cases with
any critical error messages will not be processed or stored in the warehouse. For cases to be accepted into
the warehouse all critical errors must be corrected and the case resubmitted. Informational errors are
feedback that warn of potential issues and ask for verification. Cases that receive no error messages or that
receive informational messages only will be processed as per the measure algorithm.
Missing Messages are critical edits that will cause the case to be rejected from the warehouse due to missing
data, as per the measure algorithms, resulting in a measure outcome of “X” (Data are Missing).
Measure Messages provide feedback related to the outcome of the case, as per the measure algorithm,
resulting in any other measure outcome, i.e., “B” (Not in Measure Population/Excluded), “D” (In Measure
Population/Failed), “E” (In Numerator Population/Passed), or “Y” (Unable to Determine Allowable Value Does
Not Allow Calculation of the Measure/UTD).
Joint Commission Guidelines for Submission of Hospital Clinical Data
Minimum Note: Prior to processing measure outcomes all data will be verified according to the rules in the
Data
data transmission section and the Edit and Algorithm Error Feedback Messages documents.
RequirementsCases submitted to the Joint Commission’s Data Warehouse that do not meet the requirements
outlined in these documents will be rejected.
Allowable Submission of multiple files for different measure sets for a single episode of care is allowable for
Measure Set the following Measure Set combinations:
Combination
1. Joint Commission’s Data Warehouse
per Patient
a. PC and SCIP for babies age 0 to 2 days old
Episode of
b. PC and SCIP for mothers age 8 and older
Care
c. PC and VTE for mothers age 18 and older
d. PC and HF for mothers age 18 and older
e. PC and AMI for mothers age 18 and older
f. PC and PN for mothers age 18 and older
g. PC and STK for mothers age 18 and older
h. PC and CAC for mothers under the age 18
i. PC and ED for babies age 0 to 2 days old
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j.
k.
l.
m.
n.
o.
p.
q.
r.
s.
t.
u.
v.
w.
x.
y.
PC and ED for mothers age 8 years and older
PC and IMM for mothers age 8 years and older
PC and TOB for mothers age 18 years and older
PC and SUB for mothers age 18 years and older
HBIPS and AMI for patients age 18 and older
HBIPS and HF for patients age 18 abd older
HBIPS and PN for patients age 18 and older
HBIPS and SCIP for patients age 1 and older
HBIPS and VTE for patients age 18 and older
HBIPS and STK for patients age 18 and older
HBIPS and PC mothers
HBIPS and CAC for patients age 2 years or older
HBIPS and ED for patients age 1 year and older
HBIPS and IMM for patients age 1 year and older
HBIPS and TOB for patients age 18 years and older
HBIPS and SUB for patients age 18 years and older
Submission of multiple files for the same episode of care will not be accepted into the Joint
Commission’s Data Warehouse for the following Measure Set combinations:
1. HBIPS and PC newborn
Refer to Appendix E, Table 2.7 Allowable Measure Set Combinations for further guidance.
RequirementsDo not put spaces between XML tags and associated data. Cases with inappropriate spaces will
for XML Tags be rejected from the Joint Commission’s Data Warehouse.
and
Associated
Data
Export File ORYX Vendors should refer to the ORYX Technical Implementation Guide for guidelines related
Character to file naming for submission of data to the Joint Commission’s Data Warehouse.
Limitations
Missing Data All cases submitted to the Joint Commission’s Data Warehouse must have all data required to
calculate the measures. Files submitted which are missing data required to calculate measures
Policy
(any case that would result in a Measure Category “X” assignment) will be rejected. These cases
should be reviewed by the provider and resubmitted with an allowable value indicated for any data
element that was missing. Please refer to the Missing and Invalid Data section for additional
information.
If the abstractor, after due diligence, is not able to determine an answer, a value of "UTD"
must be selected for the applicable data element. This includes:
ICD-9-CM Principal Procedure Code and ICD-9-CM Other Procedure Codes require the
data element ICD-9-CM Principal Procedure Date and ICD-9-CM Other Procedure Dates to
be submitted with the case. Please see the data element definitions for further details on
allowable values. If the case is missing the corresponding allowable answer value, the case
will be rejected from the Joint Commission's Data Warehouse.
Data
The following data elements may be transmitted to the Centers for Medicare and Medicaid (CMS)
Elements Not for the aligned national quality core measures, but they cannot be transmitted to The Joint
Accepted by Commission because the data transmitted to The Joint Commission is anonymous. For information
The Joint concerning these data elements, refer to the applicable version of the Specifications Manual for
Commission National Hospital Inpatient Quality Measures. Files transmitted to The Joint Commission that
contain the following data will be rejected:
Patient HIC #
Patient Identifier
First Name
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Last Name
Postal Code
Data
The following data elements must be transmitted to The Joint Commission:
Elements
Measure Category Assignment
Required by
Measurement Value
The Joint
Predicted Value
Commission
Unique
Record Key
(What fields
make a
record
unique?)
Discharge Measures:
Performance Measurement System Identifier, Vendor Tracking Identifier, Admission Date,
Discharge Date, Health Care Organization Identifier, and Measure Set
For each patient episode of care the following patient identifiers should match for each
Measure Set that is submitted for Discharge Measures (e.g., HBIPS-1, HBIPS-4, PC-01). For
example, if the hospital submits a separate XML file for AMI, PC, HBIPS, and TOB, the above
identifiers should be the same in each of the discharge XML files.
1. Vendor Tracking ID
2. Admission Date
3. Discharge Date
4. Birthdate
5. Health Care Organization Identifier
Event Measures:
Performance Measurement System Identifier, Vendor Tracking Identifier, Admission Date,
Event Date, Event Type, Health Care Organization Identifier, and Measure Set
For HBIPS records, if the patient has multiple events(e.g., HBIPS-2 and HBIPS-3), the
following patient identifiers should match for each event record transmitted. In addition, the
discharge record must also be transmitted with the same identifiers.
1. Vendor Tracking ID
2. Admission Date
3. Birthdate
4. Health Care Organization Identifier
Refer to the Transmission Alpha Data Dictionary for more information concerning the Vendor
Tracking ID and Health Care Organization Identifier.
Note: Refer to the ORYX Technical Implementation Guide for more information concerning
the Performance Measurement System Identifier.
Principal and Effective March 1, 2007
The National Uniform Billing Committee has implemented a Present on Admission indicator for
Other
Diagnosis Principal and Other Diagnosis codes. Data submitted to the Joint Commission’s Data Warehouse
must have the Present on Admission Indicator removed prior to submission. Failure to remove the
Codes
indicator will result in cases being rejected from the Joint Commission’s Data Warehouse.
Patient-Level Clinical Data XML File Layout
The XML File Layout is divided into the following five main sections (Please refer to Hospital Clinical Data
XML File Layout for details).
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Submission
1.
2.
3.
4.
Type – Describes the setting for which the data is being collected (Hospital)
Data – Describes the type of data being submitted (Clinical).
Version – Describes the version of the XML file layout.
Action-Code – Describes the action intended with the submission of the file. Options include:
a. Add (applicable to a file submitted for the first time for the hospital/time period or to a file
being submitted as an update/replacement of an existing file already submitted for a
provider).
b. Delete (utilize when the file is submitted for the purpose of deleting a file already
submitted to the Joint Commission’s Data Warehouse.)
Note: In order to replace or delete an existing file utilizing the Add or Delete action codes, the files
must match on the following fields:
Discharge Measures:
Performance Measurement System Identifier, Vendor Tracking Identifier, Admission Date,
Discharge Date, Health Care Organization Identifier, and Measure Set
Event Measures:
Performance Measurement System Identifier, Vendor Tracking Identifier, Admission Date, Event
Date, Event Type, Health Care Organization Identifier, and Measure Set
Note: Refer to the ORYX Technical Implementation Guide for more information concerning the
Performance Measurement System Identifier.
File Audit
Data
Note: This
section is
not required
Abstraction
Audit Data
1.
2.
3.
4.
5.
Create-Date – Indicates the date the file was created.
Create-Time – Indicates the time the file was created.
Create-By – Indicates who created the file.
Version – Indicates the version of the file being submitted.
Create-by-Tool – Indicates the software tool utilized to create the file.
1.
2.
3.
4.
Abstraction-Date – Indicates the date the file was abstracted.
Abstractor-id – Indicates the person who abstracted the file.
Total-Abstraction-Time – Indicates the time required to abstract the file (in seconds)
Comments – Area for entry of any comments regarding the abstraction.
Note: This
section is
not required
Provider This tag is required in the XML document and contains:
1. CMS Certification Number - Hospital's six digit acute care CMS Certification Number (CCN),
which is allowed and is optional for The Joint Commission.
2. NPI - National Provider Identifier as assigned by CMS, and is optional for The Joint
Commission.
3. HCOID - Identifies the healthcare organization that is accredited by The Joint Commission and
is required as a key element of the patient file.
Patient
Data elements in this section of the XML file relate to patient demographic information such as
Birthdate and Sex.
Episode of Data in this section of the XML file relate to the acute inpatient stay and clinical data associated with
the stay. Examples of associated data elements include:
Care
1. Admission Date
2. Discharge Date (discharge measures)
3. Event Date (event measures)
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4.
5.
6.
7.
Event Type (event measures)
Vendor Tracking Identifier
Measure Set
Clinical Questions and answer codes
The Joint Data in this section of the XML file support the Joint Commission’s data quality analysis and
Commissioncontinuous measure verification process of the ORYX Vendors. The following data elements are
required to be transmitted to The Joint Commission for each measure in the measure set.
1. Measure Category Assignment
2. Measurement Value
3. Predicted Value
Please refer to the data dictionary for further definition of these data elements.
Abstraction Software Skip Logic and Missing Data
Skip logic allows hospitals and vendors to minimize abstraction burden by using vendor software edit logic to
bypass abstraction of data elements not utilized in the measure algorithm. However, these bypassed elements also
negatively impact data quality when elements are incorrectly abstracted and subsequent data elements are
bypassed and left blank.
The use of skip logic by hospitals and ORYX vendors is optional and not required by The Joint Commission.
Hospitals should be aware the potential impact of skip logic on data quality and abstraction burden. Vendors and
hospitals utilizing skip logic should closely monitor the accuracy rate of abstracted data elements, particularly data
elements placed higher in the algorithm flow.
Joint Commission Guidelines for Submission of Hospital Initial Patient Population Data
Hospitals must submit to The Joint Commission on a quarterly basis the aggregate population and sample counts
for Medicare and non-Medicare discharges for each of the measure sets. If the aggregate population count is zero,
the hospital is still required to submit the Hospital Initial Inpatient Population Data file and would submit zero as the
population and sample counts. In addition, The Hospital Initial Inpatient Population Data file must be transmitted to
the Joint Commission's Data Warehouse even if the hospital has elected to not report the patient data for the
Discharge measures (e.g., HBIPS1, 4, PC-01) when they have five or fewer cases for an appropriate measure set
during the quarter.
Joint Commission Guidelines for Submission of Hospital Initial Patient Population Data
Hospital Initial Patient Population Data XML File Layout
The XML File Layout is divided into the following five main sections (Please refer to Hospital Initial
Patient Population Data XML File Layout for details).
Submission
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2.
3.
4.
Type – Describes the setting for which the data is being collected (Hospital)
Data – Describes the type of data being submitted (Population).
Version – Describes the version of the XML file layout.
Action-Code – Describes the action intended with the submission of the file. The “Add” actioncode is required for all initial patient population files submitted.
Note: In order to replace an existing file at the utilizing the Add action code, the files must match on:
Health Care Organization ID , Time-Period and Measure-Set
160
In order to replace an existing file all XML tags must be present, however, only the XML tags
mentioned above (Health Care Organization ID, Time-Period, and Measure-Set) need to be
submitted with values.
File Audit
Data*
1.
2.
3.
4.
5.
Create-Date – Indicates the date the file was created.
Create-Time – Indicates the time the file was created.
Create-By – Indicates who created the file.
Version – Indicates the version of the file being submitted.
Create-by-Tool – Indicates the software tool utilized to create the file.
*Note:* This
section is
not
required
Provider Data elements in this section of the XML file relate to Provider identification. These data elements
include:
Data
1. Provider-Id - Hospital's six digit acute care CMS Certification Number (CCN), which is allowed
and it's optional for The Joint Commission.
2. NPI - National Provider Identifier as assigned by CMS, and is optional for The Joint
Commission.
3. HCOID - Identifies the healthcare organization that is accredited by The Joint Commission and
is required as a key element of the patient file.
Time PeriodTime-Period – Dates in this field should reflect the discharge time period related to the data being
submitted. Time period start and end dates must reflect full month increments, and may not be greater
than one month. Files submitted to the Joint Commission’s Data Warehouse are required to contain a
three monthly time periods which comprise the calendar quarter for which data is being submitted.
Example: If the Hospital Initial Patient Population File is being submitted for fourth quarter 2008, the
file must contain the following time periods and appropriate associated data (including all data
elements is the Population Details section that follows):
October 2008
November 2008
December 2008
Files submitted with time periods that do not meet the above requirements will be rejected from the
Joint Commission’s Data Warehouse.
Population
Details
1. Measure-Set – Indicates the Measure Set for which the data is being submitted.
2. Stratum – Indicates the stratum (e.g., HBIPS) or sub-population (e.g., PC) related to the data
being submitted.
Additional data elements include Initial Patient Population Size – Medicare, Initial Patient
Population Size – Non-Medicare, Sampling Frequency, Sample Size – Medicare, and Sample
Size – Non-Medicare. Please refer to the Transmission Data Dictionary for further definition of these
data elements. Please refer to Hospital Initial Patient Population Data XML File Layout for further
information on details of the XML file format. All data elements are based on discharges or events that
occurred during the associated time period.
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Transmission Alphabetical Data Dictionary
These data elements are either used to identify the hospital and measure set associated to the transmitted data or
are calculated by the vendor using the hospital’s patient-level data and measure results. These data elements are
not used in the Initial Patient Population Algorithms or Measure Algorithms.
Data Element Name
CMS Certification Number
Health Care Organization Identifier
Initial Patient Population Size – Medicare Only
Initial Patient Population Size – Non-Medicare Only
Measure Set
National Provider Identifier
Predicted Value
Sample
Sample Size – Medicare Only
Sample Size – Non-Medicare Only
Sampling Frequency
Vendor Tracking Identifier
Collected For
Hospital Clinical Data File, Optional for All Records
All Records, Aggregate Data File, Patient
Population Data File, Hospital Clinical Data File
Transmission, Patient Population Data File
Transmission, Patient Population Data File
Transmission, Patient Population Data File,
Hospital Clinical Data File
Transmission
Transmission, Risk Adjustment, Hospital Clinical
Data File
Transmission, Aggregate Data File, Hospital
Clinical Data File
Transmission, Patient Population Data File
Transmission, Patient Population Data File
Transmission, Patient Population Data File
Transmission, Hospital Clinical Data File
Go to: Alphabetical List of all Data Elements
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Transmission Data Processing Flow: Clinical
Introduction
This section contains information regarding the order in which the Joint Commission’s Data Warehouse evaluates
the Joint Commission national quality core measures.
The transmission data processing flow ensures that only valid data are used in the measure algorithms. Each case
that is rejected by the process will be listed on a report along with a brief description of the problem. Vendors will
access the Joint Commission's HCD Report via the Performance Measurement System Extranet Track (PET).
Transmission Data Processing Flow for The Joint Commission
Note: HBIPS contains two Initial Patient Populations, discharges and events. Discharge information and event
information are transmitted in separate XML files. All events of the same type occurring on the same day are
transmitted in one XML file. However, different types of events occurring on the same day are transmitted in
separate XML files.
All data transmitted pass through the following process:
1. If appropriate, files are verified to be proper zip and XML files.
If the files are invalid, reject the file(s) and stop processing.
If the files are valid, continue processing.
2. The data are verified that no unexpected protected health information (PHI) (e.g., Patient HIC#, and Postal
Code) are present.
If unexpected PHI exists, reject the file(s) and stop processing.
If no unexpected PHI exists, continue processing.
Starting with this step, processing is per case (individual XML file):
3. Data are evaluated to ensure the quarter associated to the Discharge Date or Event Date is open for data
transmission.
If the Data Collection quarter is closed, reject the XML file and stop processing.
If the Data Collection quarter is open, continue processing.
4. Data are evaluated to ensure the Measure Set is expected from the submitter for the time frame (Discharge
Date or Event Date) and the Healthcare Organization Identifier in question.
If the data are not expected, reject the XML file and stop processing.
If the data are expected, continue processing.
5. Check the action-code
If the action-code = ADD, continue with step #6.
If the action-code = DELETE, continue with step #14.
6. The general data elements, as defined in the Introduction to the Data Dictionary section, are evaluated to
ensure they exist and contain valid allowable values. The HBIPS measure set is unique in that it has three
different groups of general data elements. The first group is "general" for all measures in the set. The second
group is only "general" for the HBIPS discharge measures. The third group is only "general" for the HBIPS
event measures.
In addition, HBIPS data elements may be "measure set specific" for one type of HBIPS measure and
"general" for the other type. For example, Psychiatric Care Setting is a "measure set specific" data element
for the discharge measures and a "general" data element for the event measures. See #8 for information
concerning the processing of "measure set specific" data elements.
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If any general data elements fall outside of the data integrity checks, reject the XML file and stop
processing.
If any general data element is missing or invalid, reject the XML file and stop processing.
If all general data elements exist and contain valid allowable values, continue processing.
7. The Initial Patient Population Algorithm associated to the Measure Set is evaluated to ensure that the data is
in the population of the set. Refer to the appropriate Measure Set Data Element List for the algorithm.
If the Initial Patient Population Algorithm returns an Initial Patient Population Reject Case Flag =
“Yes” (case is not in the Initial Patient Population), reject the XML file and stop processing.
If the Initial Patient Population Algorithm returns an Initial Patient Population Reject Case Flag = “No”
(case is in the Initial Patient Population), continue processing.
8. The Measure Set specific data elements are evaluated to ensure they contain valid allowable values. This
step does not evaluate for missing data because that is performed by the measure algorithms.
If any measure set specific data elements fall outside of the data integrity checks, reject the XML file
and stop processing.
If any measure set specific data elements are invalid, reject the XML file and stop processing.
If all measure set specific data elements contain valid allowable values, continue processing.
9. If appropriate for the Measure Set, grid data elements are evaluated to ensure each row does not contain
missing data. This step does not ensure that the entire grid is empty because that evaluation is performed by
the measure algorithms.
If any row of the grid is missing data, reject the XML file and stop processing.
If the grid is empty or all data elements exist in each row, continue processing.
10. Each XML file is evaluated for unexpected data. While a case may be in the population of more than one
measure set, each XML file is associated to only one set.
If any data exists that is not expected for the Measure Set, reject the XML file and stop processing.
If no unexpected data for the Measure Set exists, continue processing.
11. Each XML file is evaluated to ensure that it and existing data in the database for the patient does not create
an incorrect measure set combinations. For example if Measure Set = HBIPS for a patient less than 18 years
old and a record for the same patient has previously been accepted by the Warehouse for the Measure Set of
PN or AMI, then the new record will create an incorrect measure set combination. Refer to the Joint
Commission Guidelines for Submission of Hospital Clinical Data in the Data Transmission section, Appendix
E, for list of invalid measure set combinations.
If this record will create an incorrect measure set combination, reject the XML file and stop processing.
If this record will not create an incorrect measure set combination, continue processing.
12. Execute each measure algorithm associated to the measures the hospital has selected for the Measure Set.
Refer to the appropriate Measure Information Forms for the Measure Set for the measure algorithms.
If any measure evaluates with a Measure Category Assignment = “X”, reject the XML file and stop
processing.
If all measures evaluate with Measure Category Assignments = “B”, “D”, “E”, "U", and/or “Y”, continue
processing.
13. The case is accepted into the Joint Commission’s Data Warehouse. If any of the measures in the measure
set are Risk Adjusted:
If yes, then execute the measure risk model on xml file and then stop processing.
If no, stop processing.
The following steps are performed if the record’s action-code = DELETE:
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1. The remaining data elements that are part of the Unique Record Key, as defined in the Joint Commission
Guidelines for Submission of Hospital Clinical Data in the Data Transmission section, are evaluated to
ensure they exist and contain valid allowable values. These data elements are required for all Measure Sets.
If any Unique Record Key data element is missing or invalid, reject the XML file and stop processing.
If all Unique Record Key data elements exist and contain valid allowable values, continue processing.
2. The database is checked to see if a record with the same Unique Record Key already exists.
If the case does not already exist in the database, then the transmitted DELETE record is rejected.
If the record already exists in the database, it is deleted.
Transmission Data Processing Flow: Clinical Algorithm
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Transmission Data Processing Flow: Population
and Sampling
Introduction
This section contains information regarding the order in which the Joint Commission’s Data Warehouse evaluate
submitted files, which contain aggregate population and sampling counts. Transmission of population and sampling
counts are used to assist in evaluating completeness of submission in accordance with The Joint Commission's
sampling requirements.
Each case that is rejected by the process will be listed on a report along with a brief description of the problem.
Vendors will access the Joint Commission's HCD Reports via the Performance Measurement System Extranet
Track (PET).
Transmission Data Processing Flow
All data transmitted pass through the following process:
1. If appropriate, files are verified to be proper zip and XML files.
If the files are invalid, reject the file(s) and stop processing.
If the files are valid, continue processing.
Starting with this step, processing is per XML file:
2. Data are evaluated to ensure that three individual time periods, which make up a calendar quarter, exist within
the file.
If the data are not expected, reject the XML file and stop processing.
If the data are expected, continue processing.
3. The Measure Set /Stratum is evaluated to ensure a valid value is submitted.
If the data are not expected, reject the XML file and stop processing.
If the data are expected, continue processing.
4. Data are evaluated to ensure the quarter for Time Periods is open for data submission.
If the Data Collection quarter is closed, reject the XML file and stop processing.
If the Data Collection quarter is open, continue processing.
5. If the files are submitted to The Joint Commission: The Health Care Organization Identifier is evaluated to
ensure a valid value is submitted.
If the data are not expected, reject the XML file and stop processing.
If the data are expected, continue processing.
6. If the files are submitted to The Joint Commission: Data are evaluated to ensure the Measure Set(s) or Strata
are expected from the submitter.
If the data are not expected, set the reject 'Pending Database' flag = Yes, continue processing.
If the data are expected, set the reject 'Pending Database' flag = No, continue processing.
7. Check the action-code
If action-code equals Add, continue with processing.
If the action-code is missing or invalid, reject the XML file and stop processing..
8. The transmission data elements, as defined in the Transmission Alphabetical Data Dictionary, are evaluated
to ensure they exist and contain valid allowable values. These transmission data elements are required for all
submitted files.
If any transmission data elements fall outside of the data integrity checks, reject the XML file and stop
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processing.
If any transmission data element is missing or invalid, reject the XML file and stop processing.
If all transmission data elements exist and contain valid allowable values, continue processing.
9. Data are evaluated to ensure that the sample size fulfills the required specifications. Sample Frequency must
be consistent across all three time periods within a calendar quarter.
If the data are not expected, informational messages generated, continue processing.
If the data are expected, continue processing.
10. a. Check the Pending Database Flag
If the Pending Database flag = No, the case is accepted into the Joint Commission's Data Warehouse.
If the Pending Database flag = Yes, the case is accepted into the Joint Commission's Data Warehouse
automatically if hospital's measure selections are changed that would make the data 'expected' (refer to
step #6b above). These measure selection changes must occur prior to the transmission deadline.
Transmission Data Processing Flow Algorithm
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Appendix A
ICD-9-CM Code Tables
Download Code Tables
Table Number 10.01: Mental Disorders
Code
290.0
290.10
290.11
290.12
290.13
290.20
290.21
290.3
290.40
290.41
290.42
290.43
290.8
290.9
291.0
291.1
291.2
291.3
291.4
291.5
291.81
291.82
291.89
291.9
292.0
292.11
292.12
292.2
292.81
292.82
292.83
292.84
292.85
292.89
292.9
293.0
293.1
293.81
293.82
293.83
293.84
293.89
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Shortened Description
SENILE DEMENTIA UNCOMP
PRESENILE DEMENTIA
PRESENILE DELIRIUM
PRESENILE DELUSION
PRESENILE DEPRESSION
SENILE DELUSION
SENILE DEPRESSIVE
SENILE DELIRIUM
VASCULAR DEMENTIA,UNCOMP
VASC DEMENTIA W DELIRIUM
VASC DEMENTIA W DELUSION
VASC DEMENTIA W DEPRESSN
SENILE PSYCHOSIS NEC
SENILE PSYCHOT COND NOS
DELIRIUM TREMENS
ALCOHOL AMNESTIC DISORDR
ALCOHOL PERSIST DEMENTIA
ALCOH PSY DIS W HALLUCIN
PATHOLOGIC ALCOHOL INTOX
ALCOH PSYCH DIS W DELUS
ALCOHOL WITHDRAWAL
ALCOH INDUCE SLEEP DISOR
ALCOHOL MENTAL DISOR NEC
ALCOHOL MENTAL DISOR NOS
DRUG WITHDRAWAL
DRUG PSYCH DISOR W DELUS
DRUG PSY DIS W HALLUCIN
PATHOLOGIC DRUG INTOX
DRUG-INDUCED DELIRIUM
DRUG PERSISTING DEMENTIA
DRUG PERSIST AMNESTC DIS
DRUG-INDUCED MOOD DISORD
DRUG INDUCED SLEEP DISOR
DRUG MENTAL DISORDER NEC
DRUG MENTAL DISORDER NOS
DELIRIUM D/T OTHER COND
SUBACUTE DELIRIUM
PSY DIS W DELUS OTH DIS
PSY DIS W HALLUC OTH DIS
MOOD DISORDER OTHER DIS
ANXIETY DISORDER OTH DIS
TRANSIENT MENTAL DIS NEC
176
293.9
294.0
294.10
294.11
294.20
294.21
294.8
294.9
295.00
295.01
295.02
295.03
295.04
295.05
295.10
295.11
295.12
295.13
295.14
295.15
295.20
295.21
295.22
295.23
295.24
295.25
295.30
295.31
295.32
295.33
295.34
295.35
295.40
295.41
295.42
295.43
295.44
295.45
295.50
295.51
295.52
295.53
295.54
295.55
295.60
295.61
295.62
295.63
295.64
295.65
295.70
295.71
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TRANSIENT MENTAL DIS NOS
AMNESTIC DISORD OTH DIS
DEMENTIA W/O BEHAV DIST
DEMENTIA W BEHAVIOR DIST
DEMEN NOS W/O BEHV DSTRB
DEMEN NOS W BEHAV DISTRB
MENTAL DISOR NEC OTH DIS
MENTAL DISOR NOS OTH DIS
SIMPL SCHIZOPHREN-UNSPEC
SIMPL SCHIZOPHREN-SUBCHR
SIMPLE SCHIZOPHREN-CHR
SIMP SCHIZ-SUBCHR/EXACER
SIMPL SCHIZO-CHR/EXACERB
SIMPL SCHIZOPHREN-REMISS
HEBEPHRENIA-UNSPEC
HEBEPHRENIA-SUBCHRONIC
HEBEPHRENIA-CHRONIC
HEBEPHREN-SUBCHR/EXACERB
HEBEPHRENIA-CHR/EXACERB
HEBEPHRENIA-REMISSION
CATATONIA-UNSPEC
CATATONIA-SUBCHRONIC
CATATONIA-CHRONIC
CATATONIA-SUBCHR/EXACERB
CATATONIA-CHR/EXACERB
CATATONIA-REMISSION
PARANOID SCHIZO-UNSPEC
PARANOID SCHIZO-SUBCHR
PARANOID SCHIZO-CHRONIC
PARAN SCHIZO-SUBCHR/EXAC
PARAN SCHIZO-CHR/EXACERB
PARANOID SCHIZO-REMISS
SCHIZOPHRENIFORM DIS NOS
SCHIZOPHRENIC DIS-SUBCHR
SCHIZOPHREN DIS-CHRONIC
SCHIZO DIS-SUBCHR/EXACER
SCHIZOPHR DIS-CHR/EXACER
SCHIZOPHRENIC DIS-REMISS
LATENT SCHIZOPHREN-UNSP
LAT SCHIZOPHREN-SUBCHR
LATENT SCHIZOPHREN-CHR
LAT SCHIZO-SUBCHR/EXACER
LATENT SCHIZO-CHR/EXACER
LAT SCHIZOPHREN-REMISS
SCHIZOPHR DIS RESID NOS
SCHIZOPH DIS RESID-SUBCH
SCHIZOPHR DIS RESID-CHR
SCHIZO RESID SUBCHR/EXAC
SCHIZOPH RESID-CHRO/EXAC
SCHIZOPH DIS RESID-REMIS
SCHIZOAFFECTIVE DIS NOS
SCHIZOAFFECTV DIS-SUBCHR
177
295.72
295.73
295.74
295.75
295.80
295.81
295.82
295.83
295.84
295.85
295.90
295.91
295.92
295.93
295.94
295.95
296.00
296.01
296.02
296.03
296.04
296.05
296.06
296.10
296.11
296.12
296.13
296.14
296.15
296.16
296.20
296.21
296.22
296.23
296.24
296.25
296.26
296.30
296.31
296.32
296.33
296.34
296.35
296.36
296.40
296.41
296.42
296.43
296.44
296.45
296.46
296.50
296.51
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SCHIZOAFFECTIVE DIS-CHR
SCHIZOAFF DIS-SUBCH/EXAC
SCHIZOAFFTV DIS-CHR/EXAC
SCHIZOAFFECTVE DIS-REMIS
SCHIZOPHRENIA NEC-UNSPEC
SCHIZOPHRENIA NEC-SUBCHR
SCHIZOPHRENIA NEC-CHR
SCHIZO NEC-SUBCHR/EXACER
SCHIZO NEC-CHR/EXACERB
SCHIZOPHRENIA NEC-REMISS
SCHIZOPHRENIA NOS-UNSPEC
SCHIZOPHRENIA NOS-SUBCHR
SCHIZOPHRENIA NOS-CHR
SCHIZO NOS-SUBCHR/EXACER
SCHIZO NOS-CHR/EXACERB
SCHIZOPHRENIA NOS-REMISS
BIPOL I SINGLE MANIC NOS
BIPOL I SINGLE MANC-MILD
BIPOL I SINGLE MANIC-MOD
BIPOL I SING-SEV W/O PSY
BIPO I SIN MAN-SEV W PSY
BIPOL I SING MAN REM NOS
BIPOL I SINGLE MANIC REM
RECUR MANIC DIS-UNSPEC
RECUR MANIC DIS-MILD
RECUR MANIC DIS-MOD
RECUR MANIC DIS-SEVERE
RECUR MANIC-SEV W PSYCHO
RECUR MANIC-PART REMISS
RECUR MANIC-FULL REMISS
DEPRESS PSYCHOSIS-UNSPEC
DEPRESS PSYCHOSIS-MILD
DEPRESSIVE PSYCHOSIS-MOD
DEPRESS PSYCHOSIS-SEVERE
DEPR PSYCHOS-SEV W PSYCH
DEPR PSYCHOS-PART REMISS
DEPR PSYCHOS-FULL REMISS
RECURR DEPR PSYCHOS-UNSP
RECURR DEPR PSYCHOS-MILD
RECURR DEPR PSYCHOS-MOD
RECUR DEPR PSYCH-SEVERE
REC DEPR PSYCH-PSYCHOTIC
RECUR DEPR PSYC-PART REM
RECUR DEPR PSYC-FULL REM
BIPOL I CURRNT MANIC NOS
BIPOL I CURNT MANIC-MILD
BIPOL I CURRNT MANIC-MOD
BIPOL I MANC-SEV W/O PSY
BIPOL I MANIC-SEV W PSY
BIPOL I CUR MAN PART REM
BIPOL I CUR MAN FULL REM
BIPOL I CUR DEPRES NOS
BIPOL I CUR DEPRESS-MILD
178
296.52
296.53
296.54
296.55
296.56
296.60
296.61
296.62
296.63
296.64
296.65
296.66
296.7
296.80
296.81
296.82
296.89
296.90
296.99
297.0
297.1
297.2
297.3
297.8
297.9
298.0
298.1
298.2
298.3
298.4
298.8
298.9
299.00
299.01
299.10
299.11
299.80
299.81
299.90
299.91
300.00
300.01
300.02
300.09
300.10
300.11
300.12
300.13
300.14
300.15
300.16
300.19
300.20
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BIPOL I CUR DEPRESS-MOD
BIPOL I CURR DEP W/O PSY
BIPOL I CURRNT DEP W PSY
BIPOL I CUR DEP REM NOS
BIPOL I CURRNT DEP REMIS
BIPOL I CURRNT MIXED NOS
BIPOL I CURRNT MIX-MILD
BIPOL I CURRNT MIXED-MOD
BIPOL I CUR MIX W/O PSY
BIPOL I CUR MIXED W PSY
BIPOL I CUR MIX-PART REM
BIPOL I CUR MIXED REMISS
BIPOLOR I CURRENT NOS
BIPOLAR DISORDER NOS
ATYPICAL MANIC DISORDER
ATYPICAL DEPRESSIVE DIS
BIPOLAR DISORDER NEC
EPISODIC MOOD DISORD NOS
EPISODIC MOOD DISORD NEC
PARANOID STATE, SIMPLE
DELUSIONAL DISORDER
PARAPHRENIA
SHARED PSYCHOTIC DISORD
PARANOID STATES NEC
PARANOID STATE NOS
REACT DEPRESS PSYCHOSIS
EXCITATIV TYPE PSYCHOSIS
REACTIVE CONFUSION
ACUTE PARANOID REACTION
PSYCHOGEN PARANOID PSYCH
REACT PSYCHOSIS NEC/NOS
PSYCHOSIS NOS
AUTISTIC DISORD-CURRENT
AUTISTIC DISORD-RESIDUAL
CHILDHD DISINTEGR-ACTIVE
CHILDHD DISINTEGR-RESID
PERVASV DEV DIS-CUR NEC
PERVASV DEV DIS-RES NEC
PERVASV DEV DIS-CUR NOS
PERVASV DEV DIS-RES NOS
ANXIETY STATE NOS
PANIC DIS W/O AGORPHOBIA
GENERALIZED ANXIETY DIS
ANXIETY STATE NEC
HYSTERIA NOS
CONVERSION DISORDER
DISSOCIATIVE AMNESIA
DISSOCIATIVE FUGUE
DISSOCIATVE IDENTITY DIS
DISSOCIATIVE REACT NOS
FACTITIOUS DIS W SYMPTOM
FACTITIOUS ILL NEC/NOS
PHOBIA NOS
179
300.21
300.22
300.23
300.29
300.3
300.4
300.5
300.6
300.7
300.81
300.82
300.89
300.9
301.0
301.10
301.11
301.12
301.13
301.20
301.21
301.22
301.3
301.4
301.50
301.51
301.59
301.6
301.7
301.81
301.82
301.83
301.84
301.89
301.9
302.0
302.1
302.2
302.3
302.4
302.50
302.51
302.52
302.53
302.6
302.70
302.71
302.72
302.73
302.74
302.75
302.76
302.79
302.81
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AGORAPHOBIA W PANIC DIS
AGORAPHOBIA W/O PANIC
SOCIAL PHOBIA
ISOLATED/SPEC PHOBIA NEC
OBSESSIVE-COMPULSIVE DIS
DYSTHYMIC DISORDER
NEURASTHENIA
DEPERSONALIZATION DISORD
HYPOCHONDRIASIS
SOMATIZATION DISORDER
UNDIFF SOMATOFORM DISRDR
SOMATOFORM DISORDERS NEC
NONPSYCHOTIC DISORD NOS
PARANOID PERSONALITY
AFFECTIV PERSONALITY NOS
CHRONIC HYPOMANIC PERSON
CHR DEPRESSIVE PERSON
CYCLOTHYMIC DISORDER
SCHIZOID PERSONALITY NOS
INTROVERTED PERSONALITY
SCHIZOTYPAL PERSON DIS
EXPLOSIVE PERSONALITY
OBSESSIVE-COMPULSIVE DIS
HISTRIONIC PERSON NOS
CHR FACTITIOUS ILLNESS
HISTRIONIC PERSON NEC
DEPENDENT PERSONALITY
ANTISOCIAL PERSONALITY
NARCISSISTIC PERSONALITY
AVOIDANT PERSONALITY DIS
BORDERLINE PERSONALITY
PASSIVE-AGGRESSIV PERSON
PERSONALITY DISORDER NEC
PERSONALITY DISORDER NOS
EGO-DYSTONIC SEX ORIENT
ZOOPHILIA
PEDOPHILIA
TRANSVESTIC FETISHISM
EXHIBITIONISM
TRANS-SEXUALISM NOS
TRANS-SEXUALISM, ASEXUAL
TRANS-SEXUAL, HOMOSEXUAL
TRANS-SEX, HETEROSEXUAL
GENDR IDENTITY DIS-CHILD
PSYCHOSEXUAL DYSFUNC NOS
HYPOACTIVE SEX DESIRE
INHIBITED SEX EXCITEMENT
FEMALE ORGASMIC DISORDER
MALE ORGASMIC DISORDER
PREMATURE EJACULATION
DYSPAREUNIA, PSYCHOGENIC
PSYCHOSEXUAL DYSFUNC NEC
FETISHISM
180
302.82
302.83
302.84
302.85
302.89
302.9
306.0
306.1
306.2
306.3
306.4
306.50
306.51
306.52
306.53
306.59
306.6
306.7
306.8
306.9
307.0
307.1
307.20
307.21
307.22
307.23
307.3
307.40
307.41
307.42
307.43
307.44
307.45
307.46
307.47
307.48
307.49
307.50
307.51
307.52
307.53
307.54
307.59
307.6
307.7
307.80
307.81
307.89
307.9
308.0
308.1
308.2
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VOYEURISM
SEXUAL MASOCHISM
SEXUAL SADISM
GEND IDEN DIS, ADOL/ADULT
PSYCHOSEXUAL DIS NEC
PSYCHOSEXUAL DIS NOS
PSYCHOGEN MUSCULSKEL DIS
PSYCHOGENIC RESPIR DIS
PSYCHOGEN CARDIOVASC DIS
PSYCHOGENIC SKIN DISEASE
PSYCHOGENIC GI DISEASE
PSYCHOGENIC GU DIS NOS
PSYCHOGENIC VAGINISMUS
PSYCHOGENIC DYSMENORRHEA
PSYCHOGENIC DYSURIA
PSYCHOGENIC GU DIS NEC
PSYCHOGEN ENDOCRINE DIS
PSYCHOGENIC SENSORY DIS
PSYCHOGENIC DISORDER NEC
PSYCHOGENIC DISORDER NOS
ADULT ONSET FLNCY DISORD
ANOREXIA NERVOSA
TIC DISORDER NOS
TRANSIENT TIC DISORDER
CHR MOTOR/VOCAL TIC DIS
TOURETTE'S DISORDER
STEREOTYPIC MOVEMENT DIS
NONORGANIC SLEEP DIS NOS
TRANSIENT INSOMNIA
PERSISTENT INSOMNIA
TRANSIENT HYPERSOMNIA
PERSISTENT HYPERSOMNIA
NONORGANIC CIRCADIAN RHY
SLEEP AROUSAL DISORDER
SLEEP STAGE DYSFUNC NEC
REPETIT SLEEP INTRUSION
NONORGANIC SLEEP DIS NEC
EATING DISORDER NOS
BULIMIA NERVOSA
PICA
RUMINATION DISORDER
PSYCHOGENIC VOMITING
EATING DISORDER NEC
ENURESIS
ENCOPRESIS
PSYCHOGENIC PAIN NOS
TENSION HEADACHE
PSYCHOGENIC PAIN NEC
SPECIAL SYMPTOM NEC/NOS
STRESS REACT, EMOTIONAL
STRESS REACTION, FUGUE
STRESS REACT, PSYCHOMOT
181
308.3
308.4
308.9
309.0
309.1
309.21
309.22
309.23
309.24
309.28
309.29
309.3
309.4
309.81
309.82
309.83
309.89
309.9
310.0
310.1
310.2
310.81
310.89
310.9
311
312.00
312.01
312.02
312.03
312.10
312.11
312.12
312.13
312.20
312.21
312.22
312.23
312.30
312.31
312.32
312.33
312.34
312.35
312.39
312.4
312.81
312.82
312.89
312.9
313.0
313.1
ACUTE STRESS REACT NEC
STRESS REACT, MIXED DIS
ACUTE STRESS REACT NOS
ADJUSTMNT DIS W DEPRESSN
PROLONG DEPRESSIVE REACT
SEPARATION ANXIETY
EMANCIPATION DISORDER
ACADEMIC/WORK INHIBITION
ADJUSTMENT DIS W ANXIETY
ADJUST DIS W ANXIETY/DEP
ADJ REACT-EMOTION NEC
ADJUST DISOR/DIS CONDUCT
ADJ DIS-EMOTION/CONDUCT
POSTTRAUMATIC STRESS DIS
ADJUST REACT-PHYS SYMPT
ADJUST REACT-WITHDRAWAL
ADJUSTMENT REACTION NEC
ADJUSTMENT REACTION NOS
FRONTAL LOBE SYNDROME
PERSONALITY CHG OTH DIS
POSTCONCUSSION SYNDROME
PSEUDOBULBAR AFFECT
NONPSYCH MNTL DISORD NEC
NONPSYCHOT BRAIN SYN NOS
DEPRESSIVE DISORDER NEC
UNSOCIAL AGGRESS-UNSPEC
UNSOCIAL AGGRESSION-MILD
UNSOCIAL AGGRESSION-MOD
UNSOCIAL AGGRESS-SEVERE
UNSOCIAL UNAGGRESS-UNSP
UNSOCIAL UNAGGRESS-MILD
UNSOCIAL UNAGGRESS-MOD
UNSOCIAL UNAGGR-SEVERE
SOCIAL CONDUCT DIS-UNSP
SOCIAL CONDUCT DIS-MILD
SOCIAL CONDUCT DIS-MOD
SOCIAL CONDUCT DIS-SEV
IMPULSE CONTROL DIS NOS
PATHOLOGICAL GAMBLING
KLEPTOMANIA
PYROMANIA
INTERMITT EXPLOSIVE DIS
ISOLATED EXPLOSIVE DIS
IMPULSE CONTROL DIS NEC
MIX DIS CONDUCT/EMOTION
CNDCT DSRDR CHLDHD ONST
CNDCT DSRDR ADLSCNT ONST
OTHER CONDUCT DISORDER
CONDUCT DISTURBANCE NOS
OVERANXIOUS DISORDER
MISERY & UNHAPPINESS DIS
313.21
SHYNESS DISORDER-CHILD
PC v2014A
182
313.22
313.23
313.3
313.81
313.82
313.83
313.89
313.9
314.00
314.01
314.1
314.2
314.8
314.9
315.00
315.01
315.02
315.09
315.1
315.2
315.31
315.32
315.34
315.35
315.39
315.4
315.5
315.8
315.9
316
317
318.0
318.1
318.2
319
INTROVERTED DIS-CHILD
SELECTIVE MUTISM
RELATIONSHIP PROBLEMS
OPPOSITION DEFIANT DISOR
IDENTITY DISORDER
ACADEMIC UNDERACHIEVMENT
EMOTIONAL DIS CHILD NEC
EMOTIONAL DIS CHILD NOS
ATTN DEFIC NONHYPERACT
ATTN DEFICIT W HYPERACT
HYPERKINET W DEVEL DELAY
HYPERKINETIC CONDUCT DIS
OTHER HYPERKINETIC SYND
HYPERKINETIC SYND NOS
READING DISORDER NOS
ALEXIA
DEVELOPMENTAL DYSLEXIA
READING DISORDER NEC
MATHEMATICS DISORDER
OTH LEARNING DIFFICULTY
EXPRESSIVE LANGUAGE DIS
RECP-EXPRES LANGUAGE DIS
SPEECHDEL D/T HEAR LOSS
CHLDHD ONSET FLNCY DISOR
SPEECH/LANGUAGE DIS NEC
DEVEL COORDINATION DIS
MIXED DEVELOPMENT DIS
DEVELOPMENT DELAYS NEC
DEVELOPMENT DELAY NOS
PSYCHIC FACTOR W OTH DIS
MILD MENTAL RETARDATION
MOD MENTAL RETARDATION
SEVERE MENTAL RETARDAT
PROFOUND MENTAL RETARDAT
MENTAL RETARDATION NOS
Table Number 11.01: Complication Mainly Related to Pregnancy
Code
640.81
640.91
641.01
641.11
641.21
641.31
641.81
641.91
642.01
642.02
642.11
642.12
642.21
642.22
PC v2014A
Shortened Description
HEM EARLY PREG NEC-DELIV
HEM EARLY PREG-DELIVERED
PLACENTA PREVIA-DELIVER
PLACENTA PREV HEM-DELIV
PREM SEPAR PLACEN-DELIV
COAG DEF HEMORR-DELIVER
ANTEPARTUM HEM NEC-DELIV
ANTEPARTUM HEM NOS-DELIV
ESSEN HYPERTEN-DELIVERED
ESSEN HYPERTEN-DEL W P/P
RENAL HYPERTEN PG-DELIV
RENAL HYPERTEN-DEL P/P
OLD HYPERTEN NEC-DELIVER
OLD HYPERTEN-DELIV W P/P
183
642.31
642.32
642.41
642.42
642.51
642.52
642.61
642.62
642.71
642.72
642.91
642.92
643.01
643.11
643.21
643.81
643.91
644.21
645.11
645.21
646.01
646.11
646.12
646.21
646.22
646.31
646.41
646.42
646.51
646.52
646.61
646.62
646.71
646.81
646.82
646.91
647.01
647.02
647.11
647.12
647.21
647.22
647.31
647.32
647.41
647.42
647.51
647.52
647.61
647.62
647.81
647.82
647.91
PC v2014A
TRANS HYPERTEN-DELIVERED
TRANS HYPERTEN-DEL W P/P
MILD/NOS PREECLAMP-DELIV
MILD PREECLAMP-DEL W P/P
SEVERE PREECLAMP-DELIVER
SEV PREECLAMP-DEL W P/P
ECLAMPSIA-DELIVERED
ECLAMPSIA-DELIV W P/P
TOX W OLD HYPERTEN-DELIV
TOX W OLD HYP-DEL W P/P
HYPERTENS NOS-DELIVERED
HYPERTENS NOS-DEL W P/P
MILD HYPEREM GRAV-DELIV
HYPEREM W METAB DIS-DEL
LATE VOMIT OF PREG-DELIV
VOMIT COMPL PREG-DELIVER
VOMIT OF PREG NOS-DELIV
EARLY ONSET DELIVERY-DEL
POST TERM PREG-DEL
PROLONGED PREG-DEL
PAPYRACEOUS FETUS-DELIV
EDEMA IN PREG-DELIVERED
EDEMA IN PREG-DEL W P/P
RENAL DIS NOS-DELIVERED
RENAL DIS NOS-DEL W P/P
RECURNT PREG LOSS-DELIV
NEURITIS-DELIVERED
NEURITIS-DELIVERED W P/P
ASYM BACTERIURIA-DELIVER
ASY BACTERURIA-DEL W P/P
GU INFECTION-DELIVERED
GU INFECTION-DELIV W P/P
LIVER/BIL TRCT DISR-DEL
PREG COMPL NEC-DELIVERED
PREG COMPL NEC-DEL W P/P
PREG COMPL NOS-DELIVERED
SYPHILIS-DELIVERED
SYPHILIS-DELIVERED W P/P
GONORRHEA-DELIVERED
GONORRHEA-DELIVER W P/P
OTHER VD-DELIVERED
OTHER VD-DELIVERED W P/P
TUBERCULOSIS-DELIVERED
TUBERCULOSIS-DELIV W P/P
MALARIA-DELIVERED
MALARIA-DELIVERED W P/P
RUBELLA-DELIVERED
RUBELLA-DELIVERED W P/P
OTH VIRAL DIS-DELIVERED
OTH VIRAL DIS-DEL W P/P
INFECT DIS NEC-DELIVERED
INFECT DIS NEC-DEL W P/P
INFECT NOS-DELIVERED
184
647.92
648.01
648.02
648.11
648.12
648.21
648.22
648.31
648.32
648.41
648.42
648.51
648.52
648.61
648.62
648.71
648.72
648.81
648.82
648.91
648.92
649.01
649.02
649.11
649.12
649.21
649.22
649.31
649.32
649.41
649.42
649.51
649.61
649.62
649.81
649.82
INFECT NOS-DELIVER W P/P
DIABETES-DELIVERED
DIABETES-DELIVERED W P/P
THYROID DYSFUNC-DELIVER
THYROID DYSFUN-DEL W P/P
ANEMIA-DELIVERED
ANEMIA-DELIVERED W P/P
DRUG DEPENDENCE-DELIVER
DRUG DEPENDEN-DEL W P/P
MENTAL DISORDER-DELIVER
MENTAL DIS-DELIV W P/P
CONGEN CV DIS-DELIVERED
CONGEN CV DIS-DEL W P/P
CV DIS NEC PREG-DELIVER
CV DIS NEC-DELIVER W P/P
BONE DISORDER-DELIVERED
BONE DISORDER-DEL W P/P
ABN GLUCOSE TOLER-DELIV
ABN GLUCOSE-DELIV W P/P
OTH CURR COND-DELIVERED
OTH CURR COND-DEL W P/P
TOBACCO USE DISOR-DELLIV
TOBACCO USE DIS-DEL-P/P
OBESITY-DELIVERED
OBESITY-DELIVERED W P/P
BARIATRIC SURG STAT-DEL
BARIATRIC SURG-DEL W P/P
COAGULATION DEF-DELIV
COAGULATN DEF-DEL W P/P
EPILEPSY-DELIVERED
EPILEPSY-DELIVERED W P/P
SPOTTING-DELIVERED
UTERINE SIZE DESCREP-DEL
UTERINE SIZE-DEL W P/P
SPON LABR W PLAN C/S-DEL
LBR W PLAN C/S-DEL W P/P
Table Number 11.02: Normal Delivery and Other Indications for Care
Code
650
651.01
651.11
651.21
651.31
651.41
651.51
651.61
651.71
651.81
651.91
652.01
652.11
PC v2014A
Shortened Description
NORMAL DELIVERY
TWIN PREGNANCY-DELIVERED
TRIPLET PREGNANCY-DELIV
QUADRUPLET PREG-DELIVER
TWINS W FETAL LOSS-DEL
TRIPLETS W FET LOSS-DEL
QUADS W FETAL LOSS-DEL
MULT GES W FET LOSS-DEL
MULT GEST-FET REDUCT DEL
MULTI GESTAT NEC-DELIVER
MULT GESTATION NOS-DELIV
UNSTABLE LIE-DELIVERED
CEPHALIC VERS NOS-DELIV
185
652.21
652.31
652.41
652.51
652.61
652.71
652.81
652.91
653.01
653.11
653.21
653.31
653.41
653.51
653.61
653.71
653.81
653.91
654.01
654.02
654.11
654.12
654.21
654.31
654.32
654.41
654.42
654.51
654.52
654.61
654.62
654.71
654.72
654.81
654.82
654.91
654.92
655.01
655.11
655.21
655.31
655.41
655.51
655.61
655.71
655.81
655.91
656.01
656.11
656.21
656.31
656.41
656.51
PC v2014A
BREECH PRESENTAT-DELIVER
TRANSVER/OBLIQ LIE-DELIV
FACE/BROW PRESENT-DELIV
HIGH HEAD AT TERM-DELIV
MULT GEST MALPRES-DELIV
PROLAPSED ARM-DELIVERED
MALPOSITION NEC-DELIVER
MALPOSITION NOS-DELIVER
PELVIC DEFORM NOS-DELIV
CONTRACT PELV NOS-DELIV
INLET CONTRACTION-DELIV
OUTLET CONTRACTION-DELIV
FETOPELV DISPROPOR-DELIV
FETAL DISPROP NOS-DELIV
HYDROCEPH FETUS-DELIVER
OTH ABN FET DISPRO-DELIV
DISPROPORTION NEC-DELIV
DISPROPORTION NOS-DELIV
CONGEN ABN UTERUS-DELIV
CONG ABN UTER-DEL W P/P
UTERINE TUMOR-DELIVERED
UTERINE TUMOR-DEL W P/P
PREV C-DELIVERY-DELIVRD
RETROVERT UTERUS-DELIVER
RETROVERT UTER-DEL W P/P
ABN UTERUS NEC-DELIVERED
ABN UTERUS NEC-DEL W P/P
CERVICAL INCOMPET-DELIV
CERV INCOMPET-DEL W P/P
ABN CERVIX NEC-DELIVERED
ABN CERVIX NEC-DEL W P/P
ABNORM VAGINA-DELIVERED
ABNORM VAGINA-DEL W P/P
ABNORMAL VULVA-DELIVERED
ABNORMAL VULVA-DEL W P/P
ABN PELV ORG NEC-DELIVER
ABN PELV NEC-DELIV W P/P
FETAL CNS MALFORM-DELIV
FETAL CHROMOSO ABN-DELIV
FAMIL HEREDIT DIS-DELIV
FET DAMG D/T VIRUS-DELIV
FET DAMG D/T DIS-DELIVER
FET DAMAG D/T DRUG-DELIV
RADIAT FETAL DAMAG-DELIV
DECREASE FETAL MOVMT DEL
FETAL ABNORM NEC-DELIVER
FETAL ABNORM NOS-DELIVER
FETAL-MATERNAL HEM-DELIV
RH ISOIMMUNIZAT-DELIVER
ABO ISOIMMUNIZAT-DELIVER
FETAL DISTRESS-DELIVERED
INTRAUTER DEATH-DELIVER
POOR FETAL GROWTH-DELIV
186
656.61
656.71
656.81
656.91
657.01
658.01
658.11
658.21
658.31
658.41
658.81
658.91
659.01
659.11
659.21
659.31
659.41
659.51
659.61
659.71
659.81
659.91
EXCESS FETAL GRTH-DELIV
OTH PLACENT COND-DELIVER
FET/PLAC PROB NEC-DELIV
FET/PLAC PROB NOS-DELIV
POLYHYDRAMNIOS-DELIVERED
OLIGOHYDRAMNIOS-DELIVER
PREM RUPT MEMBRAN-DELIV
PROLONG RUPT MEMB-DELIV
ARTIFIC RUPT MEMBR-DELIV
AMNIOTIC INFECTION-DELIV
AMNIOTIC PROB NEC-DELIV
AMNIOTIC PROB NOS-DELIV
FAIL MECH INDUCT-DELIVER
FAIL INDUCTION NOS-DELIV
PYREXIA IN LABOR-DELIVER
SEPTICEM IN LABOR-DELIV
GRAND MULTIPARITY-DELIV
ELDERLY PRIMIGRAVIDA-DEL
ELDERLY MULTIGRAVIDA-DEL
ABN FTL HRT RATE/RHY-DEL
COMPLIC LABOR NEC-DELIV
COMPLIC LABOR NOS-DELIV
Table Number 11.03: Complication Mainly in the Course of Labor and Delivery
Code
660.01
660.11
660.21
660.31
660.41
660.51
660.61
660.71
660.81
660.91
661.01
661.11
661.21
661.31
661.41
661.91
662.01
662.11
662.21
662.31
663.01
663.11
663.21
663.31
663.41
663.51
663.61
PC v2014A
Shortened Description
OBSTRUC/FET MALPOS-DELIV
BONY PELV OBSTRUCT-DELIV
ABN PELV TIS OBSTR-DELIV
PERSIST OCCIPTPOST-DELIV
SHOULDER DYSTOCIA-DELIV
LOCKED TWINS-DELIVERED
FAIL TRIAL LAB NOS-DELIV
FAILED FORCEPS NOS-DELIV
OBSTRUCT LABOR NEC-DELIV
OBSTRUCT LABOR NOS-DELIV
PRIM UTERINE INERT-DELIV
SEC UTERINE INERT-DELIV
UTERINE INERT NEC-DELIV
PRECIPITATE LABOR-DELIV
UTER DYSTOCIA NOS-DELIV
ABNORMAL LABOR NOS-DELIV
PROLONG 1ST STAGE-DELIV
PROLONG LABOR NOS-DELIV
PROLONG 2ND STAGE-DELIV
DELAY DEL 2ND TWIN-DELIV
CORD PROLAPSE-DELIVERED
CORD AROUND NECK-DELIVER
CORD COMPRESS NEC-DELIV
CORD ENTANGLE NEC-DELIV
SHORT CORD-DELIVERED
VASA PREVIA-DELIVERED
VASC LESION CORD-DELIVER
187
663.81
663.91
664.01
664.11
664.21
664.31
664.41
664.51
664.81
664.91
665.01
665.11
665.22
665.31
665.41
665.51
665.61
665.71
665.72
665.81
665.82
665.91
665.92
666.02
666.12
666.22
666.32
667.02
667.12
668.01
668.02
668.11
668.12
668.21
668.22
668.81
668.82
668.91
668.92
669.01
669.02
669.11
669.12
669.21
669.22
669.32
669.41
669.42
669.51
669.61
669.71
669.81
669.82
PC v2014A
CORD COMPLICAT NEC-DELIV
CORD COMPLICAT NOS-DELIV
DEL W 1 DEG LACERAT-DEL
DEL W 2 DEG LACERAT-DEL
DEL W 3 DEG LACERAT-DEL
DEL W 4 DEG LACERAT-DEL
OB PERINEAL LAC NOS-DEL
OB PERINEAL HEMATOMA-DEL
OB PERINEAL TRAU NEC-DEL
OB PERINEAL TRAU NOS-DEL
PRELABOR RUPT UTERUS-DEL
RUPTURE UTERUS NOS-DELIV
INVERS UTERUS-DEL W P/P
LACERAT OF CERVIX-DELIV
HIGH VAGINAL LACER-DELIV
OB INJ PELV ORG NEC-DEL
DAMAGE TO PELVIC JT-DEL
OB PELVIC HEMATOMA-DELIV
PELVIC HEMATOM-DEL W PP
OB TRAUMA NEC-DELIVERED
OB TRAUMA NEC-DEL W P/P
OB TRAUMA NOS-DELIVERED
OB TRAUMA NOS-DEL W P/P
THRD-STAGE HEM-DEL W P/P
POSTPA HEM NEC-DEL W P/P
DELAY P/P HEM-DEL W P/P
P/P COAG DEF-DEL W P/P
RETND PLAC NOS-DEL W P/P
RET PROD CONC-DEL W P/P
PULM COMPL IN DEL-DELIV
PULM COMPLIC-DEL W P/P
HEART COMPL IN DEL-DELIV
HEART COMPL-DEL W P/P
CNS COMPL LAB/DEL-DELIV
CNS COMPLIC-DEL W P/P
ANESTH COMPL NEC-DELIVER
ANESTH COMPL NEC-DEL P/P
ANESTH COMPL NOS-DELIVER
ANESTH COMPL NOS-DEL P/P
MATERNAL DISTRESS-DELIV
MATERN DISTRES-DEL W P/P
OBSTETRIC SHOCK-DELIVER
OBSTET SHOCK-DELIV W P/P
MATERN HYPOTEN SYN-DELIV
MATERN HYPOTEN-DEL W P/P
AC REN FAIL-DELIV W P/P
OTH OB COMPL-DELIVERED
OTH OB COMPL-DELIV W P/P
FORCEP DELIV NOS-DELIVER
BREECH EXTR NOS-DELIVER
CESAREAN DELIVERY NOS
COMP LAB/DELIV NEC-DELIV
COMPL DEL NEC-DEL W P/P
188
669.91
669.92
COMP LAB/DELIV NOS-DELIV
COMPL DEL NOS-DEL W P/P
Table Number 11.04: Complication of the Puerperium
Code
670.02
670.12
670.22
670.32
670.82
671.01
671.02
671.11
671.12
671.21
671.22
671.31
671.42
671.51
671.52
671.81
671.82
671.91
671.92
672.02
673.01
673.02
673.11
673.12
673.21
673.22
673.31
673.32
673.81
673.82
674.01
674.02
674.12
674.22
674.32
674.42
674.82
674.92
675.01
675.02
675.11
675.12
675.21
675.22
675.81
675.82
675.91
PC v2014A
Shortened Description
MAJOR PUERP INF-DEL P/P
PUERP ENDOMET DEL W P/P
PUERPRL Septicemias or Bacteremias-DEL W P/P
PRP SPTC THRMB-DEL W P/P
MAJ PRP INF NEC-DL W P/P
VARICOSE VEIN LEG-DELIV
VARIC VEIN LEG-DEL W P/P
VARICOSE VULVA-DELIVERED
VARICOSE VULVA-DEL W P/P
THROMBOPHLEBITIS-DELIVER
THROMBOPHLEB-DELIV W P/P
DEEP THROM ANTEPAR-DELIV
THROMB POSTPAR-DEL W P/P
THROMBOSIS NEC-DELIVERED
THROMB NEC-DELIV W P/P
VENOUS COMPL NEC-DELIVER
VEN COMP NEC-DELIV W P/P
VENOUS COMPL NOS-DELIVER
VEN COMP NOS-DELIV W P/P
PUERP PYREXIA-DEL W P/P
OB AIR EMBOLISM-DELIVER
OB AIR EMBOL-DELIV W P/P
AMNIOTIC EMBOLISM-DELIV
AMNIOT EMBOL-DELIV W P/P
PULM EMBOL NOS-DELIVERED
PULM EMBOL NOS-DEL W P/P
OB PYEMIC EMBOL-DELIVER
OB PYEM EMBOL-DEL W P/P
PULMON EMBOL NEC-DELIVER
PULM EMBOL NEC-DEL W P/P
PUERP CEREBVAS DIS-DELIV
CEREBVAS DIS-DELIV W P/P
DISRUPT C-SECT-DEL W P/P
DISRUPT PERIN-DEL W P/P
OB SURG COMPL-DEL W P/P
PLACENT POLYP-DEL W P/P
PUERP COMP NEC-DEL W P/P
PUERP COMP NOS-DEL W P/P
INFECT NIPPLE-DELIVERED
INFECT NIPPLE-DEL W P/P
BREAST ABSCESS-DELIVERED
BREAST ABSCESS-DEL W P/P
MASTITIS-DELIVERED
MASTITIS-DELIV W P/P
BREAST INFECT NEC-DELIV
BREAST INF NEC-DEL W P/P
BREAST INFECT NOS-DELIV
189
675.92
676.01
676.02
676.11
676.12
676.21
676.22
676.31
676.32
676.41
676.42
676.51
676.52
676.61
676.62
676.81
676.82
676.91
676.92
BREAST INF NOS-DEL W P/P
RETRACTED NIPPLE-DELIVER
RETRACT NIPPLE-DEL W P/P
CRACKED NIPPLE-DELIVERED
CRACKED NIPPLE-DEL W P/P
BREAST ENGORGE-DELIVERED
BREAST ENGORGE-DEL W P/P
BREAST DIS NEC-DELIVERED
BREAST DIS NEC-DEL W P/P
LACTATION FAIL-DELIVERED
LACTATION FAIL-DEL W P/P
SUPPR LACTATION-DELIVER
SUPPR LACTAT-DEL W P/P
GALACTORRHEA-DELIVERED
GALACTORRHEA-DEL W P/P
LACTATION DIS NEC-DELIV
LACTAT DIS NEC-DEL W P/P
LACTATION DIS NOS-DELIV
LACTAT DIS NOS-DEL W P/P
Table Number 11.05: Medical Induction of Labor
Code
73.01
73.1
73.4
Shortened Description
INDUCT LABOR-RUPT MEMB
SURG INDUCT LABOR NEC
MEDICAL INDUCTION LABOR
Table Number 11.06: Cesarean Section
Code
74.0
74.1
74.2
74.4
74.99
Shortened Description
CLASSCIAL C-SECTION
LOW CERVICAL C-SECTION
EXTRAPERITONEAL C-SECTION
CESAREAN SECTION NEC
CESAREAN SECTION NOS
Table Number 11.06.1: Planned Cesarean Section in Labor
Code
649.81
649.82
Shortened Description
SPON LABR W PLAN C/S-DEL
LBR W PLAN C/S-DEL W P/P
Table Number 11.07: Conditions Possibly Justifying Elective Delivery Prior to 39
Weeks Gestation
Code
042
576.8
641.01
641.11
641.21
641.31
PC v2014A
Shortened Description
HUMAN IMMUNO VIRUS DIS
DIS OF BILIARY TRACT NEC
PLACENTA PREVIA-DELIVER
PLACENTA PREV HEM-DELIV
PREM SEPAR PLACEN-DELIV
COAG DEF HEMORR-DELIVER
190
641.81
641.91
642.01
642.02
642.11
642.12
642.21
642.22
642.31
642.32
642.41
642.42
642.51
642.52
642.61
642.62
642.71
642.72
642.91
642.92
645.11
646.21
646.22
646.71
648.01
648.51
648.52
648.61
648.62
648.81
648.82
649.31
649.32
651.01
651.11
651.21
651.31
651.41
651.51
651.61
651.71
651.81
651.91
652.01
652.61
655.01
655.11
655.31
655.41
655.51
655.61
655.81
656.01
PC v2014A
ANTEPARTUM HEM NEC-DELIV
ANTEPARTUM HEM NOS-DELIV
ESSEN HYPERTEN-DELIVERED
ESSEN HYPERTEN-DEL W P/P
RENAL HYPERTEN PG-DELIV
RENAL HYPERTEN-DEL P/P
OLD HYPERTEN NEC-DELIVER
OLD HYPERTEN-DELIV W P/P
TRANS HYPERTEN-DELIVERED
TRANS HYPERTEN-DEL W P/P
MILD/NOS PREECLAMP-DELIV
MILD PREECLAMP-DEL W P/P
SEVERE PREECLAMP-DELIVER
SEV PREECLAMP-DEL W P/P
ECLAMPSIA-DELIVERED
ECLAMPSIA-DELIV W P/P
TOX W OLD HYPERTEN-DELIV
TOX W OLD HYP-DEL W P/P
HYPERTENS NOS-DELIVERED
HYPERTENS NOS-DEL W P/P
POST TERM PREG-DEL
RENAL DIS NOS-DELIVERED
RENAL DIS NOS-DEL W P/P
LIVER/BIL TRCT DISR-DEL
DIABETES-DELIVERED
CONGEN CV DIS-DELIVERED
CONGEN CV DIS-DEL W P/P
CV DIS NEC PREG-DELIVER
CV DIS NEC-DELIVER W P/P
ABN GLUCOSE TOLER-DELIV
ABN GLUCOSE-DELIV W P/P
COAGULATION DEF-DELIV
COAGULATN DEF-DEL W P/P
TWIN PREGNANCY-DELIVERED
TRIPLET PREGNANCY-DELIV
QUADRUPLET PREG-DELIVER
TWINS W FETAL LOSS-DEL
TRIPLETS W FET LOSS-DEL
QUADS W FETAL LOSS-DEL
MULT GES W FET LOSS-DEL
MULT GEST-FET REDUCT DEL
MULTI GESTAT NEC-DELIVER
MULT GESTATION NOS-DELIV
UNSTABLE LIE-DELIVERED
MULT GEST MALPRES-DELIV
FETAL CNS MALFORM-DELIV
FETAL CHROMOSO ABN-DELIV
FET DAMG D/T VIRUS-DELIV
FET DAMG D/T DIS-DELIVER
FET DAMAG D/T DRUG-DELIV
RADIAT FETAL DAMAG-DELIV
FETAL ABNORM NEC-UNSPEC
FETAL-MATERNAL HEM-DELIV
191
656.11
656.21
656.31
656.41
656.51
657.01
658.01
658.11
658.21
658.41
659.71
663.01
663.51
665.01
V08
V23.5
V27.1
RH ISOIMMUNIZAT-DELIVER
ABO ISOIMMUNIZAT-DELIVER
FETAL DISTRESS-DELIVERED
INTRAUTER DEATH-DELIVER
POOR FETAL GROWTH-DELIV
POLYHYDRAMNIOS-DELIVERED
OLIGOHYDRAMNIOS-DELIVER
PREM RUPT MEMBRAN-DELIV
PROLONG RUPT MEMB-DELIV
AMNIOTIC INFECTION-DELIV
ABN FTL HRT RATE/RHY-DEL
CORD PROLAPSE - DELIVERED
VASA PREVIA-DELIVERED
PRELABOR RUPT UTERUS - DEL
ASYMP HIV INFECTN STATUS
PREG W POOR REPRODUCT HX
DELIVER-SINGLE STILLBORN
Table Number 11.08: Outcome of Delivery
Code
V27.0
Shortened Description
DELIVER-SINGLE LIVEBORN
Table Number 11.09: Contraindications to Vaginal Delivery
Code
644.21
651.01
651.11
651.21
651.31
651.41
651.51
651.61
651.81
651.91
652.21
652.31
652.41
652.61
652.81
654.21
656.41
660.51
662.31
669.61
761.5
V27.1
V27.2
V27.3
V27.4
V27.5
V27.6
PC v2014A
Shortened Description
EARLY ONSET DELIVERY-DEL
TWIN PREGNANCY-DELIVERED
TRIPLET PREGNANCY-DELIV
QUADRUPLET PREG-DELIVER
TWINS W FETAL LOSS-DEL
TRIPLETS W FET LOSS-DEL
QUADS W FETAL LOSS-DEL
MULT GES W FET LOSS-DEL
MULTI GESTAT NEC-DELIVER
MULT GESTATION NOS-DELIV
BREECH PERSENTAT-DELIVER
TRANSVER/OBLIQ LIE-DELIV
FACE/BROW PRESENT DELIV
MULT GEST MALPRE-DELIV
MALPOSITION NEC-DELIVER
PREV C-SECT NOS-DELIVER
INTRAUTER DEATH-DELIVER
LOCKED TWINS-DELIVERED
DELAY DEL 2ND TWIN-DELIV
BREECH EXTR NOS-DELIVER
MULT PREGNANCY AFF NB
DELIVER-SINGLE STILLBORN
DELIVER-TWINS, BOTH LIVE
DEL-TWINS, 1 NB, 1 SB
DELIVER-TWINS, BOTH SB
DEL-MULT BIRTH, ALL LIVE
DEL-MULT BRTH, SOME LIVE
192
V27.7
DEL-MULT BIRTH, ALL SB
Table Number 11.09.1: Fetal Demise
Code
656.40
656.41
Shortened Description
INTRAUTERINE DEATH-UNSP
INTRAUTER DEATH-DELIVER
Table Number 11.10: Newborn Septicemia or Bacteremia
Code
771.81
771.83
Shortened Description
NB SEPTICEMIA [Septicemias or Bacteremias]
BACTEREMIA OF NEWBORN
Table Number 11.10.1: Sepsis
Code
038.0
038.10
038.11
038.12
038.19
038.2
038.3
038.40
038.41
038.42
038.43
038.44
038.49
038.8
112.5
785.52
790.7
995.91
995.92
998.02
Shortened Description
STREPTOCOCCAL SEPTICEMIA
STAPHYLOCOCC SEPTICEMIA NOS
METH SUSC STAPH AUR SEPT
MRSA SEPTICEMIA
STAPHYLOCOCC SEPTICEM NEC
PNEUMOCOCCAL SEPTICEMIA
ANAEROBIC SEPTICEMIA
GRAM-NEG SEPTICEMIA NOS
H. INFLUENAE SEPTICEMIA
E COLI SEPTICEMIA
PSEUDOMONAS SEPTICEMIA
SERRATIA SEPTICEMIA
GRAM-NEG SEPTICEMIA NEC
SEPTICEMIA NEC
DISSEMINATED CANDIDIASIS
SEPTIC SHOCK
BACTEREMIA
SEPTICEMIAS OR BACTEREMIAS
SEVERE SEPTICEMIAS OR BACTEREMIAS
POSTOPERATIVE SEPTIC SHOCK
Table Number 11.10.2: Septicemias or Bacteremias
Code
038.0
038.10
038.11
038.12
038.19
038.2
038.3
038.40
038.41
038.42
038.43
038.44
PC v2014A
Shortened Description
STREPTOCOCCAL SEPTICEMIA
STAPHYLOCOCC SEPTICEMIA NOS
METH SUSC STAPH AUR SEPT
MRSA SEPTICEMIA
STAPHYLOCOCC SEPTICEM NEC
PNEUMOCOCCAL SEPTICEMIA
ANAEROBIC SEPTICEMIA
GRAM-NEG SEPTICEMIA NOS
H. INFLUENAE SEPTICEMIA
E COLI SEPTICEMIA
PSEUDOMONAS SEPTICEMIA
SERRATIA SEPTICEMIA
193
038.49
038.8
041.04
041.10
041.11
041.19
041.3
041.41
041.42
041.43
041.49
041.7
041.85
112.5
785.52
785.59
790.7
995.91
995.92
998.00
GRAM-NEG SEPTICEMIA NEC
SEPTICEMIA NEC
ENTEROCOCCUS GROUP D
STAPHYLOCOCCUS UNSPCFIED
STAPHYLOCOCCUS AUREUS
OTHER STAPHYLOCOCCUS
KLEBSIELLA INFECT NOS
SHIGA TXN-PRODUCE E.COLI
SHGA TXN PROD E.COLI NEC
SHGA TXN PROD E.COLI NOS
E.COLI INFECTION NEC/NOS
PSEUDOMONAS INFECT NOS
OTH GRAM NEGATV BACTERIA
DISSEMINATED CANDIDIASIS
SEPTIC SHOCK
SHOCK W/O TRAUMA NEC
BACTEREMIA
SEPTICEMIAS OR BACTEREMIAS
SEVERE SEPTICEMIAS OR BACTEREMIAS
POSTOPERATIVE SHOCK
Table Number 11.10.3: Liveborn Newborn
Code
V30.00
V30.01
V30.1
V30.2
V31.00
V31.01
V31.1
V31.2
V33.00
V33.01
V33.1
V33.2
V34.00
V34.01
V34.1
V34.2
V37.00
V37.01
V37.1
V37.2
V39.00
V39.01
V39.1
V39.2
Shortened Description
SINGLE LB IN-HOSP W/O CS
SINGLE LB IN-HOSP W CS
SINGL LIVEBORN-BEFORE ADM
SINGLE LIVEBORN-NONHOSP
TWIN-MATE LB-HOSP W/O CS
TWIN-MATE LB-IN HOS W CS
TWIN, MATE LB-BEFORE ADM
TWIN, MATE LB- NONHOSP
TWIN-NOS-IN HOSP W/O CS
TWIN-NOS-IN HOSP W CS
TWIN NOS-BEFORE ADMISSN
TWIN NOS-NONHOSP
OTH MULT LB-HOSP W/O CS
OTH MULT LB-IN HOSP W CS
OTH MULT NB-BEFORE ADM
OTH MULTIPLE NB-NONHOSP
MULT BRTH NOS-HOS W/O CS
MULT BIRTH NOS-HOSP W CS
MULT BRTH NOS-BEFORE ADM
MULT BIRTH NOS-NONHOSP
LIVEBORN NOS-HOSP W/O CS
LIVEBORN NOS-HOSP W CS
LIVEBORN NOS-BEFORE ADM
LIVEBORN NOS-NONHOSP
Table Number 11.12: Birth Weight 500-749 Grams
Code
PC v2014A
Shortened Description
194
764.02
764.12
764.22
764.92
765.02
765.12
LT-FOR-DATES 500-749G
LT-DATE W/MAL 500-749G
FETAL MALNUTR 500-749G
FET GROWTH RET 500-749G
EXTREME IMMATUR 500-749G
PRETERM NEC 500-749G
Table Number 11.13: Birth Weight 750-999 Grams
Code
764.03
764.13
764.23
764.93
765.03
765.13
Shortened Description
LT-FOR-DATES 750-999G
LT-DATE W/MAL 750-999G
FETAL MAL 750-999G
FET GROWTH RET 750-999G
EXTREME IMMATUR 750-999G
PRETERM NEC 750-999G
Table Number 11.13.1: Birth Weight 500-999 Grams
Code
V21.32
Shortened Description
LOW BIRTHWT 500-999G
Table Number 11.14: Birth Weight 1000-1499 Grams
Code
764.04
764.05
764.14
764.15
764.24
764.25
764.94
764.95
765.04
765.05
765.14
765.15
V21.33
Shortened Description
LT-FOR-DATES 1000-1249G
LT-FOR-DATES 1250-1499G
LT-DATE W/MAL 1000-1249G
LT-DATE W/MAL 1250-1499G
FETAL MAL 1000-1249G
FETAL MAL 1250-1499G
FET GRWTH RET 1000-1249G
FET GRWTH RET 1250-1499G
EXTREME IMMAT 1000-1249G
EXTREME IMMAT 1250-1499G
PRETERM NEC 1000-1249G
PRETERM NEC 1250-1499G
LOW BIRTHWT 1000-1499G
Table Number 11.15: Birth Weight 1500-1999 Grams
Code
764.06
764.07
764.16
764.17
764.26
764.27
764.96
764.97
765.06
765.07
765.16
PC v2014A
Shortened Description
LT-FOR-DATES 1500-1749G
LT-FOR-DATES 1750-1999G
LT-DATE W/MAL 1500-1749G
LT-DATE W/MAL 1750-1999G
FETAL MAL 1500-1749G
FETAL MALNUTR 1750-1999G
FET GRWTH RET 1500-1749G
FET GRWTH RET 1750-1999G
EXTREME IMMAT 1500-1749G
EXTREME IMMAT 1750-1999G
PRETERM NEC 1500-1749G
195
765.17
V21.34
PRETERM NEC 1750-1999G
LOW BIRTHWT 1500-1999G
Table Number 11.16: Birth Weight 2000-2499 Grams
Code
764.08
764.18
764.28
764.98
765.08
765.18
Shortened Description
LT-FOR-DATES 2000-2499G
LT-DATE W/MAL 2000-2499G
FETAL MALNUTR 2000-2499G
FET GRWTH RET 2000-2499G
EXTREME IMMAT 2000-2499G
PRETERM NEC 2000-2499G
Table Number 11.16.1: Birth Weight 2000-2500 Grams
Code
V21.35
Shortened Description
LOW BIRTHWT 2000-2500G
Table Number 11.17: Birth Weight 2500 Grams and over
Code
764.09
764.19
764.29
764.99
765.09
765.19
Shortened Description
LT-FOR-DATES 2500+G
LT-DATE W/MAL 2500+G
FETAL MALNUTR 2500+G
FET GRWTH RET 2500+G
EXTREME IMMAT 2500+G
PRETERM NEC 2500+G
Table Number 11.18: Major Surgery
Code
00.50
00.51
00.52
00.53
00.54
00.56
00.57
00.61
00.62
00.66
00.70
00.71
00.72
00.73
00.80
00.81
00.82
00.83
00.84
00.85
00.86
00.87
PC v2014A
Shortened Description
IMPL CRT PACEMAKER SYS
IMPL CRT DEFIBRILLAT SYS
IMP/REP LEAD LF VEN SYS
IMP/REP CRT PACEMAKR GEN
IMP/REP CRT DEFIB GENAT
INS/REP IMPL SENSOR LEAD
IMP/REP SUBCUE CARD DEV
PERC ANGIO PRECEREB VESS
PERC ANGIO INTRACRAN VES
PTCA OR CORONARY ATHER
REV HIP REPL-ACETAB/FEM
REV HIP REPL-ACETAB COMP
REV HIP REPL-FEM COMP
REV HIP REPL-LINER/HEAD
REV KNEE REPLACEMT-TOTAL
REV KNEE REPL-TIBIA COMP
REV KNEE REPL-FEMUR COMP
REV KNEE REPLACE-PATELLA
REV KNEE REPL-TIBIA LIN
RESRF HIPTOTAL-ACET/FEM
RESRF HIPPART-FEM HEAD
RESRF HIPPART-ACETABLUM
196
01.12
01.14
01.15
01.18
01.19
01.20
01.21
01.22
01.23
01.24
01.25
01.28
01.29
01.31
01.32
01.39
01.41
01.42
01.51
01.52
01.53
01.59
01.6
02.01
02.02
02.03
02.04
02.05
02.06
02.07
02.11
02.12
02.13
02.14
02.21
02.22
02.31
02.32
02.33
02.34
02.35
02.39
02.42
02.43
02.91
02.92
02.93
02.94
02.99
03.01
03.02
03.09
03.1
PC v2014A
OPEN CEREB MENINGES BX
OPEN BRAIN BIOPSY
SKULL BIOPSY
OTHER BRAIN DX PROCEDURE
OTHER SKULL DX PROCEDURE
IMP/REPL BRAIN PULSE GEN
CRANIAL SINUS I & D
REMOV INTRACRAN STIMULAT
REOPEN CRANIOTOMY SITE
OTHER CRANIOTOMY
OTHER CRANIECTOMY
INTRACEREB CTH-BURR HOLE
REM BRAIN PULSE GENERATR
INCISE CEREBRAL MENINGES
LOBOTOMY & TRACTOTOMY
OTHER BRAIN INCISION
THALAMUS OPERATIONS
GLOBUS PALLIDUS OPS
EX CEREB MENINGEAL LES
HEMISPHERECTOMY
BRAIN LOBECTOMY
OTHER BRAIN EXCISION
EXCISE SKULL LESION
LINEAR CRANIECTOMY
ELEVATE SKULL FX FRAGMNT
SKULL FLAP FORMATION
BONE GRAFT TO SKULL
SKULL PLATE INSERTION
CRANIAL OSTEOPLASTY NEC
SKULL PLATE REMOVAL
SIMPLE SUTURE OF DURA
BRAIN MENINGE REPAIR NEC
MENINGE VESSEL LIGATION
CHOROID PLEXECTOMY
INSERT/REPLACE EVD
INTRCRAN VENT SHUNT/ANAS
VENTRICL SHUNT-HEAD/NECK
VENTRI SHUNT-CIRCULA SYS
VENTRICL SHUNT-THORAX
VENTRICL SHUNT-ABDOMEN
VENTRI SHUNT-UNINARY SYS
OTHER VENTRICULAR SHUNT
REPLACE VENTRICLE SHUNT
REMOVE VENTRICLE SHUNT
LYSIS CORTICAL ADHESION
BRAIN REPAIR
IMPLANT BRAIN STIMULATOR
INSERT/REPLAC SKULL TONG
SKULL & BRAIN OP NEC
REMOVAL FB SPINAL CANAL
REOPEN LAMINECTOMY SITE
SPINAL CANAL EXPLOR NEC
INTRASPIN NERVE ROOT DIV
197
03.21
03.29
03.32
03.39
03.4
03.51
03.52
03.53
03.59
03.6
03.71
03.72
03.79
03.93
03.94
03.97
03.98
03.99
04.01
04.02
04.03
04.04
04.05
04.06
04.07
04.12
04.19
04.3
04.41
04.42
04.43
04.44
04.49
04.5
04.6
04.71
04.72
04.73
04.74
04.75
04.76
04.79
04.91
04.92
04.93
04.99
05.0
05.11
05.19
05.21
05.22
05.23
PC v2014A
PERCUTANEOUS CHORDOTOMY
OTHER CHORDOTOMY
SPINAL CORD/MENINGES BX
OTHER SPINAL DX PROC
EXCIS SPINAL CORD LESION
SPINE MENINGOCELE REPAIR
MYELOMENINGOCEL REPAIR
VERTEBRAL FX REPAIR
SPINAL STRUCT REPAIR NEC
SPINAL CORD ADHESIOLYSIS
SUBARACH-PERITON SHUNT
SUBARACH-URETERAL SHUNT
OTH SPINAL THECAL SHUNT
INSERT SPINAL STIMULATOR
REMOVE SPINAL STIMULATOR
REVISE SPINE THECA SHUNT
REMOVE SPINE THECA SHUNT
SPINE CANAL STRUC OP NEC
EXCISION ACOUSTC NEUROMA
TRIGEMINAL NERV DIVISION
PERIPH NERVE DIV NEC
PERIPH NERVE INCIS NEC
GASSERIAN GANGLIONECTOMY
PERIPH GANGLIONECT NEC
PERIPH NERV EXCISION NEC
OPEN PERIPH NERVE BIOPSY
PERIPH NERVE DX PROC NEC
PERIPHERAL NERVE SUTURE
DECOMPRESS TRIGEM ROOT
CRAN NERV ROOT DECOM NEC
CARPAL TUNNEL RELEASE
TARSAL TUNNEL RELEASE
PER NERVE ADHESIOLYS NEC
PERIPHERAL NERVE GRAFT
PERIPH NERVE TRANSPOSIT
HYPOGLOSS-FACIAL ANASTOM
ACCESSORY-FACIAL ANASTOM
ACCESS-HYPOGLOSS ANASTOM
PERIPH NERV ANASTOM NEC
POSTOP REVIS PER NERV OP
LATE REPAIR PER NERV INJ
OTHER NEUROPLASTY
NEURECTASIS
IMPLANT PERIPH STIMULAT
REMOVE PERIPH STIMULATOR
PERIPHERAL NERVE OPS NEC
SYMPATH NERVE DIVISION
SYMPATHETIC NERVE BIOPSY
SYMPATH NRV DX PROC NEC
SPHENOPALATIN GANGLIONEC
CERVICAL SYMPATHECTOMY
LUMBAR SYMPATHECTOMY
198
05.24
05.25
05.29
05.81
05.89
05.9
06.02
06.09
06.12
06.13
06.19
06.2
06.31
06.39
06.4
06.50
06.51
06.52
06.6
06.7
06.81
06.89
06.91
06.92
06.93
06.94
06.95
06.98
06.99
07.00
07.01
07.02
07.12
07.13
07.14
07.15
07.16
07.17
07.19
07.21
07.22
07.29
07.3
07.41
07.42
07.43
07.44
07.45
07.49
07.51
07.52
07.53
07.54
PC v2014A
PRESACRAL SYMPATHECTOMY
PERIART SYMPATHECTOMY
OTHER SYMPATHECTOMY
SYMPATHETIC NERVE REPAIR
SYMPATHETIC NERVE OP NEC
OTHER NERVOUS SYSTEM OPS
REOPEN THYROID FIELD WND
INCIS THYROID FIELD NEC
OPEN THYROID GLAND BX
PARATHYROID BIOPSY
THYR/PARATHY DX PROC NEC
UNILAT THYROID LOBECTOMY
EXCISION THYROID LESION
PART THYROIDECTOMY NEC
COMPLETE THYROIDECTOMY
SUBSTERN THYROIDECT NOS
PART SUBSTERN THYROIDECT
TOT SUBSTERN THYROIDECT
LINGUAL THYROID EXCISION
THYROGLOSS DUCT EXCISION
TOTAL PARATHYROIDECTOMY
OTHER PARATHYROIDECTOMY
THYROID ISTHMUS DIVISION
THYROID VESSEL LIGATION
THYROID SUTURE
THYROID REIMPLANTATION
PARATHYROID REIMPLANT
OTHER THYROID OPERATIONS
OTHER PARATHYROID OPS
ADRENAL EXPLORATION NOS
UNILAT ADRENAL EXPLORAT
BILAT ADRENAL EXPLORAT
OPEN ADRENAL GLAND BX
TRANSFRONT PITUITARY BX
TRANSPHEN PITUITARY BX
PITUITARY BIOPSY NOS
THYMUS BIOPSY
PINEAL BIOPSY
ENDOCRINE DX PROC NEC
ADRENAL LESION EXCISION
UNILATERAL ADRENALECTOMY
PART ADRENALECTOMY NEC
BILATERAL ADRENALECTOMY
ADRENAL INCISION
ADRENAL NERVE DIVISION
ADRENAL VESSEL LIGATION
ADRENAL REPAIR
ADRENAL REIMPLANTATION
ADRENAL OPERATION NEC
PINEAL FIELD EXPLORATION
PINEAL GLAND INCISION
PARTIAL PINEALECTOMY
TOTAL PINEALECTOMY
199
07.59
07.61
07.62
07.63
07.64
07.65
07.68
07.69
07.71
07.72
07.79
07.80
07.81
07.82
07.83
07.84
07.91
07.92
07.93
07.94
07.95
07.98
07.99
08.11
08.20
08.21
08.22
08.23
08.24
08.25
08.31
08.32
08.33
08.34
08.35
08.36
08.37
08.38
08.41
08.42
08.43
08.44
08.49
08.51
08.52
08.59
08.61
08.62
08.63
08.64
08.69
08.70
PC v2014A
PINEAL OPERATION NEC
EXC PITUIT LES-TRANSFRON
EXC PITUIT LES-TRANSPHEN
PART EXCIS PITUITARY NOS
TOT EXC PITUIT-TRANSFRON
TOT EXC PITUIT-TRANSPHEN
TOTAL EXC PITUITARY NEC
TOTAL EXC PITUITARY NOS
PITUITARY FOSSA EXPLORAT
PITUITARY GLAND INCISION
PITUITARY OPERATION NEC
THYMECTOMY NOS
PART EXCISION OF THYMUS
TOTAL EXCISION OF THYMUS
THORAC PART EXISN THYMUS
THORAC TOTAL EXC THYMUS
THYMUS FIELD EXPLORATION
INCISION OF THYMUS
REPAIR OF THYMUS
THYMUS TRANSPLANTATION
THORAC INCISION THYMUS
OTH THORAC OP THYMUS NOS
THYMUS OPERATION NEC
EYELID BIOPSY
REMOVE EYELID LESION NOS
CHALAZION EXCISION
EXCISE MINOR LES LID NEC
EXC MAJ LES LID PRT-THIC
EXC MAJ LES LID FUL-THIC
DESTRUCTION LID LESION
PTOSIS REP-FRONT MUS SUT
PTOSIS REP-FRON MUS SLNG
PTOSIS REP-LEVAT MUS ADV
PTOSIS REP-LEVAT MUS NEC
PTOS REP-TARSAL TECHNIQ
BLEPHAROPTOS REPAIR NEC
REDUC OVERCORRECT PTOSIS
CORRECT LID RETRACTION
THERMOCAUT/ENTROPION REP
SUTURE ENTROPION REPAIR
WEDG RESEC ENTROPION REP
LID RECONS ENTROPION REP
ENTROPION/ECTROP REP NEC
CANTHOTOMY
BLEPHARORRHAPHY
ADJUST LID POSITION NEC
LID RECONST W SKIN GRAFT
LID RECONST W MUC GRAFT
LID RECONST W HAIR GRAFT
LID RECON-TARSOCONJ FLAP
LID RECONSTR W GRAFT NEC
LID RECONSTRUCTION NOS
200
08.71
08.72
08.73
08.74
08.91
08.92
08.93
08.99
09.0
09.11
09.12
09.19
09.20
09.21
09.22
09.23
09.3
09.41
09.42
09.43
09.44
09.49
09.51
09.52
09.53
09.59
09.6
09.71
09.72
09.73
09.81
09.82
09.83
09.91
09.99
10.0
10.1
10.21
10.29
10.31
10.32
10.33
10.41
10.42
10.43
10.44
10.49
10.5
10.6
10.91
10.99
11.0
11.1
PC v2014A
LID MARG RECON-PART THIC
LID RECONS-PART THIC NEC
LID MARG RECONS FUL THIC
LID RECONST-FUL THIC NEC
ELECTROSURG LID EPILAT
CRYOSURG LID EPILATION
EYELID EPILATION NEC
EYELID OPERATION NEC
LACRIMAL GLAND INCISION
LACRIMAL GLAND BIOPSY
LACRIMAL SAC BIOPSY
LACRIMAL SYS DX PROC NEC
EXC LACRIMAL GLAND NOS
EXCIS LES LACRIMAL GLAND
PART DACRYOADENECT NEC
TOTAL DACRYOADENECTOMY
OTHER LACRIMAL GLAND OPS
LACRIMAL PUNCTUM PROBE
LAC CANALICULI PROBE
NASOLACRIMAL DUCT PROBE
NASOLAC DUCT INTUBAT
LAC PASSAGE MANIP NEC
LAC PUNCTUM INCISION
LAC CANALICULI INCISION
LACRIMAL SAC INCISION
LACRIM PASSAGE INCIS NEC
LACRIM SAC/PASSAGE EXCIS
CORRECT EVERTED PUNCTUM
PUNCTUM REPAIR NEC
CANALICULUS REPAIR
DACRYOCYSTORHINOSTOMY
CONJUNCTIVOCYSTORHINOST
CONJUNCTIVORHINOS W TUBE
LAC PUNCTUM OBLITERATION
LACRIMAL SYSTEM OP NEC
INCISE/REMOV CONJUNCT FB
CONJUNCTIVA INCISION NEC
CONJUNCTIVAL BIOPSY
CONJUNCTIVA DX PROC NEC
EXCISE CONJUNCTIV LESION
DESTRUCT CONJUNC LES NEC
OTH CONJUNC DESTRUC PROC
SYMBLEPH REP W FREE GRFT
GRAFT CONJUNC CUL-DE-SAC
CONJUN CUL-DE-SAC RX NEC
CONJUNC FREE GRAFT NEC
CONJUNCTIVOPLASTY NEC
CONJUNC/LID ADHESIOLYSIS
REPAIR CONJUNCT LACERAT
SUBCONJUNCTIVAL INJECT
CONJUNCTIVAL OP NEC
MAGNET REMOVAL CORNEA FB
CORNEAL INCISION
201
11.21
11.22
11.29
11.31
11.32
11.39
11.41
11.42
11.43
11.49
11.51
11.52
11.53
11.59
11.60
11.61
11.62
11.63
11.64
11.69
11.71
11.72
11.73
11.74
11.75
11.76
11.79
11.91
11.92
11.99
12.00
12.01
12.02
12.11
12.12
12.13
12.14
12.21
12.22
12.29
12.31
12.32
12.33
12.34
12.35
12.39
12.40
12.41
12.42
12.43
12.44
12.51
CORNEAL SCRAPE FOR SMEAR
CORNEAL BIOPSY
CORNEAL DX PROC NEC
PTERYGIUM TRANSPOSITION
PTERYG EXC W CORNEA GRFT
PTERYGIUM EXCISION NEC
MECH REMOV CORNEA EPITH
THERMOCAUT CORNEA LESION
CRYOTHERAP CORNEA LESION
DESTRUCT CORNEA LES NEC
SUTURE CORNEA LACERATION
REP CORNEA POSTOP DEHISC
RX CORNEA LAC W CONJ FLP
CORNEAL REPAIR NEC
CORNEAL TRANSPLANT NOS
LAM KERATPLAST W AUTGRFT
LAMELLAR KERATOPLAST NEC
PERF KERATOPL W AUTOGRFT
PERFORAT KERATOPLAST NEC
CORNEAL TRANSPLANT NEC
KERATOMILEUSIS
KERATOPHAKIA
KERATOPROSTHESIS
THERMOKERATOPLASTY
RADIAL KERATOTOMY
EPIKERATOPHAKIA
CORNEA RECONSTRUCT NEC
CORNEAL TATTOOING
REMOVE CORNEAL IMPLANT
CORNEAL OPERATION NEC
REMOV ANT SEGMNT FB NOS
MAGNET REMOV ANT SEG FB
NONMAG REMOV ANT SEG FB
IRIDOTOMY W TRANSFIXION
IRIDOTOMY NEC
PROLAPSED IRIS EXCISION
IRIDECTOMY NEC
DX ASPIRAT-ANT CHAMBER
IRIS BIOPSY
ANT SEGMENT DX PROC NEC
GONIOSYNECHIAE LYSIS
ANT SYNECHIA LYSIS NEC
POST SYNECHIAE LYSIS
CORNEOVITREAL ADHESIOLYS
COREOPLASTY
IRIDOPLASTY NEC
REMOV ANT SEGMNT LES NOS
NONEXC DESTRUC IRIS LES
EXCISION OF IRIS LESION
NONEXC DESTR CIL BOD LES
EXCISE CILIARY BODY LES
GONIOPUNCTURE
12.52
GONIOTOMY
PC v2014A
202
12.53
12.54
12.55
12.59
12.61
12.62
12.63
12.64
12.65
12.66
12.67
12.69
12.71
12.72
12.73
12.74
12.79
12.81
12.82
12.83
12.84
12.85
12.86
12.87
12.88
12.89
12.91
12.92
12.93
12.97
12.98
12.99
13.00
13.01
13.02
13.11
13.19
13.2
13.3
13.41
13.42
13.43
13.51
13.59
13.64
13.65
13.66
13.69
13.70
13.71
13.72
13.8
13.90
PC v2014A
GONIOTOMY W GONIOPUNCTUR
TRABECULOTOMY AB EXTERNO
CYCLODIALYSIS
FACILIT INTRAOC CIRC NEC
TREPHIN SCLERA W IRIDECT
THERMCAUT SCLER W IRIDEC
IRIDENCLEISIS/IRIDOTASIS
TRABECULECTOM AB EXTERNO
SCLER FISTULIZ W IRIDECT
POSTOP REVIS SCL FISTUL
INSERT AQUEOUS DRAIN DEV (Begin 2011)
SCLER FISTULIZING OP NEC
CYCLODIATHERMY
CYCLOCRYOTHERAPY
CYCLOPHOTOCOAGULATION
CIL BODY DIMINUTION NOS
GLAUCOMA PROCEDURE NEC
SUTURE SCLERAL LACER
SCLERAL FISTULA REPAIR
REVIS ANT SEG OP WND NEC
DESTRUCT SCLERAL LESION
REPAIR STAPHYLOM W GRAFT
REP SCLER STAPHYLOMA NEC
GRAFT REINFORCE SCLERA
SCLERA REINFORCEMENT NEC
SCLERAL OPERATION NEC
THERAPEUT EVAC ANT CHAMB
ANTERIOR CHAMBER INJECT
REMOV EPITHEL DOWNGROWTH
IRIS OPERATION NEC
CILIARY BODY OP NEC
ANTERIOR CHAMBER OP NEC
REMOVE FB LENS NOS
MAGNET REMOVE FB LENS
NONMAGNET REMOVE FB LENS
TEMP-INF INTRCAP LENS EX
INTRACAPSUL LENS EXT NEC
LINEAR EXTRACAP LENS EXT
SIMPL ASPIR LENS EXTRACT
CATARAC PHACOEMULS/ASPIR
POST CATARAC FRAG/ASPIR
CATARACT FRAG/ASPIR NEC
TEMP-INF XTRACAP LENS EX
EXTRACAP LENS EXTRAC NEC
AFTER-CATAR DISCISSION
AFTER-CATARACT EXCISION
AFTER CATAR FRAGMNTATION
CATARACT EXTRACTION NEC
INSERT PSEUDOPHAKOS NOS
INSERT LENS AT CATAR EXT
SECONDARY INSERT LENS
IMPLANTED LENS REMOVAL
OPERATION ON LENS NEC
203
13.91
14.00
14.01
14.02
14.11
14.19
14.21
14.22
14.26
14.27
14.29
14.31
14.32
14.39
14.41
14.49
14.51
14.52
14.53
14.54
14.55
14.59
14.6
14.71
14.72
14.73
14.74
14.75
14.79
14.9
15.01
15.09
15.11
15.12
15.13
15.19
15.21
15.22
15.29
15.3
15.4
15.5
15.6
15.7
15.9
16.01
16.02
16.09
16.1
16.22
16.23
16.29
16.31
PC v2014A
IMPL INTRAOC TELESC PROS
REMOV POST SEGMNT FB NOS
MAGNET REMOV POST SEG FB
NONMAG REMOV POST SEG FB
DIAGNOST VITREOUS ASPIR
DX PROC POST SEG NEC
CHORIORET LES DIATHERMY
CHORIORETIN LES CRYOTHER
CHORIORET LES RADIOTHER
CHORIORET LES RAD IMPLAN
CHORIORET LES DESTR NEC
RETINAL TEAR DIATHERMY
RETINAL TEAR CRYOTHERAPY
RETINAL TEAR REPAIR NEC
SCLERAL BUCKLE W IMPLANT
SCLERAL BUCKLING NEC
DETACH RETINA-DIATHERMY
DETACH RETINA-CRYOTHERAP
DETACH RETINA XENON COAG
DETACH RETINA LASER COAG
DETACH RET PHOTOCOAG NOS
REPAIR RETINA DETACH NEC
REMOV PROS MAT POST SEG
ANTERIOR REMOV VITREOUS
VITREOUS REMOVAL NEC
ANTERIOR MECHAN VITRECT
MECH VITRECTOMY NEC
VITREOUS SUBSTITUT INJEC
VITREOUS OPERATION NEC
OTHER POST SEGMENT OPS
EXTRAOC MUSC-TEND BIOPSY
EXTRAOC MUSC DX PROC NEC
ONE EXTRAOC MUS RECESS
1 EXTRAOC MUSCL ADVANCE
1 EXTRAOC MUSCL RESECT
XTRAOC MUS OP/DETACH NEC
LENGTHEN 1 EXTRAOC MUSC
SHORTEN 1 EXTRAOC MUSC
OP ON 1 EXTRAOC MUSC NEC
TEMP DETACH >1 XTROC MUS
OTH OP ON >L EXTRAOC MUS
EXTRAOCUL MUS TRANSPOSIT
REVIS EXTRAOC MUSC SURG
EXTRAOC MUSC INJ REPAIR
OTH EXTRAOC MUS-TEND OP
ORBITOTOMY W BONE FLAP
ORBITOTOMY W IMPLANT
ORBITOTOMY NEC
REMOVE PENETRAT FB EYE
DIAGNOSTIC ASP OF ORBIT
EYEBALL & ORBIT BIOPSY
EYEBAL/ORBIT DX PROC NEC
EYE EVISC W SYNCH IMPLAN
204
16.39
16.41
16.42
16.49
16.51
16.52
16.59
16.61
16.62
16.63
16.64
16.65
16.66
16.69
16.71
16.72
16.81
16.82
16.89
16.92
16.93
16.98
16.99
17.11
17.12
17.13
17.21
17.22
17.23
17.24
17.31
17.32
17.33
17.34
17.35
17.36
17.39
17.51
17.52
17.53
17.54
17.55
17.56
17.61
17.62
17.63
17.69
18.21
18.31
18.39
18.5
EYEBALL EVISCERATION NEC
EYE ENUC/IMPLAN/MUSC ATT
EYE ENUC W IMPLANT NEC
EYEBALL ENUCLEATION NEC
RADICAL ORBITOMAXILLECT
ORBIT EXENT W BONE REMOV
ORBITAL EXENTERATION NEC
2NDRY OCULAR IMP INSERT
REVIS/REINSERT OCUL IMP
REVIS ENUC SOCKET W GRFT
ENUC SOCKET REVIS NEC
2NDRY EXENT CAVITY GRAFT
REVIS EXENTER CAVITY NEC
2ND OP POST EYE REM NEC
REMOVE OCULAR IMPLANT
REMOVE ORBITAL IMPLANT
REPAIR OF ORBITAL WOUND
REPAIR EYEBALL RUPTURE
EYE/ORBIT INJ REPAIR NEC
EXCISION ORBITAL LESION
EXCISION EYE LESION NOS
OPERATION ON ORBIT NEC
OPERATION ON EYEBALL NEC
LAP DIR ING HERN-GRAFT
LAP INDIR ING HERN-GRAFT
LAP ING HERN-GRAFT NOS
LAP BIL DIR ING HRN-GRFT
LAP BI INDIR ING HRN-GRF
LAP BI DR/IND ING HRN-GR
LAP BIL ING HERN-GRF NOS
LAP MUL SEG RES LG INTES
LAPAROSCOPIC CECECTOMY
LAP RIGHT HEMICOLECTOMY
LAP RES TRANSVERSE COLON
LAP LEFT HEMICOLECTOMY
LAP SIGMOIDECTOMY
LAP PT EX LRG INTEST NEC
IMPLANT CCM,TOTAL SYSTEM
IMPLANT CCM PULSE GENRTR
PERC ATHER EXTRACRAN VSL (Begin 2011)
PERC ATHER INTRACRAN VSL (Begin 2011)
TRANSLUM COR ATHERECTOMY (Begin 2011)
ATHER OTH NON-COR VESSEL (Begin 2011)
LITT LESN BRAIN,GUIDANCE
LITT LES HD/NCK,GUIDANCE
LITT LESN LIVER,GUIDANCE
LITT LESN, GUIDE OTH/NOS
PREAURICULAR SINUS EXCIS
RAD EXCIS EXT EAR LES
EXCIS EXTERNAL EAR NEC
CORRECTION PROMINENT EAR
18.6
18.71
EXT AUDIT CANAL RECONSTR
CONSTRUCTION EAR AURICLE
PC v2014A
205
18.72
18.79
18.9
19.0
19.11
19.19
19.21
19.29
19.3
19.4
19.52
19.53
19.54
19.55
19.6
19.9
20.01
20.21
20.22
20.23
20.32
20.39
20.41
20.42
20.49
20.51
20.59
20.61
20.62
20.71
20.72
20.79
20.91
20.92
20.93
20.95
20.96
20.97
20.98
20.99
21.04
21.05
21.06
21.07
21.09
21.4
21.5
21.61
21.62
21.69
REATTACH AMPUTATED EAR
PLASTIC REP EXT EAR NEC
OTHER EXT EAR OPERATIONS
STAPES MOBILIZATION
STAPEDECT W REPLAC INCUS
STAPEDECTOMY NEC
REV STAPDEC W INCUS REPL
STAPEDECTOMY REVIS NEC
OSSICULAR CHAIN OP NEC
MYRINGOPLASTY
TYPE 2 TYMPANOPLASTY
TYPE 3 TYMPANOPLASTY
TYPE 4 TYMPANOPLASTY
TYPE 5 TYMPANOPLASTY
TYMPANOPLASTY REVISION
MIDDLE EAR REPAIR NEC
MYRINGOTOMY W INTUBATION
MASTOID INCISION
PETRUS PYRAM AIR CEL INC
MIDDLE EAR INCISION
MID & INNER EAR BIOPSY
MID/IN EAR DX PROC NEC
SIMPLE MASTOIDECTOMY
RADICAL MASTOIDECTOMY
MASTOIDECTOMY NEC
EXCISE MIDDLE EAR LESION
MIDDLE EAR EXCISION NEC
INNER EAR FENESTRATION
REVIS INNER EAR FENESTRA
ENDOLYMPHATIC SHUNT
INNER EAR INJECTION
INC/EXC/DESTR IN EAR NEC
TYMPANOSYMPATHECTOMY
MASTOIDECTOMY REVISION
REPAIR OVAL/ROUND WINDOW
ELECMAG HEAR DEV IMPLANT
IMPLT COCHLEAR PROST NOS
IMP/REP SCHAN COCH PROS
IMP/REP MCHAN COCHL PROS
MID-INNER EAR OPS NEC
ETHMOID ART LIGAT-EPIST
MAX ART LIG FOR EPISTAX
EXT CAROT ART LIG-EPIST
NASAL SEPT GRFT-EPISTAX
EPISTAXIS CONTROL NEC
RESECTION OF NOSE
SUBMUC NASAL SEPT RESECT
DIATHER/CRYO TURBINECTOM
TURBINATE FRACTURE
TURBINECTOMY NEC
21.72
21.82
OPEN REDUCTION NASAL FX
NASAL FISTULA CLOSURE
PC v2014A
206
21.83
21.84
21.85
21.86
21.87
21.88
21.89
21.99
22.12
22.31
22.39
22.41
22.42
22.50
22.51
22.52
22.53
22.60
22.61
22.62
22.63
22.64
22.71
22.79
22.9
24.2
24.4
24.5
25.02
25.1
25.2
25.3
25.4
25.59
25.94
25.99
26.12
26.21
26.29
26.30
26.31
26.32
26.41
26.42
26.49
26.99
27.0
27.1
27.21
27.22
TOT NASAL RECONSTRUCTION
REVISION RHINOPLASTY
AUGMENTATION RHINOPLASTY
LIMITED RHINOPLASTY
RHINOPLASTY NEC
SEPTOPLASTY NEC
NASAL REPAIR NEC
NASAL OPERATION NEC
OPEN BIOPSY NASAL SINUS
RADICAL MAXILLARY ANTROT
EXT MAXILLARY ANTROT NEC
FRONTAL SINUSOTOMY
FRONTAL SINUSECTOMY
SINUSOTOMY NOS
ETHMOIDOTOMY
SPHENOIDOTOMY
MULTIPLE SINUS INCISION
SINUSECTOMY NOS
C-LUC EXC MAX SINUS LES
EXC MAX SINUS LESION NEC
ETHMOIDECTOMY
SPHENOIDECTOMY
NASAL SINUS FISTULA CLOS
NASAL SINUS REPAIR NEC
OTHER NASAL SINUS OPS
GINGIVOPLASTY
EXC OF DENTAL LES OF JAW
ALVEOLOPLASTY
OPEN BIOPSY OF TONGUE
DESTRUCTION TONGUE LES
PARTIAL GLOSSECTOMY
COMPLETE GLOSSECTOMY
RADICAL GLOSSECTOMY
REPAIR OF TONGUE NEC
OTHER GLOSSOTOMY
TONGUE OPERATION NEC
OPEN BX SALIV GLAND/DUCT
SALIVARY CYST MARSUPIAL
SALIV LESION EXCIS NEC
SIALOADENECTOMY NOS
PARTIAL SIALOADENECTOMY
COMPLETE SIALOADENECTOMY
SUTURE OF SALIV GLND LAC
SALIVARY FISTULA CLOSURE
SALIVARY REPAIR NEC
SALIVARY OPERATION NEC
DRAIN FACE & MOUTH FLOOR
INCISION OF PALATE
BONY PALATE BIOPSY
UVULA AND SOFT PALATE BX
27.31
27.32
LOC EXC BONY PALATE LES
WIDE EXC BONY PALATE LES
PC v2014A
207
27.42
27.43
27.49
27.53
27.54
27.55
27.56
27.57
27.59
27.61
27.62
27.63
27.69
27.71
27.72
27.73
27.79
27.92
27.99
28.0
28.11
28.19
28.2
28.3
28.4
28.5
28.6
28.7
28.91
28.92
28.99
29.0
29.2
29.31
29.32
29.33
29.39
29.4
29.51
29.52
29.53
29.54
29.59
29.92
29.99
30.01
30.09
30.1
30.21
30.22
WIDE EXCISION OF LIP LES
EXCISION OF LIP LES NEC
EXCISION OF MOUTH NEC
CLOSURE OF MOUTH FISTULA
REPAIR OF CLEFT LIP
FULL-THICK GRFT TO MOUTH
SKIN GRAFT TO MOUTH NEC
PEDICLE ATTACH TO MOUTH
MOUTH REPAIR NEC
SUTURE OF PALATE LACERAT
CLEFT PALATE CORRECTION
REVIS CLEFT PALAT REPAIR
OTH PLASTIC REPAIR PALAT
INCISION OF UVULA
EXCISION OF UVULA
REPAIR OF UVULA
OTHER UVULA OPERATIONS
MOUTH INCISION NOS
ORAL CAVITY OPS NEC
PERITONSILLAR I & D
TONSIL&ADENOID BIOPSY
TONSIL&ADENOID DX OP NEC
TONSILLECTOMY
TONSILLECTOMY/ADENOIDEC
EXCISION OF TONSIL TAG
EXCISION LINGUAL TONSIL
ADENOIDECTOMY
HEMORR CONTRL POST T & A
INCIS TO REMOV TONSIL FB
EXCIS TONSIL/ADENOID LES
TONSIL/ADENOID OPS NEC
PHARYNGOTOMY
EXC BRANCHIAL CLEFT CYST
CRICOPHARYNGEAL MYOTOMY
PHARYNGEAL DIVERTICULEC
PHARYNGECTOMY
EXCIS/DESTR LES PHAR NEC
PLASTIC OP ON PHARYNX
SUTURE OF PHARYNGEAL LAC
CLOS BRANCH CLEFT FISTUL
CLOS PHARYNX FISTULA NEC
LYSIS PHARYNGEAL ADHES
PHARYNGEAL REPAIR NEC
DIVIS GLOSSOPHARYNG NERV
PHARYNGEAL OPERATION NEC
LARYNX CYST MARSUPIALIZ
DESTRUCT LARYNX LES NEC
HEMILARYNGECTOMY
EPIGLOTTIDECTOMY
VOCAL CORDECTOMY
30.29
30.3
30.4
OTHER PART LARYNGECTOMY
COMPLETE LARYNGECTOMY
RADICAL LARYNGECTOMY
PC v2014A
208
31.21
31.29
31.3
31.45
31.5
31.61
31.62
31.63
31.64
31.69
31.71
31.72
31.73
31.74
31.75
31.79
31.91
31.92
31.98
31.99
32.09
32.1
32.20
32.21
32.22
32.23
32.24
32.25
32.26
32.27
32.29
32.30
32.39
32.41
32.49
32.50
32.59
32.6
32.9
33.0
33.1
33.20
33.25
33.27
33.28
33.29
33.34
33.39
33.41
33.42
MEDIASTINAL TRACHEOSTOMY
OTHER PERM TRACHEOSTOMY
INCIS LARYNX TRACHEA NEC
OPN BX LARYNX OR TRACHEA
LOCAL DESTRUC TRACH LES
SUTURE OF LARYNGEAL LAC
LARYNGEAL FISTULA CLOS
LARYNGOSTOMY REVISION
LARYNGEAL FX REPAIR
OTHER LARYNGEAL REPAIR
SUTURE OF TRACHEAL LACER
CLOSURE OF TRACHEOSTOMY
TRACHEA FISTULA CLOS NEC
REVISION OF TRACHEOSTOMY
TRACHEAL RECONSTRUCTION
OTHER TRACHEAL REPAIR
LARYNGEAL NERV DIVISION
LYSIS TRACH/LARYNX ADHES
OTH LARYNGEAL OPERATION
OTHER TRACHEAL OPERATION
OTHER DESTRUC BRONC LES
OTHER BRONCHIAL EXCISION
THORAC EXC LUNG LESION
EMPHYSEMA BLEB PLICATION
LUNG VOL REDUCTION SURG
OPEN ABLTN LUNG LES/TISS
PERC ABLTN LUNG LES/TISS
THOR ABLTN LUNG LES/TISS
ABLTN LUNG TISS NEC/NOS
BRNC THRMPLSTYABLT MSCL
DESTROY LOC LUNG LES NEC
THORAC SEG LUNG RESECT
OTH SEG LUNG RESECT NOS
THORAC LOBECTOMY LUNG
LOBECTOMY OF LUNG NEC
THORACOSPC PNEUMONECTOMY
OTHER PNEUMONECTOMY NOS
RAD DISSEC THORAC STRUCT
OTHER EXCISION OF LUNG
INCISION OF BRONCHUS
INCISION OF LUNG
THORACOSCOPC LUNG BIOPSY
OPEN BRONCHIAL BIOPSY
CLOS ENDOSCOPIC LUNG BX
OPEN LUNG BIOPSY
BRONCH/LUNG DX PROC NEC
THORACOPLASTY
SURG COLLAPS OF LUNG NEC
BRONCHIAL LACERAT SUTURE
BRONCHIAL FISTULA CLOS
33.43
33.48
33.49
LUNG LACERATION CLOSURE
BRONCHIAL REPAIR NEC
LUNG REPAIR NEC
PC v2014A
209
33.50
33.51
33.52
33.6
33.92
33.93
33.98
33.99
34.02
34.03
34.06
34.1
34.20
34.21
34.22
34.26
34.27
34.28
34.29
34.3
34.4
34.51
34.52
34.59
34.6
34.73
34.74
34.79
34.81
34.82
34.83
34.84
34.85
34.89
34.93
34.99
35.00
35.01
35.02
35.03
35.04
35.05
35.06
35.07
35.08
35.09
35.10
35.11
35.12
35.13
35.14
35.20
35.21
PC v2014A
LUNG TRANSPLANT NOS
UNILAT LUNG TRANSPLANT
BILAT LUNG TRANSPLANT
COMB HEART/LUNG TRANSPLA
BRONCHIAL LIGATION
PUNCTURE OF LUNG
BRONCHIAL OPERATION NEC
LUNG OPERATION NEC
EXPLORATORY THORACOTOMY
REOPEN THORACOTOMY SITE
THORAC DRAIN PLEURL CAV
INCISION OF MEDIASTINUM
THORACOSCOPIC PLEURAL BX
TRANSPLEURA THORACOSCOPY
MEDIASTINOSCOPY
OPEN MEDIASTINAL BIOPSY
BIOPSY OF DIAPHRAGM
DX PROCEDURE THORAX NEC
DX PROC MEDIASTINUM NEC
DESTRUCT MEDIASTIN LES
DESTRUCT CHEST WALL LES
DECORTICATION OF LUNG
THORACOSCOPC DECORT LUNG
OTHER PLEURAL EXCISION
SCARIFICATION OF PLEURA
CLOS THORACIC FISTUL NEC
PECTUS DEFORMITY REPAIR
OTHER CHEST WALL REPAIR
EXCISE DIAPHRAGM LESION
SUTURE DIAPHRAGM LACERAT
CLOSE DIAPHRAGM FISTULA
OTHER DIAPHRAGM REPAIR
IMPLANT DIAPHRA PACEMAKE
DIAPHRAGM OPERATION NEC
REPAIR OF PLEURA
THORACIC OPERATION NEC
CLOSED VALVOTOMY NOS
CLOSED AORTIC VALVOTOMY
CLOSED MITRAL VALVOTOMY
CLOSED PULMON VALVOTOMY
CLOSED TRICUSP VALVOTOMY
ENDOVAS REPL AORTC VALVE
TRNSAPCL REP AORTC VALVE
ENDOVAS REPL PULM VALVE
TRNSAPCL REPL PULM VALVE
ENDOVAS REPL UNS HRT VLV
OPEN VALVULOPLASTY NOS
OPN AORTIC VALVULOPLASTY
OPN MITRAL VALVULOPLASTY
OPN PULMON VALVULOPLASTY
OPN TRICUS VALVULOPLASTY
REPLACE HEART VALVE NOS
REPLACE AORT VALV-TISSUE
210
35.22
35.23
35.24
35.25
35.26
35.27
35.28
35.31
35.32
35.33
35.34
35.35
35.39
35.42
35.50
35.51
35.52
35.53
35.54
35.55
35.60
35.61
35.62
35.63
35.70
35.71
35.72
35.73
35.81
35.82
35.83
35.84
35.91
35.92
35.93
35.94
35.95
35.96
35.97
35.98
35.99
36.03
36.09
36.10
36.11
36.12
36.13
36.14
36.15
REPLACE AORTIC VALVE NEC
REPLACE MITR VALV-TISSUE
REPLACE MITRAL VALVE NEC
REPLACE PULM VALV-TISSUE
REPLACE PULMON VALVE NEC
REPLACE TRIC VALV-TISSUE
REPLACE TRICUSP VALV NEC
PAPILLARY MUSCLE OPS
CHORDAE TENDINEAE OPS
ANNULOPLASTY
INFUNDIBULECTOMY
TRABECUL CARNEAE CORD OP
TISS ADJ TO VALV OPS NEC
CREATE SEPTAL DEFECT
PROSTH REP HRT SEPTA NOS
PROS REP ATRIAL DEF-OPN
PROS REPAIR ATRIA DEF-CL
PROST REPAIR VENTRIC DEF
PROS REP ENDOCAR CUSHION
PROS REP VENTRC DEF-CLOS
GRFT REPAIR HRT SEPT NOS
GRAFT REPAIR ATRIAL DEF
GRAFT REPAIR VENTRIC DEF
GRFT REP ENDOCAR CUSHION
HEART SEPTA REPAIR NOS
ATRIA SEPTA DEF REP NEC
VENTR SEPTA DEF REP NEC
ENDOCAR CUSHION REP NEC
TOT REPAIR TETRAL FALLOT
TOTAL REPAIR OF TAPVC
TOT REP TRUNCUS ARTERIOS
TOT COR TRANSPOS GRT VES
INTERAT VEN RETRN TRANSP
CONDUIT RT VENT-PUL ART
CONDUIT LEFT VENTR-AORTA
CONDUIT ARTIUM-PULM ART
HEART REPAIR REVISION
PERC HEART VALVULOPLASTY
PERC MTRL VLV REPR W IMP
OTHER HEART SEPTA OPS
OTHER HEART VALVE OPS
OPEN CORONRY ANGIOPLASTY
REM OF COR ART OBSTR NEC
AORTOCORONARY BYPASS NOS
AORTOCOR BYPAS-1 COR ART
AORTOCOR BYPAS-2 COR ART
AORTOCOR BYPAS-3 COR ART
AORTCOR BYPAS-4+ COR ART
1 INT MAM-COR ART BYPASS
36.16
36.17
36.19
36.2
2 INT MAM-COR ART BYPASS
ABD-CORON ARTERY BYPASS
HRT REVAS BYPS ANAS NEC
ARTERIAL IMPLANT REVASC
PC v2014A
211
36.31
36.32
36.33
36.34
36.39
36.91
36.99
37.10
37.11
37.12
37.24
37.31
37.32
37.33
37.34
37.35
37.37
37.41
37.49
37.51
37.52
37.53
37.54
37.55
37.60
37.61
37.62
37.63
37.64
37.65
37.66
37.67
37.68
37.74
37.75
37.76
37.77
37.79
37.80
37.85
37.86
37.87
37.89
37.91
37.94
37.95
37.96
37.97
37.98
37.99
38.00
38.01
38.02
PC v2014A
OPEN CHEST TRANS REVASC
OTH TRANSMYO REVASCULAR
ENDO TRANSMYO REVASCULAR
PERC TRANSMYO REVASCULAR
OTH HEART REVASCULAR
CORON VESS ANEURYSM REP
HEART VESSEL OP NEC
INCISION OF HEART NOS
CARDIOTOMY
PERICARDIOTOMY
PERICARDIAL BIOPSY
PERICARDIECTOMY
HEART ANEURYSM EXCISION
EXC/DEST HRT LESION OPEN
EXC/DEST HRT LES OTHER
PARTIAL VENTRICULECTOMY
EXC/DEST HRT LES THRSPC
IMPL CARDIAC SUPPORT DEV
HEART/PERICARD REPR NEC
HEART TRANSPLANTATION
IMPLANT TOT REP HRT SYS
REPL/REP THORAC UNIT HRT
REPL/REP OTH TOT HRT SYS
REM INT BIVENT HRT SYS
IMP BIVN EXT HRT AST SYS
PULSATION BALLOON IMPLAN
IMPLANT HRT ASST SYS NEC
REPLACE HRT ASSIST SYST
REMOVE HEART ASSIST SYS
IMP EXT PUL HRT ASST SYS
IMP IMP PUL HRT ASST SYS
IMP CARDIOMYOSTIMUL SYS
PERCUTAN HRT ASSIST SYST
INT OR REPL LEAD EPICAR
REVISION OF LEAD
REPL TV ATRI-VENT LEAD
REMOVAL OF LEAD W/O REPL
REVIS OR RELOCATE POCKET
INT OR REPL PERM PACEMKR
REPL PACEM W 1-CHAM, NON
REPL PACEM 1-CHAM, RATE
REPL PACEM W DUAL-CHAM
REVISE OR REMOVE PACEMAK
OPN CHEST CARDIAC MASSAG
IMPLT/REPL CARDDEFIB TOT
IMPLT CARDIODEFIB LEADS
IMPLT CARDIODEFIB GENATR
REPL CARDIODEFIB LEADS
REPL CARDIODEFIB GENRATR
OTHER HEART/PERICARD OPS
INCISION OF VESSEL NOS
INTRACRAN VESSEL INCIS
HEAD/NECK VES INCIS NEC
212
38.03
38.04
38.05
38.06
38.07
38.08
38.09
38.10
38.11
38.12
38.13
38.14
38.15
38.16
38.18
38.21
38.26
38.29
38.30
38.31
38.32
38.33
38.34
38.35
38.36
38.37
38.38
38.39
38.40
38.41
38.42
38.43
38.44
38.45
38.46
38.47
38.48
38.49
38.50
38.51
38.52
38.53
38.55
38.57
38.59
38.60
38.61
UPPER LIMB VESSEL INCIS
INCISION OF AORTA
THORACIC VESSEL INC NEC
ABDOMEN ARTERY INCISION
ABDOMINAL VEIN INCISION
LOWER LIMB ARTERY INCIS
LOWER LIMB VEIN INCISION
ENDARTERECTOMY NOS
INTRACRAN ENDARTERECTOMY
HEAD & NECK ENDARTER NEC
UPPER LIMB ENDARTERECTOM
ENDARTERECTOMY OF AORTA
THORACIC ENDARTERECTOMY
ABDOMINAL ENDARTERECTOMY
LOWER LIMB ENDARTERECT
BLOOD VESSEL BIOPSY
INSRT PRSR SNSR W/O LEAD
BLOOD VESSEL DX PROC NEC
VESSEL RESECT/ANAST NOS
INTRACRAN VES RESEC-ANAS
HEAD/NECK VES RESEC-ANAS
ARM VESSEL RESECT/ANAST
AORTA RESECTION & ANAST
THOR VESSEL RESECT/ANAST
ABD VESSEL RESECT/ANAST
ABD VEIN RESECT & ANAST
LEG ARTERY RESECT/ANAST
LEG VEIN RESECT/ANASTOM
VESSEL RESECT/REPLAC NOS
INTRACRAN VES RESEC-REPL
HEAD/NECK VES RESEC-REPL
ARM VES RESECT W REPLACE
RESECT ABDM AORTA W REPL
RESECT THORAC VES W REPL
ABD ARTERY RESEC W REPLA
ABD VEIN RESECT W REPLAC
LEG ARTERY RESEC W REPLA
LEG VEIN RESECT W REPLAC
VARICOSE V LIG-STRIP NOS
INTCRAN VAR V LIG-STRIP
HEAD/NECK VAR V LIG-STR
ARM VARICOSE V LIG-STRIP
THORAC VAR V LIG-STRIP
ABD VARICOS V LIGA-STRIP
LEG VARICOS V LIGA-STRIP
EXCISION OF VESSEL NOS
INTRACRAN VESSEL EXCIS
38.62
38.63
38.64
38.65
38.66
HEAD/NECK VESSEL EXCIS
ARM VESSEL EXCISION
EXCISION OF AORTA
THORACIC VESSEL EXCISION
ABDOMINAL ARTERY EXCIS
PC v2014A
213
38.67
38.68
38.69
38.80
38.81
38.82
38.83
38.84
38.85
38.86
38.87
38.88
38.89
39.0
39.1
39.21
39.22
39.23
39.24
39.25
39.26
39.27
39.28
39.29
39.30
39.31
39.32
39.41
39.42
39.43
39.49
39.50
39.51
39.52
39.53
39.54
39.55
39.56
39.57
39.58
39.59
39.71
39.72
39.73
39.74
39.75
39.76
39.77
ABDOMINAL VEIN EXCISION
LEG ARTERY EXCISION
LEG VEIN EXCISION
SURG VESSEL OCCLUS NEC
OCCLUS INTRACRAN VES NEC
OCCLUS HEAD/NECK VES NEC
OCCLUDE ARM VESSEL NEC
OCCLUDE AORTA NEC
OCCLUDE THORACIC VES NEC
OCCLUDE ABD ARTERY NEC
OCCLUDE ABD VEIN NEC
OCCLUDE LEG ARTERY NEC
OCCLUDE LEG VEIN NEC
SYSTEMIC-PULM ART SHUNT
INTRA-ABD VENOUS SHUNT
CAVAL-PULMON ART ANASTOM
AORTA-SUBCLV-CAROT BYPAS
INTRATHORACIC SHUNT NEC
AORTA-RENAL BYPASS
AORTA-ILIAC-FEMOR BYPASS
INTRA-ABDOMIN SHUNT NEC
DIALYSIS ARTERIOVENOSTOM
EXTRACRAN-INTRACR BYPASS
VASC SHUNT & BYPASS NEC
SUTURE OF VESSEL NOS
SUTURE OF ARTERY
SUTURE OF VEIN
POSTOP VASC OP HEM CONTR
REVIS REN DIALYSIS SHUNT
REMOV REN DIALYSIS SHUNT
VASC PROC REVISION NEC
ANGIO/ATH NON-CORO VES
CLIPPING OF ANEURYSM
ANEURYSM REPAIR NEC
ARTERIOVEN FISTULA REP
RE-ENTRY OPERATION
REIMPLAN ABERR RENAL VES
REPAIR VESS W TIS PATCH
REP VESS W SYNTH PATCH
REPAIR VESS W PATCH NOS
REPAIR OF VESSEL NEC
ENDO IMPL GRFT ABD AORTA
ENDOVASC REPAIR HEAD VES
ENDO IMP GRFT THOR AORTA
ENDO REM OBS HD/NECK VES
ENDO EMB HD/NK,BARE COIL
ENDO EM HD/NK,BIOAC COIL
TEMP ENDOVSC OCCLS VESSL
39.78
39.79
39.81
39.82
39.83
ENDOVAS IMPLN GRFT AORTA
ENDO REPAIR OTHER VESSEL
IMP CRTD SINUS STMTOTL
IMP/REP CRTD SINUS LEAD
IMP/REP CRTD SINUS GNRTR
PC v2014A
214
39.84
39.85
39.86
39.87
39.88
39.89
39.91
39.92
39.93
39.94
39.98
39.99
40.0
40.11
40.19
40.21
40.22
40.23
40.24
40.29
40.3
40.40
40.41
40.42
40.50
40.51
40.52
40.53
40.54
40.59
40.61
40.62
40.63
40.64
40.69
40.9
41.2
41.33
41.41
41.42
41.43
41.5
41.93
41.94
41.95
41.99
42.01
42.09
REV CRTD SINUS STM LEADS
REV CRTD SINUS PULSE GEN
REM CRTD SINUS STM TOTL
REM CRTD SINUS STM LEAD
REM CRTD SINUS PULSE GEN
OTH CARTD BODY/SINUS OP
FREEING OF VESSEL
VEIN INJECT-SCLEROS AGNT
INSERT VES-TO-VES CANNUL
REPLAC VES-TO-VES CANNUL
HEMORRHAGE CONTROL NOS
VESSEL OPERATION NEC
INCIS LYMPHATIC STRUCTUR
LYMPHATIC STRUCT BIOPSY
LYMPHATIC DIAG PROC NEC
EXCIS DEEP CERVICAL NODE
EXCISE INT MAMMARY NODE
EXCISE AXILLARY NODE
EXCISE INGUINAL NODE
SIMP EXC LYMPH STRUC NEC
REGIONAL LYMPH NODE EXC
RAD NECK DISSECTION NOS
UNILAT RAD NECK DISSECT
BILAT RAD NECK DISSECT
RAD NODE DISSECTION NOS
RAD DISSEC AXILLARY NODE
RAD DISSEC PERIAORT NODE
RAD DISSECT ILIAC NODES
RADICAL GROIN DISSECTION
RAD NODE DISSECTION NEC
THORAC DUCT CANNULATION
THORACIC DUCT FISTULIZAT
CLOSE THORACIC DUCT FIST
LIGATE THORACIC DUCT
THORACIC DUCT OP NEC
LYMPH STRUCTURE OP NEC
SPLENOTOMY
OPEN SPLEEN BIOPSY
SPLENIC CYST MARSUPIAL
EXC SPLENIC LESION/TISS
PARTIAL SPLENECTOMY
TOTAL SPLENECTOMY
EXC OF ACCESSORY SPLEEN
SPLEEN TRANSPLANTATION
REPAIR OF SPLEEN
SPLEEN OPERATION NEC
ESOPHAGEAL WEB INCISION
ESOPHAGEAL INCISION NEC
42.10
42.11
42.12
42.19
42.21
ESOPHAGOSTOMY NOS
CERVICAL ESOPHAGOSTOMY
ESOPH POUCH EXTERIORIZAT
EXT FISTULIZAT ESOPH NEC
ESOPHAGOSCOPY BY INCIS
PC v2014A
215
42.25
42.31
42.32
42.39
42.40
42.41
42.42
42.51
42.52
42.53
42.54
42.55
42.56
42.58
42.59
42.61
42.62
42.63
42.64
42.65
42.66
42.68
42.69
42.7
42.82
42.83
42.84
42.85
42.86
42.87
42.89
42.91
43.0
43.3
43.42
43.49
43.5
43.6
43.7
43.81
43.82
43.89
43.91
43.99
44.00
44.01
44.02
44.03
44.11
44.15
44.21
44.29
44.31
PC v2014A
OPEN BIOPSY OF ESOPHAGUS
LOC EXCIS ESOPH DIVERTIC
LOCAL EXCIS ESOPHAG NEC
DESTRUCT ESOPHAG LES NEC
ESOPHAGECTOMY NOS
PARTIAL ESOPHAGECTOMY
TOTAL ESOPHAGECTOMY
THORAC ESOPHAGOESOPHAGOS
THORAC ESOPHAGOGASTROST
THORAC SM BOWEL INTERPOS
THORAC ESOPHAGOENTER NEC
THORAC LG BOWEL INTERPOS
THORAC ESOPHAGOCOLOS NEC
THORAC INTERPOSITION NEC
THORAC ESOPHAG ANAST NEC
STERN ESOPHAGOESOPHAGOST
STERN ESOPHAGOGASTROSTOM
STERN SM BOWEL INTERPOS
STERN ESOPHAGOENTER NEC
STERN LG BOWEL INTERPOS
STERN ESOPHAGOCOLOS NEC
STERN INTERPOSITION NEC
STERN ESOPHAG ANAST NEC
ESOPHAGOMYOTOMY
SUTURE ESOPHAGEAL LACER
ESOPHAGOSTOMY CLOSURE
ESOPH FISTULA REPAIR NEC
ESOPHAG STRICTURE REPAIR
PROD SUBQ TUNNEL NO ANAS
ESOPHAGEAL GRAFT NEC
ESOPHAGEAL REPAIR NEC
LIGATION ESOPH VARIX
GASTROTOMY
PYLOROMYOTOMY
LOCAL GASTR EXCISION NEC
LOCAL GASTR DESTRUCT NEC
PROXIMAL GASTRECTOMY
DISTAL GASTRECTOMY
PART GASTREC W JEJ ANAST
PART GAST W JEJ TRANSPOS
LAP VERTICAL GASTRECTOMY
PARTIAL GASTRECTOMY NEC
TOT GAST W INTES INTERPO
TOTAL GASTRECTOMY NEC
VAGOTOMY NOS
TRUNCAL VAGOTOMY
HIGHLY SELECT VAGOTOMY
SELECTIVE VAGOTOMY NEC
TRANSABDOMIN GASTROSCOPY
OPEN GASTRIC BIOPSY
DILATE PYLORUS, INCISION
OTHER PYLOROPLASTY
HIGH GASTRIC BYPASS
216
44.32
44.38
44.39
44.40
44.41
44.42
44.5
44.61
44.63
44.64
44.65
44.66
44.67
44.68
44.69
44.91
44.92
44.95
44.96
44.97
44.98
44.99
45.00
45.01
45.02
45.03
45.11
45.15
45.21
45.26
45.31
45.32
45.33
45.34
45.41
45.49
45.50
45.51
45.52
45.61
45.62
45.63
45.71
45.72
45.73
45.74
45.75
PERCU GASTROJEJUNOSTOMY
LAP GASTROENTEROSTOMY
GASTROENTEROSTOMY NEC
SUTURE PEPTIC ULCER NOS
SUT GASTRIC ULCER SITE
SUTURE DUODEN ULCER SITE
REVISION GASTRIC ANASTOM
SUTURE GASTRIC LACERAT
CLOSE GASTRIC FISTUL NEC
GASTROPEXY
ESOPHAGOGASTROPLASTY
CREAT ESOPHAGASTR SPHINC
LAP CREAT ESOPH SPHINCT
LAPAROSCOP GASTROPLASTY
GASTRIC REPAIR NEC
LIGATE GASTRIC VARICES
INTRAOP GASTRIC MANIPUL
LAP GASTRIC RESTRIC PROC
LAP REV GAST RESTRI PROC
LAP REM GAST RESTRIC DEV
ADJUST GAST RESTRICT DEV
GASTRIC OPERATION NEC
INTESTINAL INCISION NOS
DUODENAL INCISION
SMALL BOWEL INCISION NEC
LARGE BOWEL INCISION
TRANSAB SM BOWEL ENDOSC
OPEN SMALL BOWEL BIOPSY
TRANSAB LG BOWEL ENDOSC
OPEN LARGE BOWEL BIOPSY
OTH EXCISE DUODENUM LES
DESTRUCT DUODEN LES NEC
LOCAL EXCIS SM BOWEL NEC
DESTR SM BOWEL LES NEC
EXCISE LG INTESTINE LES
DESTRUC LG BOWEL LES NEC
INTEST SEG ISOLAT NOS
SM BOWEL SEGMENT ISOLAT
LG BOWEL SEGMENT ISOLAT
MULT SEG SM BOWEL EXCIS
PART SM BOWEL RESECT NEC
TOTAL REMOVAL SM BOWEL
MULT SEG LG BOWEL EXCIS
CECECTOMY
RIGHT HEMICOLECTOMY
TRANSVERSE COLON RESECT
LEFT HEMICOLECTOMY
45.76
45.79
45.81
45.82
45.83
45.90
SIGMOIDECTOMY
PART LG BOWEL EXCIS NEC
LAP TOT INTR-AB COLECTMY
OP TOT INTR-ABD COLECTMY
TOT ABD COLECTMY NEC/NOS
INTESTINAL ANASTOM NOS
PC v2014A
217
45.91
45.92
45.93
45.94
45.95
46.01
46.02
46.03
46.04
46.10
46.11
46.13
46.20
46.21
46.22
46.23
46.40
46.41
46.42
46.43
46.50
46.51
46.52
46.60
46.61
46.62
46.63
46.64
46.71
46.72
46.73
46.74
46.75
46.76
46.79
46.80
46.81
46.82
46.91
46.92
46.93
46.94
46.97
46.99
47.01
47.09
47.11
47.19
47.2
47.91
47.92
47.99
48.0
PC v2014A
SM-TO-SM BOWEL ANASTOM
SM BOWEL-RECT STUMP ANAS
SMALL-TO-LARGE BOWEL NEC
LG-TO-LG BOWEL ANASTOM
ANAL ANASTOMOSIS
SM BOWEL EXTERIORIZATION
RESECT EXT SEG SM BOWEL
LG BOWEL EXTERIORIZATION
RESECT EXT SEG LG BOWEL
COLOSTOMY NOS
TEMPORARY COLOSTOMY
PERMANENT COLOSTOMY
ILEOSTOMY NOS
TEMPORARY ILEOSTOMY
CONTINENT ILEOSTOMY
PERMANENT ILEOSTOMY NEC
INTEST STOMA REVIS NOS
SM BOWEL STOMA REVISION
PERICOLOST HERNIA REPAIR
LG BOWEL STOMA REVIS NEC
INTEST STOMA CLOSURE NOS
SM BOWEL STOMA CLOSURE
LG BOWEL STOMA CLOSURE
INTESTINAL FIXATION NOS
SM BOWEL-ABD WALL FIXAT
SMALL BOWEL FIXATION NEC
LG BOWEL-ABD WALL FIXAT
LARGE BOWEL FIXATION NEC
DUODENAL LACERAT SUTURE
DUODENAL FISTULA CLOSURE
SMALL BOWEL SUTURE NEC
CLOSE SM BOWEL FIST NEC
SUTURE LG BOWEL LACERAT
CLOSE LG BOWEL FISTULA
REPAIR OF INTESTINE NEC
INTRA-AB BOWEL MANIP NOS
INTRA-ABD SM BOWEL MANIP
INTRA-ABD LG BOWEL MANIP
MYOTOMY OF SIGMOID COLON
MYOTOMY OF COLON NEC
REVISE SM BOWEL ANASTOM
REVISE LG BOWEL ANASTOM
TRANSPLANT OF INTESTINE
INTESTINAL OP NEC
LAP APPENDECTOMY
OTHER APPENDECTOMY
LAP INCID APPENDECTOMY
OTHER INCID APPENDECTOMY
DRAIN APPENDICEAL ABSC
APPENDICOSTOMY
CLOSE APPENDICEAL FISTUL
APPENDICEAL OPS NEC
PROCTOTOMY
218
48.1
48.21
48.25
48.35
48.40
48.41
48.42
48.43
48.49
48.50
48.51
48.52
48.59
48.61
48.62
48.63
48.64
48.65
48.69
48.71
48.72
48.73
48.74
48.75
48.76
48.79
48.81
48.82
48.91
48.92
48.93
48.99
49.01
49.02
49.04
49.11
49.12
49.39
49.44
49.45
49.46
49.49
49.51
49.52
49.59
49.6
PROCTOSTOMY
TRANSAB PROCTOSIGMOIDOSC
OPEN RECTAL BIOPSY
LOCAL EXCIS RECTAL LES
PULL-THRU RES RECTUM NOS
SOAVE SUBMUC RECT RESECT
LAP PULL-THRU RES RECTUM
OPN PULL-THRU RES RECTUM
PULL-THRU RECT RESEC NEC
ABDPERNEAL RES RECTM NOS
LAP ABDPERNEAL RESC REC
OPN ABDPERNEAL RESC REC
ABDPERNEAL RESC RECT NEC
TRANSSAC RECTOSIGMOIDECT
ANT RECT RESECT W COLOST
ANTERIOR RECT RESECT NEC
POSTERIOR RECT RESECTION
DUHAMEL RECTAL RESECTION
RECTAL RESECTION NEC
SUTURE OF RECTAL LACER
CLOSURE OF PROCTOSTOMY
CLOSE RECTAL FIST NEC
RECTORECTOSTOMY
ABDOMINAL PROCTOPEXY
PROCTOPEXY NEC
REPAIR OF RECTUM NEC
PERIRECTAL INCISION
PERIRECTAL EXCISION
INCIS RECTAL STRICTURE
ANORECTAL MYOMECTOMY
REPAIR PERIRECT FISTULA
RECTAL PERIRECT OP NEC
INCIS PERIANAL ABSCESS
PERIANAL INCISION NEC
PERIANAL EXCISION NEC
ANAL FISTULOTOMY
ANAL FISTULECTOMY
OTHER DESTRUC ANUS LES
HEMORRHOID CRYOTHERAPY
HEMORRHOID LIGATION
HEMORRHOIDECTOMY
HEMORRHOID PROCEDURE NEC
LEFT LAT SPHINCTEROTOMY
POST SPHINCTEROTOMY
ANAL SPHINCTEROTOMY NEC
EXCISION OF ANUS
49.71
49.72
49.73
49.74
49.75
49.76
SUTURE ANAL LACERATION
ANAL CERCLAGE
CLOSURE OF ANAL FISTULA
GRACILIS MUSC TRANSPLAN
IMPL OR REV ART ANAL SPH
REMOV ART ANAL SPHINCTER
PC v2014A
219
49.79
49.91
49.92
49.93
49.94
49.95
49.99
50.0
50.12
50.14
50.19
50.21
50.22
50.23
50.24
50.25
50.26
50.29
50.3
50.4
50.51
50.59
50.61
50.69
51.02
51.03
51.04
51.13
51.19
51.21
51.22
51.23
51.24
51.31
51.32
51.33
51.34
51.35
51.36
51.37
51.39
51.41
51.42
51.43
51.49
51.51
ANAL SPHINCT REPAIR NEC
INCISION OF ANAL SEPTUM
INSERT SUBQ ANAL STIMUL
ANAL INCISION NEC
REDUCTION ANAL PROLAPSE
CONTROL ANAL HEMORRHAGE
ANAL OPERATION NEC
HEPATOTOMY
OPEN LIVER BIOPSY
LAPAROSCOPIC LIVER BX
HEPATIC DX PROC NEC
MARSUPIALIZAT LIVER LES
PARTIAL HEPATECTOMY
OPN ABLTN LIVER LES/TISS
PERC ABLTN LIVER LES/TIS
LAP ABLTN LIVER LES/TISS
ABLTN LIVER LES/TISS NEC
DESTRUC HEPATIC LES NEC
HEPATIC LOBECTOMY
TOTAL HEPATECTOMY
AUXILIARY LIVER TRANSPL
LIVER TRANSPLANT NEC
CLOSURE LIVER LACERAT
LIVER REPAIR NEC
TROCAR CHOLECYSTOSTOMY
CHOLECYSTOSTOMY NEC
CHOLECYSTOTOMY NEC
OPEN BILIARY TRACT BX
BILIARY TR DX PROC NEC
OTH PART CHOLECYSTECTOMY
CHOLECYSTECTOMY
LAPAROSCOPIC CHOLECYSTEC
LAP PART CHOLECYSTECTOMY
GB-TO-HEPAT DUCT ANAST
GB-TO-INTESTINE ANASTOM
GB-TO-PANCREAS ANASTOM
GB-TO-STOMACH ANASTOMOS
GALLBLADDER ANASTOM NEC
CHOLEDOCHOENTEROSTOMY
HEPATIC DUCT-GI ANASTOM
BILE DUCT ANASTOMOS NEC
CDE FOR CALCULUS REMOV
CDE FOR OBSTRUCTION NEC
CHOLEDOCHOHEPAT INTUBAT
INCIS OBSTR BILE DUC NEC
COMMON DUCT EXPLORATION
51.59
51.61
51.62
51.63
51.69
51.71
BILE DUCT INCISION NEC
EXCIS CYST DUCT REMNANT
EXCIS AMPULLA OF VATER
COMMON DUCT EXCIS NEC
BILE DUCT EXCISION NEC
SIMPLE SUT-COMMON DUCT
PC v2014A
220
51.72
51.79
51.81
51.82
51.83
51.89
51.91
51.92
51.93
51.94
51.95
51.99
52.01
52.09
52.12
52.19
52.22
52.3
52.4
52.51
52.52
52.53
52.59
52.6
52.7
52.80
52.81
52.82
52.83
52.92
52.95
52.96
52.99
53.00
53.01
53.02
53.03
53.04
53.05
53.10
53.11
53.12
53.13
53.14
53.15
53.16
53.17
CHOLEDOCHOPLASTY
BILE DUCT REPAIR NEC
SPHINCTER OF ODDI DILAT
PANCREAT SPHINCTEROTOM
PANCREAT SPHINCTEROPLAS
SPHINCT OF ODDI OP NEC
REPAIR GB LACERATION
CLOSURE CHOLECYSTOSTOMY
CLOS BILIARY FISTUL NEC
REVIS BILE TRACT ANASTOM
REMOVE BILE DUCT PROSTH
BILIARY TRACT OP NEC
CATH DRAIN-PANCREAT CYST
PANCREATOTOMY NEC
OPEN PANCREATIC BIOPSY
PANCREATIC DX PROC NEC
OTHER DESTRU PANCREA LES
PANCREAT CYST MARSUPIALI
INT DRAIN PANCREAT CYST
PROXIMAL PANCREATECTOMY
DISTAL PANCREATECTOMY
RAD SUBTOT PANCREATECTOM
PARTIAL PANCREATECT NEC
TOTAL PANCREATECTOMY
RAD PANCREATICODUODENECT
PANCREAT TRANSPLANT NOS
REIMPLANT PANCREATIC TIS
PANCREATIC HOMOTRANSPLAN
PANCREATIC HETEROTRANSPL
CANNULATION PANCREA DUC
PANCREATIC REPAIR NEC
PANCREATIC ANASTOMOSIS
PANCREATIC OPERATION NEC
UNILAT ING HERN REP NOS
REPAIR DIRECT ING HERNIA
REPAIR INDIR ING HERNIA
DIR ING HERNIA REP-GRAFT
IND ING HERNIA REP-GRAFT
ING HERNIA REP-GRAFT NOS
BILAT ING HERNIA REP NOS
BILAT DIR ING HERN REP
BILAT IND ING HERN REP
BIL DIR/IND ING HRN REP
BIL DIR ING HRN REP-GRFT
BIL IND ING HRN REP-GRFT
BIL DIR/IND ING HERN-PRO
BIL ING HRN REP-GRFT NOS
53.21
53.29
53.31
53.39
53.41
53.42
UNIL FEMOR HRN REP-GRFT
UNIL FEMOR HERN REP NEC
BIL FEM HERN REPAIR-GRFT
BIL FEM HERN REPAIR NEC
UMBIL HERNIA REPAIR-GRFT
LAP UMBIL HERNIA-GRAFT
PC v2014A
221
53.43
53.49
53.51
53.59
53.61
53.62
53.63
53.69
53.71
53.72
53.75
53.80
53.81
53.82
53.83
53.84
53.9
54.0
54.11
54.12
54.19
54.21
54.22
54.23
54.29
54.3
54.4
54.51
54.59
54.61
54.62
54.63
54.64
54.71
54.72
54.73
54.74
54.75
54.92
54.93
54.94
54.95
55.01
55.02
55.03
55.04
55.11
LAP UMBILICAL HERNIA NEC
UMBIL HERNIA REPAIR NEC
INCISIONAL HERNIA REPAIR
ABD WALL HERN REPAIR NEC
INCIS HERNIA REPAIR-GRFT
LAP INCIS HERN REPR-GRFT
LAP HERN ANT ABD-GFT NEC
ABD HERN REPAIR-GRFT NEC
LAP ABD REP-DIAPHR HERN
OPN ABD DIAPHRM HERN NEC
ABD REP-DIAPHR HERN NOS
THOR REP-DIAPH HERN NOS
DIAPHRAGMATIC PLICATION
PARASTERN HERNIA REPAIR
LAP THORC APP-DIAPH HERN
OPN THORC DIAPH HERN NEC
OTHER HERNIA REPAIR
ABDOMINAL WALL INCISION
EXPLORATORY LAPAROTOMY
REOPEN RECENT LAP SITE
LAPAROTOMY NEC
LAPAROSCOPY
ABDOMINAL WALL BIOPSY
PERITONEAL BIOPSY
ABD REGION DX PROC NEC
DESTRUCT ABD WALL LESION
DESTRUCT PERITONEAL TISS
LAP PERITON ADHESIOLYSIS
OTH PERITON ADHESIOLYSIS
RECLOSE POST OP DISRUPT
DELAYED CLOS ABD WOUND
ABD WALL SUTURE NEC
PERITONEAL SUTURE
REPAIR OF GASTROSCHISIS
ABDOMEN WALL REPAIR NEC
PERITONEAL REPAIR NEC
OMENTAL REPAIR NEC
MESENTERIC REPAIR NEC
REMOVE FB FROM PERITON
CREATE CUTANPERITON FIST
CREAT PERITONEOVAS SHUNT
PERITONEAL INCISION
NEPHROTOMY
NEPHROSTOMY
PERCU NEPHROSTM W/O FRAG
PERCU NEPHROSTMY W FRAG
PYELOTOMY
55.12
55.24
55.29
55.31
55.32
55.33
PYELOSTOMY
OPEN RENAL BIOPSY
RENAL DIAGNOST PROC NEC
RENAL LES MARSUPIALIZAT
OPN ABLTN RENAL LES/TISS
PERC ABLTN RENL LES/TISS
PC v2014A
222
55.34
55.35
55.39
55.4
55.51
55.52
55.53
55.54
55.61
55.69
55.7
55.81
55.82
55.83
55.84
55.85
55.86
55.87
55.89
55.91
55.97
55.98
55.99
56.0
56.1
56.2
56.34
56.39
56.40
56.41
56.42
56.51
56.52
56.61
56.62
56.71
56.72
56.73
56.74
56.75
56.79
56.81
56.82
56.83
56.84
56.85
LAP ABLTN RENAL LES/TISS
ABLTN RENAL LES/TISS NEC
LOC DESTR RENAL LES NEC
PARTIAL NEPHRECTOMY
NEPHROURETERECTOMY
SOLITARY KIDNEY NEPHRECT
REJECTED KIDNEY NEPHRECT
BILATERAL NEPHRECTOMY
RENAL AUTOTRANSPLANT
KIDNEY TRANSPLANT NEC
NEPHROPEXY
SUTURE KIDNEY LACERATION
CLOSE NEPHROST & PYELOST
CLOSE RENAL FISTULA NEC
REDUCE RENAL PEDICL TORS
SYMPHYSIOTOMY
RENAL ANASTOMOSIS
CORRECT URETEROPELV JUNC
RENAL REPAIR NEC
RENAL DECAPSULATION
IMPLANT MECHANIC KIDNEY
REMOV MECHANICAL KIDNEY
RENAL OPERATION NEC
TU REMOV URETER OBSTRUCT
URETERAL MEATOTOMY
URETEROTOMY
OPEN URETERAL BIOPSY
URETERAL DX PROCEDUR NEC
URETERECTOMY NOS
PARTIAL URETERECTOMY
TOTAL URETERECTOMY
FORM CUTAN ILEOURETEROST
REVIS CUTAN ILEOURETEROS
FORM CUTAN URETEROSTOMY
REVIS CUTAN URETEROS NEC
URIN DIVERSION TO BOWEL
REVIS URETEROENTEROSTOMY
NEPHROCYSTANASTOMOSI NOS
URETERONEOCYSTOSTOMY
TRANSURETEROURETEROSTOMY
URETERAL ANASTOMOSIS NEC
INTRALUM URETE ADHESIOLY
SUTURE URETERAL LACERAT
URETEROSTOMY CLOSURE
CLOSE URETER FISTULA NEC
URETEROPEXY
56.86
56.89
56.92
56.93
56.94
56.95
56.99
REMOVE URETERAL LIGATURE
REPAIR OF URETER NEC
IMPLANT URETERAL STIMUL
REPLACE URETERAL STIMUL
REMOVE URETERAL STIMULAT
LIGATION OF URETER
URETERAL OPERATION NEC
PC v2014A
223
57.12
57.18
57.19
57.21
57.22
57.33
57.34
57.39
57.41
57.49
57.51
57.59
57.6
57.71
57.79
57.81
57.82
57.83
57.84
57.85
57.86
57.87
57.88
57.89
57.91
57.93
57.96
57.97
57.98
57.99
58.0
58.1
58.41
58.42
58.43
58.44
58.45
58.46
58.47
58.49
58.5
58.91
58.92
58.93
58.99
59.00
59.02
59.03
59.09
59.11
59.12
59.19
59.21
PC v2014A
CYSTOTOMY & ADHESIOLYSIS
OTHER SUPRAPU CYSTOSTOMY
CYSTOTOMY NEC
VESICOSTOMY
REVISE CLO VESICOSTOMY
CLOS TRANSURETH BLADD BX
OPEN BLADDER BIOPSY
BLADDER DIAGNOS PROC NEC
TU ADHESIOLYSIS BLADDER
TU DESTRUC BLADD LES NEC
EXCISION OF URACHUS
BLADDER LES DESTRUCT NEC
PARTIAL CYSTECTOMY
RADICAL CYSTECTOMY
TOTAL CYSTECTOMY NEC
SUTURE BLADDER LACERAT
CYSTOSTOMY CLOSURE
ENTEROVESICO FIST REPAIR
VESIC FISTULA REPAIR NEC
CYSTOURETHROPLASTY
BLADDER EXSTROPHY REPAIR
BLADDER RECONSTRUCTION
BLADDER ANASTOMOSIS NEC
BLADDER REPAIR NEC
BLADDER SPHINCTEROTOMY
CONTROL BLADD HEMORRHAGE
IMPLANT BLADDER STIMULAT
REPLACE BLADDER STIMULAT
REMOVE BLADDER STIMULAT
BLADDER OPERATION NEC
URETHROTOMY
URETHRAL MEATOTOMY
SUTURE URETHRAL LACERAT
URETHROSTOMY CLOSURE
CLOSE URETH FISTULA NEC
URETHRAL REANASTOMOSIS
HYPO-EPISPADIUS REPAIR
URETH RECONSTRUCTION NEC
URETHRAL MEATOPLASTY
URETHRAL REPAIR NEC
URETH STRICTURE RELEASE
PERIURETHRAL INCISION
PERIURETHRAL EXCISION
IMPLT ARTF URIN SPHINCT
URETH/PERIURETH OP NEC
RETROPERIT DISSECT NOS
PERIREN ADHESIOLYS NEC
LAP LYS PERIREN/URET ADH
PERIREN/URETER INCIS NEC
OTH LYS PERIVES ADHESIO
LAP LYS PERIVESURETH ADH
PERIVESICAL INCISION NEC
PERIREN/URETERAL BIOPSY
224
59.29
59.3
59.4
59.5
59.6
59.71
59.79
59.91
59.92
60.0
60.12
60.14
60.15
60.18
60.19
60.21
60.29
60.3
60.4
60.5
60.61
60.62
60.69
60.72
60.73
60.79
60.81
60.82
60.93
60.94
60.95
60.96
60.97
60.99
61.2
61.42
61.49
61.92
61.99
62.0
62.12
62.19
62.2
62.3
PERIREN/URET DX PROC NEC
URETHROVES JUNCT PLICAT
SUPRAPUBIC SLING OP
RETROPUBIC URETH SUSPENS
PARAURETHRAL SUSPENSION
LEVATOR MUSC SUSPENSION
URIN INCONTIN REPAIR NEC
PERIREN/VESICLE EXCISION
PERIREN/VESICLE OP NEC
INCISION OF PROSTATE
OPEN PROSTATIC BIOPSY
OPEN SEMINAL VESICLES BX
PERIPROSTATIC BIOPSY
PROSTATIC DX PROCED NEC
SEMIN VES DX PROCED NEC
TRANSURETH PROSTATECTOMY
OTH TRANSURETH PROSTATEC
SUPRAPUBIC PROSTATECTOMY
RETROPUBIC PROSTATECTOMY
RADICAL PROSTATECTOMY
LOS EXCIS PROSTATIC LES
PERINEAL PROSTATECTOMY
PROSTATECTOMY NEC
SEMINAL VESICLE INCISION
SEMINAL VESICLE EXCISION
SEMINAL VESICLE OP NEC
PERIPROSTATIC INCISION
PERIPROSTATIC EXCISION
REPAIR OF PROSTATE
CONTROL PROSTATE HEMORR
TRANS BAL DIL PROS URETH
TU DESTR PROSTATE BY MT
OTH TU DESTR PROS - RT
PROSTATIC OPERATION NEC
EXCISION OF HYDROCELE
SCROTAL FISTULA REPAIR
SCROTUM/TUNIC REPAIR NEC
EXCISION TUNICA LES NEC
SCROTUM & TUNICA OP NEC
INCISION OF TESTES
OPEN TESTICULAR BIOPSY
TESTES DX PROCEDURE NEC
TESTICULAR LES DESTRUCT
UNILATERAL ORCHIECTOMY
62.41
62.42
62.5
62.61
62.69
62.7
62.99
63.09
REMOVE BOTH TESTES
REMOVE SOLITARY TESTIS
ORCHIOPEXY
SUTURE TESTICULAR LACER
TESTICULAR REPAIR NEC
INSERT TESTICULAR PROSTH
TESTICULAR OPERATION NEC
SPERMAT CORD/VAS DX NEC
PC v2014A
225
63.1
63.2
63.3
63.4
63.51
63.53
63.59
63.81
63.82
63.83
63.85
63.89
63.92
63.93
63.94
63.95
63.99
64.11
64.2
64.3
64.41
64.42
64.43
64.44
64.45
64.49
64.5
64.92
64.93
64.95
64.96
64.97
64.98
64.99
65.01
65.09
65.11
65.12
65.13
65.14
65.19
65.21
65.22
65.23
65.24
EXC SPERMATIC VARICOCELE
EXCISE EPIDIDYMIS CYST
EXCISE CORD/EPID LES NEC
EPIDIDYMECTOMY
SUTURE CORD & EPID LACER
TRANSPLANT SPERMAT CORD
CORD & EPIDID REPAIR NEC
SUTURE VAS & EPIDID LAC
POSTOP VAS RECONSTRUCT
EPIDIDYMOVASOSTOMY
REMOV VAS DEFERENS VALVE
VAS & EPIDIDY REPAIR NEC
EPIDIDYMOTOMY
SPERMATIC CORD INCISION
SPERM CORD ADHESIOLYSIS
INSERT VALVE IN VAS DEF
CORD/EPID/VAS OPS NEC
PENILE BIOPSY
LOCAL EXCIS PENILE LES
AMPUTATION OF PENIS
SUTURE PENILE LACERATION
RELEASE OF CHORDEE
CONSTRUCTION OF PENIS
RECONSTRUCTION OF PENIS
REPLANTATION OF PENIS
PENILE REPAIR NEC
SEX TRANSFORMAT OP NEC
INCISION OF PENIS
DIVISION OF PENILE ADHES
INS NONINFL PENIS PROSTH
REMOVE INT PENILE PROSTH
INS INFLATE PENIS PROSTH
PENILE OPERATION NEC
MALE GENITAL OP NEC
LAPAROSCOPIC OOPHOROTOMY
OTHER OOPHOROTOMY
OVARIAN ASPIRAT BIOPSY
OVARIAN BIOPSY NEC
LAP BIOPSY OF OVARY
OTH LAP DX PROC OVARIES
OVARIAN DX PROCEDURE NEC
OVARIAN CYST MARSUPIALIZ
OVARIAN WEDGE RESECTION
LAP MARSUP OVARIAN CYST
LAP WEDGE RESECT OVARY
65.25
65.29
65.31
65.39
65.41
65.49
65.51
65.52
OTH LAP LOC EXC DEST OVA
LOCAL DESTR OVA LES NEC
LAP UNILAT OOPHORECTOMY
OTH UNILAT OOPHORECTOMY
LAP UNI SALPINGO-OOPHOR
OTH UNI SALPINGO-OOPHOR
OTH REMOVE BOTH OVARIES
OTH REMOVE REMAIN OVARY
PC v2014A
226
65.53
65.54
65.61
65.62
65.63
65.64
65.71
65.72
65.73
65.74
65.75
65.76
65.79
65.81
65.89
65.91
65.92
65.93
65.94
65.95
65.99
66.01
66.02
66.11
66.19
66.21
66.22
66.29
66.31
66.32
66.39
66.4
66.51
66.52
66.61
66.62
66.63
66.69
66.71
66.72
66.73
66.74
66.79
66.92
LAP REMOVE BOTH OVARIES
LAP REMOVE REMAIN OVARY
OTH REMOVE OVARIES/TUBES
OTH REMOVE REM OVA/TUBE
LAP REMOVE OVARIES/TUBES
LAP REMOVE REM OVA/TUBE
OTH SIMPLE SUTURE OVARY
OTH REIMPLANT OF OVARY
OTH SALPINGO-OOPHOROPLAS
LAP SIMPLE SUTURE OVARY
LAP REIMPLANT OF OVARY
LAP SALPINGO-OOPHOROPLAS
REPAIR OF OVARY NEC
LAP ADHESIOLYS OVA/TUBE
ADHESIOLYSIS OVARY/TUBE
ASPIRATION OF OVARY
TRANSPLANTATION OF OVARY
MANUAL RUPT OVARIAN CYST
OVARIAN DENERVATION
OVARIAN TORSION RELEASE
OVARIAN OPERATION NEC
SALPINGOTOMY
SALPINGOSTOMY
FALLOPIAN TUBE BIOPSY
FALLOP TUBE DX PROC NEC
BILAT ENDOSC CRUSH TUBE
BILAT ENDOSC DIVIS TUBE
BILAT ENDOS OCC TUBE NEC
BILAT TUBAL CRUSHING NEC
BILAT TUBAL DIVISION NEC
BILAT TUBAL DESTRUCT NEC
TOTAL UNILAT SALPINGECT
REMOVE BOTH FALLOP TUBES
REMOVE SOLITARY FAL TUBE
DESTROY FALLOP TUBE LES
REMOV TUBE & ECTOP PREG
BILAT PART SALPINGEC NOS
PARTIAL SALPINGECTOM NEC
SIMPL SUTURE FALLOP TUBE
SALPINGO-OOPHOROSTOMY
SALPINGO-SALPINGOSTOMY
SALPINGO-UTEROSTOMY
FALLOP TUBE REPAIR NEC
UNILAT FALLOP TUBE DESTR
66.93
66.94
66.95
66.96
66.97
66.99
67.11
67.12
67.19
IMPL FALLOP TUBE PROSTH
REMOV FALLOP TUBE PROSTH
BLOW THERAPEUT INTO TUBE
FALLOPIAN TUBE DILATION
BURY FIMBRIAE IN UTERUS
FALLOPIAN TUBE OP NEC
ENDOCERVICAL BIOPSY
CERVICAL BIOPSY NEC
CERVICAL DX PROCEDUR NEC
PC v2014A
227
67.2
67.31
67.32
67.33
67.39
67.4
67.51
67.59
67.61
67.62
67.69
68.0
68.13
68.14
68.15
68.16
68.19
68.21
68.22
68.23
68.24
68.25
68.29
68.31
68.39
68.41
68.49
68.51
68.59
68.61
68.69
68.71
68.79
68.8
68.9
69.01
69.02
69.09
69.19
69.21
69.22
69.23
69.29
69.3
CONIZATION OF CERVIX
CERVICAL CYST MARSUPIAL
CERVICAL LES CAUTERIZAT
CERVICAL LES CRYOTHERAPY
CERVICAL LES DESTRUC NEC
AMPUTATION OF CERVIX
TRANSAB CERCLAGE CERVIX
OTH REP INT CERVICAL OS
SUTURE CERVICAL LACERAT
CERVICAL FISTULA REPAIR
CERVICAL REPAIR NEC
HYSTEROTOMY
OPEN UTERINE BIOPSY
OPEN UTERINE LIGAMENT BX
CLOS UTERINE LIGAMENT BX
CLOSED UTERINE BIOPSY
UTERUS/ADNEX DX PROC NEC
ENDOMET SYNECHIAE DIVIS
INCISION UTERINE SEPTUM
ENDOMETRIAL ABLATION
UTERINE ART EMB W COILS
UTERINE ART EMB W/O COIL
UTERINE LES DESTRUCT NEC
LAP SCERVIC HYSTERECTOMY
OTH SUBTOT ABD HYSTERECT
LAP TOTAL ABDOMINAL HYST
TOTAL ABD HYST NEC/NOS
LAP AST VAG HYSTERECTOMY
OTHER VAG HYSTERECTOMY
LAP RADICAL ABDOMNL HYST
RADICAL ABD HYST NEC/NOS
LAP RADICAL VAGINAL HYST
RADICAL VAG HYST NEC/NOS
PELVIC EVISCERATION
HYSTERECTOMY NEC/NOS
D & C FOR PREG TERMINAT
D & C POST DELIVERY
D & C NEC
DESTRUC UTER SUPPORT NEC
INTERPOSIT OP UTERIN LIG
UTERINE SUSPENSION NEC
VAG REPAIR INVERS UTERUS
UTERUS/ADNEXA REPAIR NEC
PARACERV UTERINE DENERV
69.41
69.42
69.49
69.51
69.52
69.95
69.97
69.98
69.99
SUTURE UTERINE LACERAT
CLOSURE UTERINE FISTULA
UTERINE REPAIR NEC
ASPIRAT CURET-PREG TERMI
ASPIRAT CURET-POST DELIV
INCISION OF CERVIX
REMOVE PENETRAT CERV FB
UTERINE SUPPORT OP NEC
UTERINE OPERATION NEC
PC v2014A
228
70.12
70.13
70.14
70.23
70.24
70.29
70.31
70.32
70.33
70.4
70.50
70.51
70.52
70.53
70.54
70.55
70.61
70.62
70.63
70.64
70.71
70.72
70.73
70.74
70.75
70.76
70.77
70.78
70.79
70.8
70.91
70.92
70.93
71.01
71.09
71.11
71.19
71.22
71.23
71.24
71.29
71.3
71.4
CULDOTOMY
INTRALUM VAG ADHESIOLYS
VAGINOTOMY NEC
CUL-DE-SAC BIOPSY
VAGINAL BIOPSY
VAGIN/CUL-DE-SAC DX NEC
HYMENECTOMY
EXCIS CUL-DE-SAC LESION
EXCISION VAGINAL LESION
VAGINAL OBLITERATION
CYSTOCEL/RECTOCEL REPAIR
CYSTOCELE REPAIR
RECTOCELE REPAIR
CYSTO & RECTO W GRF/PROS
REP CYSTOCEL W GRFT/PROS
REP RECTOCELE W GRF/PROS
VAGINAL CONSTRUCTION
VAGINAL RECONSTRUCTION
VAGINAL CONST W GRF/PROS
VAG RECONST W GRFT/PROS
SUTURE VAGINA LACERATION
REPAIR COLOVAGIN FISTULA
REPAIR RECTOVAG FISTULA
REP VAGINOENT FISTUL NEC
REPAIR VAG FISTULA NEC
HYMENORRHAPHY
VAGINAL SUSPENS & FIXAT
VAG SUSP/FIX W GRFT/PROS
VAGINAL REPAIR NEC
VAGINAL VAULT OBLITERAT
VAGINAL OPERATION NEC
CUL-DE-SAC OPERATION NEC
CUL-DE-SAC GRF/PROS NEC
VULVAR ADHESIOLYSIS
INCIS VULVA/PERINEUM NEC
VULVAR BIOPSY
VULVAR DIAGNOS PROC NEC
INCISE BARTHOLIN"S GLAND
BARTHOLIN GLAND MARSUP
DESTRUC BARTHOLIN GLAND
BARTHOLIN"S GLAND OP NEC
LOCAL VULVAR EXCIS NEC
OPERATIONS ON CLITORIS
71.5
71.61
71.62
71.71
71.72
71.79
71.8
71.9
73.94
73.99
RADICAL VULVECTOMY
UNILATERAL VULVECTOMY
BILATERAL VULVECTOMY
SUTURE VULVAR LACERATION
REPAIR VULVAR FISTULA
VULVAR/PERIN REPAIR NEC
OTHER VULVAR OPERATIONS
OTHER FEMALE GENITAL OPS
PUBIOTOMY TO ASSIST DEL
OPS ASSISTING DELIV NEC
PC v2014A
229
74.0
74.1
74.2
74.3
74.4
74.91
74.99
75.36
75.50
75.51
75.52
75.61
75.93
75.99
76.01
76.09
76.11
76.19
76.2
76.31
76.39
76.41
76.42
76.43
76.44
76.45
76.46
76.5
76.61
76.62
76.63
76.64
76.65
76.66
76.67
76.68
76.69
76.70
76.72
76.74
76.76
76.77
76.79
76.91
76.92
76.94
76.97
76.99
77.00
77.01
77.02
77.03
77.04
PC v2014A
CLASSICAL C-SECTION
LOW CERVICAL C-SECTION
EXTRAPERITONEAL C-SECT
REM EXTRATUB ECTOP PREG
CESAREAN SECTION NEC
HYSTEROTOMY TO TERMIN PG
CESAREAN SECTION NOS
CORRECTION FETAL DEFECT
REPAIR OB LAC UTERUS NOS
REPAIR OB LACERAT CERVIX
REPAIR OB LAC CORP UTERI
REPAIR OB LAC BLAD/URETH
SURG CORR INVERT UTERUS
OBSTETRIC OPERATION NEC
FACIAL BONE SEQUESTRECT
FACIAL BONE INCISION NEC
FACIAL BONE BIOPSY
FACIAL BONE DX PROC NEC
DESTRUCT FACIAL BONE LES
PARTIAL MANDIBULECTOMY
PART FACIAL OSTECTOM NEC
TOT MANDIBULEC W RECONST
TOTAL MANDIBULECTOMY NEC
MANDIBULAR RECONST NEC
TOT FACE OSTECT W RECONS
TOT FACE BONE OSTECT NEC
FACIAL BONE RECONSTR NEC
TEMPOROMAND ARTHROPLASTY
CL OSTEOPLASTY MAND RAMI
OPEN OSTEOPLAS MAND RAMI
OSTEOPLASTY MANDIBLE BDY
MAND ORTHOGNATHIC OP NEC
SEG OSTEOPLASTY MAXILLA
TOT OSTEOPLASTY MAXILLA
REDUCTION GENIOPLASTY
AUGMENTATION GENIOPLASTY
FACIAL BONE REPAIR NEC
REDUCTION FACIAL FX NOS
OPN REDUCT MALAR/ZYGO FX
OPEN REDUCT MAXILLARY FX
OPEN REDUCT MANDIBLE FX
OPEN REDUCT ALVEOLAR FX
OPEN REDUCT FACE FX NEC
BONE GRAFT TO FACE BONE
SYN IMPLANT TO FACE BONE
OPEN REDUCT TM DISLOCAT
REMOVE INT FIX FACE BONE
FACIAL BONE/JNT OP NEC
SEQUESTRECTOMY NOS
CHEST CAGE SEQUESTREC
HUMERUS SEQUESTRECTOMY
RADIUS & ULNA SEQUESTREC
METACARP/CARP SEQUESTREC
230
77.05
77.06
77.07
77.08
77.09
77.10
77.11
77.12
77.13
77.14
77.15
77.16
77.17
77.18
77.19
77.20
77.21
77.22
77.23
77.24
77.25
77.26
77.27
77.28
77.29
77.30
77.31
77.32
77.33
77.34
77.35
77.36
77.37
77.38
77.39
77.40
77.41
77.42
77.43
77.44
77.45
77.46
FEMORAL SEQUESTRECTOMY
PATELLAR SEQUESTRECTOMY
TIBIA/FIBULA SEQUESTREC
METATAR/TAR SEQUESTREC
SEQUESTRECTOMY NEC
OTHER BONE INCISION NOS
OTHER CHEST CAGE INCIS
OTHER HUMERUS INCISION
OTHER RADIUS/ULNA INCIS
OTH METACARP/CARP INCIS
OTHER FEMORAL INCISION
OTHER PATELLAR INCISION
OTHER TIBIA/FIBULA INCIS
OTH METATARS/TARS INCIS
BONE INCIS W/O DIV NEC
WEDGE OSTEOTOMY NOS
CHEST CAGE WEDG OSTEOTOM
HUMERUS WEDGE OSTEOTOMY
RADIUS/ULNA WEDG OSTEOTO
METACAR/CAR WEDG OSTEOTO
FEMORAL WEDGE OSTEOTOMY
PATELLAR WEDGE OSTEOTOMY
TIBIA/FIBUL WEDG OSTEOT
METATAR/TAR WEDG OSTEOT
WEDGE OSTEOTOMY NEC
OTHER BONE DIVISION NOS
CHEST CAGE BONE DIV NEC
HUMERUS DIVISION NEC
RADIUS/ULNA DIVISION NEC
METACAR/CAR DIVISION NEC
FEMORAL DIVISION NEC
PATELLAR DIVISION NEC
TIBIA/FIBULA DIV NEC
METATAR/TAR DIVISION NEC
BONE DIVISION NEC
BONE BIOPSY NOS
CHEST CAGE BONE BIOPSY
HUMERUS BIOPSY
RADIUS & ULNA BIOPSY
METACARPAL/CARPAL BIOPSY
FEMORAL BIOPSY
PATELLAR BIOPSY
77.47
77.48
77.49
77.51
77.52
77.53
77.54
77.56
77.57
77.58
TIBIA & FIBULA BIOPSY
METATARSAL/TARSAL BIOPSY
BONE BIOPSY NEC
BUNIONECT/SFT/OSTEOTOMY
BUNIONECT/SFT/ARTHRODES
OTH BUNIONECT W SFT CORR
EXC CORRECT BUNIONETTE
REPAIR OF HAMMER TOE
REPAIR OF CLAW TOE
OTH EXC, FUS, REPAIR TOE
PC v2014A
231
77.59
77.60
77.61
77.62
77.63
77.64
77.65
77.66
77.67
77.68
77.69
77.70
77.71
77.72
77.73
77.74
77.75
77.76
77.77
77.78
77.79
77.80
77.81
77.82
77.83
77.84
77.85
77.86
77.87
77.88
77.89
77.90
77.91
77.92
77.93
77.94
77.95
77.96
77.97
77.98
77.99
78.00
78.01
BUNIONECTOMY NEC
LOC EXC BONE LESION NOS
EXC CHEST CAGE BONE LES
LOC EXC BONE LES HUMERUS
LOC EXC LES RADIUS/ULNA
LOC EXC LES METACAR/CAR
LOC EXC BONE LES FEMUR
LOC EXC BONE LES PATELLA
LOC EXC LES TIBIA/FIBULA
LOC EXC LES METATAR/TAR
LOC EXC BONE LESION NEC
EXCISE BONE FOR GRFT NOS
EX CHEST CAGE BONE-GFT
EXCISE HUMERUS FOR GRAFT
EXCIS RADIUS/ULNA-GRAFT
EXCIS METACAR/CAR-GRAFT
EXCISE FEMUR FOR GRAFT
EXCISE PATELLA FOR GRAFT
EXCISE TIB/FIB FOR GRAFT
EXCIS METATAR/TAR-GRAFT
EXCISE BONE FOR GFT NEC
OTH PART OSTECTOMY NOS
OTH CHEST CAGE OSTECTOMY
PARTIAL HUMERECTOMY NEC
PART OSTECT-RADIUS/ULNA
PART OSTECT-METACAR/CAR
PART OSTECTOMY-FEMUR
PARTIAL PATELLECTOMY
PART OSTECT-TIBIA/FIBULA
PART OSTECT-METATAR/TAR
PARTIAL OSTECTOMY NEC
TOTAL OSTECTOMY NOS
TOT CHEST CAGE OSTECTOMY
TOTAL OSTECTOMY-HUMERUS
TOT OSTECT-RADIUS/ULNA
TOT OSTECT-METACARP/CARP
TOT OSTECTOMY-FEMUR
TOTAL PATELLECTOMY
TOT OSTECT-TIBIA/FIBULA
TOT OSTECT-METATARS/TARS
TOTAL OSTECTOMY NEC
BONE GRAFT NOS
BONE GRAFT TO CHEST CAGE
78.02
78.03
78.04
78.05
78.06
78.07
78.08
78.09
78.10
78.11
BONE GRAFT TO HUMERUS
BONE GRAFT-RADIUS/ULNA
BONE GRFT TO METACAR/CAR
BONE GRAFT TO FEMUR
BONE GRAFT TO PATELLA
BONE GRAFT-TIBIA/FIBULA
BONE GRAFT-METATAR/TAR
BONE GRAFT NEC
APPLIC EXT FIX DEV NOS
APPL EXT FIX-CHEST CAGE
PC v2014A
232
78.12
78.13
78.14
78.15
78.16
78.17
78.18
78.19
78.20
78.22
78.23
78.24
78.25
78.27
78.28
78.29
78.30
78.32
78.33
78.34
78.35
78.37
78.38
78.39
78.40
78.41
78.42
78.43
78.44
78.45
78.46
78.47
78.48
78.49
78.50
78.51
78.52
78.53
78.54
78.55
78.56
78.57
78.58
78.59
78.60
78.61
78.62
78.63
78.64
78.65
78.66
78.67
78.68
PC v2014A
APPLIC EXT FIX-HUMERUS
APPL EXT FIX-RADIUS/ULNA
APPL EXT FIX-METACAR/CAR
APPLIC EXT FIX DEV-FEMUR
APPL EXT FIX DEV-PATELLA
APPL EXT FIX-TIB/FIBULA
APPL EXT FIX-METATAR/TAR
APPLIC EXT FIX DEV NEC
LIMB SHORTEN PROC NOS
LIMB SHORT PROC-HUMERUS
LIMB SHORTEN-RADIUS/ULNA
LIMB SHORTEN-METACAR/CAR
LIMB SHORT PROC-FEMUR
LIMB SHORTEN-TIB/FIBULA
LIMB SHORTEN-METATAR/TAR
LIMB SHORTEN PROC NEC
LIMB LENGTHEN PROC NOS
LIMB LENGTH PROC-HUMERUS
LIMB LENGTH-RADIUS/ULNA
LIMB LENGTH-METACAR/CAR
LIMB LENGTH PROC-FEMUR
LIMB LENGTHEN-TIB/FIBULA
LIMB LENGTHN-METATAR/TAR
LIMB LENGTHEN PROC NEC
OTH BONE REPAIR/PLAST OP
OTH CHEST CAGE REP/PLAST
OTH HUMERUS REPAIR/PLAST
OTH RAD/ULN REPAIR/PLAST
OTH METAC/CARP REP/PLAST
OTH FEMUR REPAIR/PLASTIC
OTH PATELLA REPAIR/PLAST
OTH TIB/FIB REPAIR/PLAST
OTH META/TAR REPA/PLAST
OTH BONE REPA/PLAST NEC
INT FIX W/O FX REDUC NOS
INT FIXATION-CHEST CAGE
INT FIXATION-HUMERUS
INT FIXATION-RADIUS/ULNA
INT FIXATION-METACAR/CAR
INTERNAL FIXATION-FEMUR
INTERNAL FIX-PATELLA
INT FIXATION-TIBIA/FIBUL
INT FIXATION-METATAR/TAR
INT FIX-NO FX REDUCT NEC
REMOVE IMP DEVICE NOS
REMOV IMP DEV-CHEST CAGE
REMOVE IMPL DEV-HUMERUS
REMOV IMP DEV-RADIUS/ULN
REMOV IMP DEV-METAC/CARP
REMOVE IMP DEVICE-FEMUR
REMOV IMP DEVICE-PATELLA
REMOV IMP DEV-TIB/FIBULA
REMOVE IMP DEV-METAT/TAR
233
78.69
78.70
78.71
78.72
78.73
78.74
78.75
78.76
78.77
78.78
78.79
78.80
78.81
78.82
78.83
78.84
78.85
78.86
78.87
78.88
78.89
78.90
78.91
78.92
78.93
78.94
78.95
78.96
78.97
78.98
78.99
79.10
79.11
79.12
79.13
79.14
79.15
79.16
79.17
79.18
79.19
79.20
REMOVE IMPL DEVICE NEC
OSTEOCLASIS NOS
OSTEOCLASIS-CHEST CAGE
OSTEOCLASIS-HUMERUS
OSTEOCLASIS-RADIUS/ULNA
OSTEOCLASIS-METACAR/CAR
OSTEOCLASIS-FEMUR
OSTEOCLASIS-PATELLA
OSTEOCLASIS-TIBIA/FIBULA
OSTEOCLASIS-METATAR/TAR
OSTEOCLASIS NEC
OTHER BONE DX PROC NOS
OTH DX PROCED-CHEST CAGE
OTH DX PROCED-HUMERUS
OTH DX PROC-RADIUS/ULNA
OTH DX PROC-METACAR/CAR
OTH DX PROCED-FEMUR
OTH DX PROCED-PATELLA
OTH DX PROC-TIBIA/FIBULA
OTH DX PROC-METATAR/TAR
OTHER BONE DX PROC NEC
INSERT BONE STIMUL NOS
INSERT BONE STIMUL-CHEST
INSERT BONE STIM-HUMERUS
INSER BONE STIM-RAD/ULNA
INSER BONE STIM-META/CAR
INSERT BONE STIM-FEMUR
INSERT BONE STIM-PATELLA
INSER BONE STIM-TIB/FIB
INSER BONE STIM-META/TAR
INSERT BONE STIMUL NEC
CL FX REDUC-INT FIX NOS
CLOS RED-INT FIX HUMERUS
CL RED-INT FIX RAD/ULNA
CL RED-INT FIX METAC/CAR
CLOSE RED-INT FIX FINGER
CLOSED RED-INT FIX FEMUR
CL RED-INT FIX TIB/FIBU
CL RED-INT FIX METAT/TAR
CLOSE RED-INT FIX TOE FX
CL FX REDUC-INT FIX NEC
OPEN FX REDUCTION NOS
79.21
79.22
79.23
79.24
79.25
79.26
79.27
79.28
79.29
79.30
79.31
OPEN REDUC-HUMERUS FX
OPEN REDUC-RADIUS/ULN FX
OPEN REDUC-METAC/CAR FX
OPEN REDUCTION-FINGER FX
OPEN REDUCTION-FEMUR FX
OPEN REDUC-TIBIA/FIB FX
OPEN REDUC-METAT/TARS FX
OPEN REDUCTION-TOE FX
OPEN FX REDUCTION NEC
OPN FX RED W INT FIX NOS
OPEN RED-INT FIX HUMERUS
PC v2014A
234
79.32
79.33
79.34
79.35
79.36
79.37
79.38
79.39
79.40
79.41
79.42
79.45
79.46
79.49
79.50
79.51
79.52
79.55
79.56
79.59
79.60
79.61
79.62
79.63
79.64
79.65
79.66
79.67
79.68
79.69
79.80
79.81
79.82
79.83
79.84
79.85
79.86
79.87
79.88
79.89
79.90
OP RED-INT FIX RAD/ULNA
OP RED-INT FIX METAC/CAR
OPEN RED-INT FIX FINGER
OPEN REDUC-INT FIX FEMUR
OP RED-INT FIX TIB/FIBUL
OP RED-INT FIX METAT/TAR
OPEN REDUCT-INT FIX TOE
OPN FX RED W INT FIX NEC
CLS REDUC-SEP EPIPHY NOS
CLOSE RED-HUMERUS EPIPHY
CLS RED-RADIUS/UL EPIPHY
CLOSE REDUC-FEMUR EPIPHY
CLS RED-TIBIA/FIB EPIPHY
CLS REDUC-SEP EPIPHY NEC
OPEN RED-SEP EPIPHY NOS
OPN RED-SEP EPIPHY-HUMER
OP RED-RADIUS/ULN EPIPHY
OPN RED-SEP EPIPHY-FEMUR
OP RED-TIBIA/FIB EPIPHYS
OPEN RED-SEP EPIPHY NEC
OPEN FX SITE DEBRIDE NOS
DEBRID OPEN FX-HUMERUS
DEBRID OPN FX-RADIUS/ULN
DEBRID OPN FX-METAC/CAR
DEBRID OPN FX-FINGER
DEBRID OPN FX-FEMUR
DEBRID OPN FX-TIBIA/FIB
DEBRID OPN FX-METAT/TAR
DEBRID OPN FX-TOE
OPEN FX SITE DEBRIDE NEC
OPEN REDUC-DISLOCAT NOS
OPN REDUC DISLOC-SHOULDR
OPEN REDUC-ELBOW DISLOC
OPEN REDUC-WRIST DISLOC
OPN REDUC DISLOC-HAND
OPEN REDUC-HIP DISLOCAT
OPEN REDUC-KNEE DISLOCAT
OPEN REDUC-ANKLE DISLOC
OPN REDUC DISLOC-FT/TOE
OPEN REDUC-DISLOCAT NEC
UNSPEC OP BONE INJ NOS
79.91
79.92
79.93
79.94
79.95
79.96
79.97
79.98
79.99
80.00
80.01
80.02
HUMERUS INJURY OP NOS
RADIUS/ULNA INJ OP NOS
METACARP/CARP INJ OP NOS
FINGER INJURY OP NOS
FEMUR INJURY OP NOS
TIBIA/FIBULA INJ OP NOS
METATARS/TARS INJ OP NOS
TOE INJURY OPERATION NOS
UNSPEC OP-BONE INJ NEC
ARTHROT & PROS REMOV NOS
ARTHROT/PROS REMOV-SHLDR
ARTHROT/PROS REMOV-ELBOW
PC v2014A
235
80.03
80.04
80.05
80.06
80.07
80.08
80.09
80.10
80.11
80.12
80.13
80.14
80.15
80.16
80.17
80.18
80.19
80.20
80.21
80.22
80.23
80.24
80.25
80.26
80.27
80.28
80.29
80.40
80.41
80.42
80.43
80.44
80.45
80.46
80.47
80.48
80.49
80.50
80.51
80.53
80.54
ARTHROT/PROS REMOV-WRIST
ARTHROT/PROS REMOV-HAND
ARTHROT/PROS REMOV-HIP
ARTHROT/PROS REMOV-KNEE
ARTHROT/PROS REMOV-ANKLE
ARTHROT/PROS REMOV-FOOT
ARTHROT & PROS REMOV NEC
OTHER ARTHROTOMY NOS
OTH ARTHROTOMY-SHOULDER
OTH ARTHROTOMY-ELBOW
OTH ARTHROTOMY-WRIST
OTH ARTHROTOMY-HAND/FNGR
OTH ARTHROTOMY-HIP
OTH ARTHROTOMY-KNEE
OTH ARTHROTOMY-ANKLE
OTH ARTHROTOMY-FOOT/TOE
OTHER ARTHROTOMY NEC
ARTHROSCOPY NOS
SHOULDER ARTHROSCOPY
ELBOW ARTHROSCOPY
WRIST ARTHROSCOPY
HAND & FINGER ARTHROSCOP
HIP ARTHROSCOPY
KNEE ARTHROSCOPY
ANKLE ARTHROSCOPY
FOOT & TOE ARTHROSCOPY
ARTHROSCOPY NEC
JT STRUCTUR DIVISION NOS
SHOULDER STRUCT DIVISION
ELBOW STRUCTURE DIVISION
WRIST STRUCTURE DIVISION
HAND JOINT STRUCT DIVIS
HIP STRUCTURE DIVISION
KNEE STRUCTURE DIVISION
ANKLE STRUCTURE DIVISION
FOOT JOINT STRUCT DIVIS
JT STRUCTUR DIVISION NEC
EXC/DEST INTVRT DISC NOS
EXCISION INTERVERT DISC
REP ANULUS FIBROSUS-GRFT
REP ANULS FIBROS NEC/NOS
80.59
80.6
80.70
80.71
80.72
80.73
80.74
80.75
80.76
80.77
80.78
80.79
OTH EXC/DEST INTVRT DISC
EXCIS KNEE SEMILUN CARTL
SYNOVECTOMY-SITE NOS
SHOULDER SYNOVECTOMY
ELBOW SYNOVECTOMY
WRIST SYNOVECTOMY
HAND SYNOVECTOMY
HIP SYNOVECTOMY
KNEE SYNOVECTOMY
ANKLE SYNOVECTOMY
FOOT SYNOVECTOMY
SYNOVECTOMY-SITE NEC
PC v2014A
236
80.80
80.81
80.82
80.83
80.84
80.85
80.86
80.87
80.88
80.89
80.90
80.91
80.92
80.93
80.94
80.95
80.96
80.97
80.98
80.99
81.00
81.01
81.02
81.03
81.04
81.05
81.06
81.07
81.08
81.11
81.12
81.13
81.14
81.15
81.16
81.17
81.18
81.20
81.21
81.22
DESTRUCT JOINT LES NOS
DESTRUC-SHOULDER LES NEC
DESTRUC-ELBOW LESION NEC
DESTRUC-WRIST LESION NEC
DESTRUC-HAND JT LES NEC
DESTRUCT-HIP LESION NEC
DESTRUCT-KNEE LESION NEC
DESTRUC-ANKLE LESION NEC
DESTRUC-FOOT JT LES NEC
DESTRUCT JOINT LES NEC
EXCISION OF JOINT NOS
EXCISION OF SHOULDER NEC
EXCISION OF ELBOW NEC
EXCISION OF WRIST NEC
EXCISION HAND JOINT NEC
EXCISION OF HIP NEC
EXCISION OF KNEE NEC
EXCISION OF ANKLE NEC
EXCISION FOOT JOINT NEC
EXCISION OF JOINT NEC
SPINAL FUSION NOS
ATLAS-AXIS FUSION
OTHER CERVICAL FUS ANT
OTHER CERVICAL FUS POST
DORSAL/DORSOLUM FUS ANT
DORSAL/DORSOLUM FUS POST
LUMBAR/LUMBOSAC FUS ANT
LUMBAR/LUMBOSAC FUS LAT
LUMBAR/LUMBOSAC FUS POST
ANKLE FUSION
TRIPLE ARTHRODESIS
SUBTALAR FUSION
MIDTARSAL FUSION
TARSOMETATARSAL FUSION
METATARSOPHALANGEAL FUS
OTHER FUSION OF FOOT
OTHER FUSION OF FOOT
ARTHRODESIS NOS
ARTHRODESIS OF HIP
ARTHRODESIS OF KNEE
81.23
81.24
81.25
81.26
81.27
81.28
81.29
81.30
81.31
81.32
81.33
81.34
ARTHRODESIS OF SHOULDER
ARTHRODESIS OF ELBOW
CARPORADIAL FUSION
METACARPOCARPAL FUSION
METACARPOPHALANGEAL FUS
INTERPHALANGEAL FUSION
ARTHRODESIS NEC
SPINAL REFUSION NOS
REFUSION OF ATLAS-AXIS
REFUSION OF OTH CERV ANT
REFUS OF OTH CERV POST
REFUSION OF DORSAL ANT
PC v2014A
237
81.35
81.36
81.37
81.38
81.39
81.40
81.42
81.43
81.44
81.45
81.46
81.47
81.49
81.51
81.52
81.53
81.54
81.55
81.56
81.57
81.59
81.62
81.63
81.64
81.65
81.66
81.71
81.72
81.73
81.74
81.75
81.79
81.80
81.81
81.82
81.83
81.84
81.85
81.88
81.93
81.94
REFUSION OF DORSAL POST
REFUSION OF LUMBAR ANT
REFUSION OF LUMBAR LAT
REFUSION OF LUMBAR POST
REFUSION OF SPINE NEC
REPAIR OF HIP, NEC
FIVE-IN-ONE KNEE REPAIR
TRIAD KNEE REPAIR
PATELLAR STABILIZATION
CRUCIATE LIG REPAIR NEC
COLLATERL LIG REPAIR NEC
OTHER REPAIR OF KNEE
OTHER REPAIR OF ANKLE
TOTAL HIP REPLACEMENT
PARTIAL HIP REPLACEMENT
REVISE HIP REPLACEMENT
TOTAL KNEE REPLACEMENT
REVISE KNEE REPLACEMENT
TOTAL ANKLE REPLACEMENT
REPL JOINT OF FOOT, TOE
REV JT REPL LOW EXT NEC
FUS/REFUS 2-3 VERTEBRAE
FUS/REFUS 4-8 VERTEBRAE
FUS/REFUS 9 VERTEBRAE
VERTEBROPLASTY
KYPHOPLASTY
ARTHROPLAS METACARP WIT
ARTHROPLASTY METACAR W/O
TOTAL WRIST REPLACEMENT
ARTHROPLASTY CARPAL WIT
ARTHROPLASTY CARPAL W/O
OTH REPAIR HAN/FIN/WRIS
TOTAL SHOULDER REPLACE
PARTIAL SHOULDER REPLACE
REP RECUR SHLDER DISLOC
SHOULDER ARTHROPLAST NEC
TOTAL ELBOW REPLACEMENT
ELBOW ARTHROPLASTY NEC
RVRS TOTL SHLDR REPLACMT
SUTUR CAPSUL/LIGAMEN ARM
SUTURE CAPSUL/LIG ANK/FT
81.95
81.96
81.97
81.98
81.99
82.01
82.02
82.03
82.09
82.11
82.12
82.19
SUTUR CAPSUL/LIG LEG NEC
OTHER REPAIR OF JOINT
REV JT REPL UPPER EXTREM
OTHER JOINT DX PROCEDURE
JOINT STRUCTURE OP NEC
EXPLOR TEND SHEATH-HAND
MYOTOMY OF HAND
BURSOTOMY OF HAND
INC SOFT TISSUE HAND NEC
TENOTOMY OF HAND
FASCIOTOMY OF HAND
DIV SOFT TISSUE HAND NEC
PC v2014A
238
82.21
82.22
82.29
82.31
82.32
82.33
82.34
82.35
82.36
82.39
82.41
82.42
82.43
82.44
82.45
82.46
82.51
82.52
82.53
82.54
82.55
82.56
82.57
82.58
82.59
82.61
82.69
82.71
82.72
82.79
82.81
82.82
82.83
82.84
82.85
82.86
82.89
82.91
82.99
83.01
83.02
83.03
83.09
83.11
83.12
83.13
83.14
83.19
83.21
83.29
83.31
83.32
83.39
PC v2014A
EXC LES TEND SHEATH HAND
EXCISION HAND MUSCLE LES
EXC LES SFT TISS HND NEC
BURSECTOMY OF HAND
EXCIS HAND TEND FOR GRFT
HAND TENONECTOMY NEC
EXC HND MUS/FAS FOR GRFT
HAND FASCIECTOMY NEC
OTHER MYECTOMY OF HAND
HAND SOFT TISSUE EXC NEC
SUTURE TENDN SHEATH HAND
DELAY SUT FLEX TEND HAND
DELAY SUT HAND TEND NEC
SUTUR FLEX TEND HAND NEC
SUTURE HAND TENDON NEC
SUTURE HAND MUSCLE/FASC
HAND TENDON ADVANCEMENT
HAND TENDON RECESSION
HAND TENDON REATTACHMENT
HAND MUSCLE REATTACHMENT
CHNG HND MUS/TEN LNG NEC
TRANSPLANT HAND TEND NEC
TRANSPOSIT HAND TEND NEC
TRANSPLANT HAND MUSC NEC
TRANSPOSIT HAND MUSC NEC
POLLICIZATION OPERATION
THUMB RECONSTRUCTION NEC
HAND TEND PULLEY RECONST
PLAST OP HND-MUS/FAS GRF
PLAST OP HAND W GRFT NEC
TRANSFER OF FINGER
REPAIR OF CLEFT HAND
REPAIR OF MACRODACTYLY
REPAIR OF MALLET FINGER
OTHER TENODESIS OF HAND
OTHER TENOPLASTY OF HAND
HAND PLASTIC OP NEC
LYSIS OF HAND ADHESIONS
HAND MUS/TEN/FAS/OPS NEC
TENDON SHEATH EXPLORAT
MYOTOMY
BURSOTOMY
SOFT TISSUE INCISION NEC
ACHILLOTENOTOMY
ADDUCTOR TENOTOMY OF HIP
OTHER TENOTOMY
FASCIOTOMY
SOFT TISSUE DIVISION NEC
SOFT TISSUE BIOPSY
SOFT TISSUE DX PROC NEC
EXCIS LES TENDON SHEATH
EXCIS LESION OF MUSCLE
EXC LES SOFT TISSUE NEC
239
83.41
83.42
83.43
83.44
83.45
83.49
83.5
83.61
83.62
83.63
83.64
83.65
83.71
83.72
83.73
83.74
83.75
83.76
83.77
83.79
83.81
83.82
83.83
83.84
83.85
83.86
83.87
83.88
83.89
83.91
83.92
83.93
83.99
84.00
84.01
84.02
84.03
84.04
84.05
84.06
TENDON EXCISION FOR GRFT
OTHER TENONECTOMY
MUSC/FASC EXCIS FOR GRFT
OTHER FASCIECTOMY
OTHER MYECTOMY
OTHER SOFT TISSUE EXCIS
BURSECTOMY
TENDON SHEATH SUTURE
DELAYED TENDON SUTURE
ROTATOR CUFF REPAIR
OTHER SUTURE OF TENDON
OTHER MUSCLE/FASC SUTURE
TENDON ADVANCEMENT
TENDON RECESSION
TENDON REATTACHMENT
MUSCLE REATTACHMENT
TENDON TRNSFR/TRANSPLANT
OTHER TENDON TRANSPOSIT
MUSCLE TRNSFR/TRANSPLANT
OTHER MUSCLE TRANSPOSIT
TENDON GRAFT
MUSCLE OR FASCIA GRAFT
TENDON PULLEY RECONSTRUC
CLUBFOOT RELEASE NEC
MUSC/TEND LNG CHANGE NEC
QUADRICEPSPLASTY
OTHER PLASTIC OPS MUSCLE
OTHER PLASTIC OPS TENDON
OTHER PLASTIC OPS FASCIA
ADHESIOLYSIS MUS/TEN/FAS
INSERT SKEL MUSC STIMULA
REMOV SKEL MUSC STIMULAT
MUS/TEN/FAS/BUR OP NEC
UPPER LIMB AMPUTAT NOS
FINGER AMPUTATION
THUMB AMPUTATION
AMPUTATION THROUGH HAND
DISARTICULATION OF WRIST
AMPUTATION THRU FOREARM
DISARTICULATION OF ELBOW
84.07
84.08
84.09
84.10
84.11
84.12
84.13
84.14
84.15
84.16
84.17
84.18
AMPUTATION THRU HUMERUS
SHOULDER DISARTICULATION
FOREQUARTER AMPUTATION
LOWER LIMB AMPUTAT NOS
TOE AMPUTATION
AMPUTATION THROUGH FOOT
DISARTICULATION OF ANKLE
AMPUTAT THROUGH MALLEOLI
BELOW KNEE AMPUTAT NEC
DISARTICULATION OF KNEE
ABOVE KNEE AMPUTATION
DISARTICULATION OF HIP
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84.19
84.21
84.22
84.23
84.24
84.25
84.26
84.27
84.28
84.29
84.3
84.40
84.44
84.48
84.59
84.60
84.61
84.62
84.63
84.64
84.65
84.66
84.67
84.68
84.69
84.80
84.81
84.82
84.83
84.84
84.85
84.91
84.92
84.93
84.94
84.99
85.12
85.20
85.21
85.22
HINDQUARTER AMPUTATION
THUMB REATTACHMENT
FINGER REATTACHMENT
FOREARM/WRIST/HAND REATT
UPPER ARM REATTACHMENT
TOE REATTACHMENT
FOOT REATTACHMENT
LOWER LEG/ANKLE REATTACH
THIGH REATTACHMENT
REATTACHMENT NEC
AMPUTATION STUMP REVIS
IMPLNT/FIT PROS LIMB NOS
IMPLANT ARM PROSTHESIS
IMPLANT LEG PROSTHESIS
INSERT OTHR SPIN DEVICE
INSERT DISC PROS NOS
INS PART DISC PROS CERV
INS TOT DISC PROST CERV
INS SPIN DISC PROS THOR
INS PART DISC PROS LUMB
INS TOTL DISC PROS LUMB
REVISE DISC PROST CERV
REVISE DISC PROST THORA
REVISE DISC PROSTH LUMB
REVISE DISC PROSTH NOS
INS/REPL INTERSPINE DEV
REV INTERSPINE DEVICE
INS/REPL PDCL STABIL DEV
REV PEDCL DYN STABIL DEV
INS/REPL FACET REPLC DEV
REV FACET REPLACE DEVICE
AMPUTATION NOS
SEPARAT EQUAL JOIN TWIN
SEPARAT UNEQUL JOIN TWIN
INS STRN FIX W RGD PLATE
MUSCULOSKELETAL OP NEC
OPEN BREAST BIOPSY
BREAST TISSU DESTRUC NOS
LOCAL EXCIS BREAST LES
QUADRANT RESECT BREAST
85.23
85.24
85.25
85.31
85.32
85.33
85.34
85.35
85.36
85.41
85.42
85.43
85.44
SUBTOTAL MASTECTOMY
EXC ECTOPIC BREAST TISSU
EXCISION OF NIPPLE
UNILAT REDUCT MAMMOPLAST
BILAT REDUCT MAMMOPLASTY
UNIL SUBQ MAMMECT-IMPLNT
UNILAT SUBQ MAMMECT NEC
BIL SUBQ MAMMECT-IMPLANT
BILAT SUBQ MAMMECTOM NEC
UNILAT SIMPLE MASTECTOMY
BILAT SIMPLE MASTECTOMY
UNILAT EXTEN SIMP MASTEC
BILAT EXTEND SIMP MASTEC
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85.45
85.46
85.47
85.48
85.50
85.53
85.54
85.55
85.6
85.70
85.71
85.72
85.73
85.74
85.75
85.76
85.79
85.82
85.83
85.84
85.85
85.86
85.87
85.89
85.93
85.94
85.95
85.96
85.99
86.06
86.21
86.22
86.25
86.4
86.60
86.61
86.62
86.63
86.65
UNILAT RADICAL MASTECTOM
BILAT RADICAL MASTECTOMY
UNIL EXT RAD MASTECTOMY
BIL EXTEN RAD MASTECTOMY
AUGMENT MAMMOPLASTY NOS
UNILAT BREAST IMPLANT
BILATERAL BREAST IMPLANT
FAT GRAFT TO BREAST
MASTOPEXY
TOTL RECONSTC BREAST NOS
LATISS DORSI MYOCUT FLAP
TRAM FLAP, PEDICLED
TRAM FLAP, FREE
DIEP FLAP, FREE
SIEA FLAP, FREE
GAP FLAP, FREE
TOTL RECONST BREAST NEC
BREAST SPLIT-THICK GRAFT
BREAST FULL-THICK GRAFT
BREAST PEDICLE GRAFT
BREAST MUSCLE FLAP GRAFT
TRANSPOSITION OF NIPPLE
NIPPLE REPAIR NEC
MAMMOPLASTY NEC
BREAST IMPLANT REVISION
BREAST IMPLANT REMOVAL
INSER BREAST TISSU EXPAN
REMOV BREAST TISSU EXPAN
BREAST OPERATION NEC
INSERT INFUSION PUMP
EXCISION OF PILONID CYST
EXC WOUND DEBRIDEMENT
DERMABRASION
RADICAL EXCIS SKIN LES
FREE SKIN GRAFT NOS
FULL-THICK HAND SKIN GRF
HAND SKIN GRAFT NEC
FULL-THICK SKIN GRFT NEC
HETEROGRAFT TO SKIN
86.66
86.67
86.69
86.70
86.71
86.72
86.73
86.74
86.75
86.81
86.82
86.83
86.84
86.85
HOMOGRAFT TO SKIN
DERMAL REGENER GRAFT
FREE SKIN GRAFT NEC
PEDICLE GRAFT/FLAP NOS
CUT & PREP PEDICLE GRAFT
PEDICLE GRAFT ADVANCEMEN
ATTACH PEDICLE TO HAND
ATTACH PEDICLE GRAFT NEC
REVISION OF PEDICLE GRFT
REPAIR FACIAL WEAKNESS
FACIAL RHYTIDECTOMY
SIZE REDUCT PLASTIC OP
RELAXATION OF SCAR
SYNDACTYLY CORRECTION
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86.86
86.87
86.89
86.90
86.91
86.93
86.94
86.95
86.96
86.97
86.98
87.53
92.27
95.04
ONYCHOPLASTY
FAT GRFT SKIN/SUBQ TISS
SKIN REPAIR & PLASTY NEC
EXT FAT FOR GRFT/BANKING
SKIN EXCISION FOR GRAFT
INSERT TISSUE EXPANDER
INS/REPL SINGLE PUL GEN
INS/REPL DUAL PULSE GEN
INSERT/REPL OTH NEUROST
INS/REP 1 PUL GEN
INS/REP 2 PUL GEN
INTRAOPER CHOLANGIOGRAM
RADIOACTIVE ELEM IMPLANT
ANESTHETIZED EYE EXAM
Table Number 11.19: Mechanical Ventilation
Code
96.70
96.71
96.72
Shortened Description
CON INV MEC VEN-UNSP DUR
CONT INV MEC VEN <96 HRS
CONT INV MEC VEN 96+ HRS
Table Number 11.20: Birth Weight Less Than 500 Grams
Code
764.01
764.11
764.21
764.91
765.01
765.11
V21.31
Shortened Description
LIGHT-FOR-DATES <500G
LT-FOR-DATE W/MAL <500G
FETAL MALNUTRITION <500G
FET GROWTH RETARD <500G
EXTREME IMMATUR <500G
PRETERM NEC <500G
LOW BIRTHWT < 500G STATUS
Table Number 11.20.1: Single Liveborn Newborn
Code
V30.00
V30.01
Shortened Description
SINGLE LB IN-HOSP W/O CS
SINGLE LB IN-HOSP W CS
Table Number 11.21: Galactosemia
Code
271.1
Shortened Description
GALACTOSEMIA
Table Number 11.22: Parenteral Infusion
Code
99.15
Shortened Description
PARENT INFUS NUTRIT SUB
Table Number 11.23: Premature Newborns
Code
PC v2014A
Shortened Description
243
765.20
765.21
765.22
765.23
765.24
765.25
765.26
765.27
765.28
PC v2014A
WEEKS OF GESTATION NOS
<24 COMP WKS GESTATION
24 COMP WKS GESTATION
25-26 COMP WKS GESTATION
27-28 COMP WKS GESTATION
29-30 COMP WKS GESTATION
31-32 COMP WKS GESTATION
33-34 COMP WKS GESTATION
35-36 COMP WKS GESTATION
244
Appendix B
Medication Tables
Download Medication Tables (MS Excel)
Table Number 10.0: Antipsychotic Medications (Ver. 2011B)
Medication
Abilify Discmelt
Abilify Oral Solution
Abilify Tablets
Antipsychotic Not Otherwise Specified (NOS)
Aripiprazole Oral Solution
Aripiprazole Tablets
Asenapine
Chlorpromazine Oral Solution
Chlorpromazine Oral Syrup
Chlorpromazine Tablets
Clozapine Tablets
Clozaril Tablets
Etrafon
Fanapt
FazaClo Orally Disintegrating Tablets
Fluphenazine
Fluphenazine Decanoate Injectable
Fluphenazine HCL Oral Solution
Fluphenazine HCL Tablets
Geodon Capsules
Haldol Decanoate Injectable-Long Acting
Haldol Oral Solution
Haldol Tablets
Haloperidol Decanoate Injectable Long-Acting
Haloperidol Oral Solution
Haloperidol Tablets
Iloperidone
Invega Sustenna Injectable
Invega Tablets
Latuda
Loxapine Capsules
Loxitane Capsules
Lurasidone
Mellaril Tablets
Mesoridazine
Navane Capsules
Olanzapine + Fluoxetine Capsules
Olanzapine Tablets
Olanzapine ZYDIS Orally Disintegrating Tablets
Orap Tablets
Paliperidone Tablets
PC v2014A
Generic
Aripiprazole
Aripiprazole
Aripiprazole
Antipsychotic Not Otherwise Specified (NOS)
Aripiprazole
Aripiprazole
Asenapine
Chlorpromazine
Chlorpromazine
Chlorpromazine
Clozapine
Clozapine
Amitriptyline + Perphenazine
Iloperidone
Clozapine
Fluphenazine
Fluphenazine
Fluphenazine
Fluphenazine
Ziprasidone
Haloperidol
Haloperidol
Haloperidol
Haloperidol
Haloperidol
Haloperidol
Iloperidone
Paliperidone Palmitate
Paliperidone
Lurasidone
Loxapine
Loxapine
Lurasidone
Thioridazine
Mesoridazine
Thiothixene
Olanzapine + Fluoxetine
Olanzapine
Olanzapine
Pimozide
Paliperidone
245
Permitril
Perphenazine Tablets
Pimozide Tablets
Prolixin Decanoate Injectable- Long Acting
Prolixin Oral Solution
Prolixin Tablets
Quetiapine Fumarate
Quetiapine Tablets
Risperal Consta Injectable- Long Acting
Risperdal M-Tab Orally Disintegrating Tablets
Risperdal Oral Solution
Risperdal Tablets
Risperidone Injectable - Long Acting
Risperidone M- Tab Orally Disintegrating Tablets
Risperidone Tablets
Saphris
Serentil
Seroquel Tablets
Seroquel XR Tablets
Stelazine Tablets
Symbyax Capsules
Thioridazine HCL Tablets
Thiothixene Capsules
Thorazine Oral Solution
Thorazine Oral Syrup
Thorazine Tablets
Triavil
Trifluroperazine HCL Tablets
Trilafon Tablets
Ziprasidone HCL Tablets
Zyprexa Relprevv Injectable
Zyprexa Tablets
Zyprexa ZYDIS Orally Disintegrating Tablets
Fluphenazine
Perphenazine
Pimozide
Fluphenazine
Fluphenazine
Fluphenazine
Quetiapine
Quetiapine
Risperidone
Risperidone
Risperidone
Risperidone
Risperidone
Risperidone
Risperidone
Asenapine
Mesoridazine
Quetiapine
Quetiapine
Trifluoperazine
Olanzapine + Fluoxetine
Thiothixene
Thioridazine
Chlorpromazine
Chlorpromazine
Chlorpromazine
Amitriptyline + Perphenazine
Trifluoperazine
Perphenazine
Ziprasidone
Olanzapine
Olanzapine
Olanzapine
Table Number 10.1: Short-Acting Intramuscular Antipsychotic Medications (Ver.
2010A)
Medication
Generic
Aripiprazole
Aripiprazole
Chlorpromazine
Ziprasidone
Haloperidol
Haloperidol
Olanzapine
Fluphenazine
Chlorpromazine
Ziprasidone
Olanzapine
Abilify Injectable- Short Acting
Aripiprazole Injectable- Short Acting
Chlorpromazine Injectable- Short Acting
Geodon Injectable- Short Acting
Haldol Injectable- Short Acting
Haloperidol Injectable- Short Acting
Olanzapine Injectable- Short Acting
Prolixin Injectable- Short Acting
Thorazine Injectable- Short Acting
Ziprasidone Mesylate Injectable- Short Acting
Zyprexa Injectable- Short Acting
Table Number 11.0: Antenatal Steroid Medications (Ver. 2010A)
Medication
PC v2014A
Generic
246
Betamethasone
Betamethasone
Betamethasone Sodium Phosphate
Betamethasone Sodium Phosphate
Betamethasone Sodium Phosphate and Betamethasone Betamethasone Sodium Phosphate and Betamethasone
Acetate
Acetate
Celestone
Betamethasone
Celestone Phosphate
Betamethasone Sodium Phosphate
Celestone Soluspan
Betamethasone Sodium Phosphate and Betamethasone
Acetate
Cortastat
Dexamethasone Sodium Phosphate
Dalalone
Dexamethasone Sodium Phosphate
Dalalone DP
Dexamethasone Acetate
Dalalone LA
Dexamethasone Acetate
Decadron
Dexamethasone
Decadron LA
Dexamethasone Acetate
Decadron Phosphate
Dexamethasone Sodium Phosphate
Decadron w/Xylocaine
Dexamethasone Sodium Phosphate with Lidocaine HCL
Decaject
Dexamethasone Sodium Phosphate
Decaject LA
Dexamethasone Sodium Phosphate
Dexamethasone
Dexamethasone
Dexamethasone Acetate
Dexamethasone Acetate
Dexamethasone Intensol
Dexamethasone
Dexamethasone Sodium Phosphate
Dexamethasone Sodium Phosphate
Dexamethasone Sodium Phosphate with Lidocaine
Dexamethasone Sodium Phosphate with Lidocaine
Dexamethasone Sodium Phosphate with Lidocaine HCL Dexamethasone Sodium Phosphate with Lidocaine HCL
Dexasone
Dexamethasone Sodium Phosphate
Dexasone LA
Dexamethasone Acetate
Dexone
Dexamethasone
Dexone LA
Dexamethasone Acetate
Hexadrol
Dexamethasone
Hexadrol Phosphate
Dexamethasone Sodium Phosphate
Solurex
Dexamethasone Sodium Phosphate
Solurex LA
Dexamethasone Acetate
PC v2014A
247
Appendix C
General Glossary of Terms
AMA (Against Medical Advice) When a patient checks himself out of a hospital against the advice of his doctor.
accuracy (of data) The extent to which data are free of identifiable errors.
acute hemorrhagic stroke A non-traumatic intracerebral hemorrhage, subarachnoid hemorrhage or hemorrhagic
infarction.
acute ischemic stroke A measurable neurological deficit of sudden onset, presumed secondary to focal cerebral
ischemia, and not otherwise attributable to intracerebral hemorrhage (ICH) or another disease process.
Cerebrovascular disorder caused by deprivation of blood flow to an area of the brain, generally as a result of
thrombosis, embolism, or reduced blood pressure.
acute myocardial infarction (AMI) Death of heart muscle resulting from insufficient blood supply to the heart.
administrative/billing data (data source) Administrative data are patient-identifiable data used for
administrative, regulatory, and payment (financial) purposes. Administrative data that generally reflect the content of
discharge abstracts (for example, demographic information on patients such as age, sex, zip code; information
about the episode of care such as admission source, length of stay, charges, discharge status; and ICD-9-CM
diagnostic and procedure codes). Namely, the Uniform Hospital Discharge Data Set and the Uniform Bill of the
Health Care Financing Administration (UB-04) provides specifications for the abstraction of administrative/billing
data.
Agency for Healthcare Research and Quality (AHRQ) The Agency for Healthcare Research and Quality
(AHRQ) is the health services research arm of the U.S. Department of Health and Human Services (HHS),
complementing the biomedical research mission of its sister agency, the National Institutes of Health. AHRQ is a
home to research centers that specialize in major areas of health care research such as quality improvement and
patient safety, outcomes and effectiveness of care, clinical practice and technology assessment, and health care
organization and delivery systems.
aftercare (see next level of care) Inpatient or outpatient care that the patient will receive after discharge from the
hospital.
aggregate (hospital data) Aggregate data elements derived for a specific hospital from the results of each
measure's algorithm over a given time period (e.g., monthly, quarterly). These data are transmitted to The Joint
Commission by ORYX® Vendors.
aggregate risk-adjusted data elements Aggregate data elements derived from episode of care (EOC) records
that result from the application of risk adjustment models by ORYX® Vendors for transmission to The Joint
Commission.
algorithm An ordered sequence of data element retrieval and aggregation through which numerator and
denominator events or continuous variable values are identified by a measure. The algorithms are depicted using
flowcharting symbols.
allowable value A list of acceptable responses for a data element.
angioplasty Reconstruction of blood vessels damaged by disease or injury.
ANSI X12 The American National Standards Institute’s standard for transmitting data electronically, or electronic
data interchange (EDI).
PC v2014A
248
antenatal steroids Steroids given before birth.
antithrombotic therapy Pharmacologic agents (oral or parenteral) preventing or interfering with the formation of a
thrombus or blood coagulation.
atherosclerosis Common disorder characterized by yellowish plaques of cholesterol, other lipids, and cellular
debris in the inner layers of the walls of arteries.
atrial fibrillation Cardiac arrhythmia characterized by disorganized electrical activity in the atria accompanied by
an irregular ventricular response that is usually rapid. The atria quiver instead of pumping in an organized fashion,
resulting in compromised ventricular filling and reduced stroke volume. Stasis of left atrial flow increases the risk of
stroke.
atrial flutter Type of atrial tachycardia characterized by contraction rates between 230/min and 380/min.
binary outcome Events or conditions that occur in one or two possible states often labeled 0 or 1. Such data are
frequently encountered in medical research. Common examples include dead or alive, and improved or not
improved.
calculation model A description of the steps or statistical calculations (computations) used to derive the
numerator and denominator or continuous variable values required for a measure. Measure Information Forms in
this manual will include either an algorithm or calculation model.
cardiac module A set of evidence-based process measures designed to prevent cardiac complications in
surgical patients.
caregiver The patient’s family or any other person who will be responsible for care of the patient after discharge.
central tendency A property of the distribution of a variable, usually measured by statistics such as the mean,
median, and mode.
cesarean section Surgical delivery of a fetus through incision in the abdominal wall and the uterine wall. Does not
include removal of the fetus from the abdominal cavity in case of rupture of the uterus or abdominal pregnancy.
children’s asthma care (CAC) Asthma is defined as a lung disorder marked by breathing difficulty, wheezing, or
coughing. For purposes of this measure set, the population is defined as children equal or greater than 2 through 17
years of age.
clinical measures Measures designed to evaluate the processes or outcomes of care associated with the delivery
of clinical services; allow for intra- and interorganizational comparisons to be used to continuously improve patient
health outcomes; may focus on the appropriateness of clinical decision making and implementation of these
decisions; must be condition specific, procedure specific, or address important functions of patient care (e.g.,
medication use, infection control, patient assessment, etc.).
comparison group The group of health care organizations to which an individual health care organization is
compared. (ORYX® Vendors transmit aggregated comparison group data for non-core measures. The Joint
Commission will aggregate health care organization-level data to create the comparison group for each core
measure.)
confounding factors Intervening variables that distort the true relationship between/among the variables of
interest. They are related to the outcome of interest, but extraneous to the study question and are non-randomly
distributed among the groups being compared. They can hide a true correlation or give the appearance of a
correlation when none actually exists.
continuous variable An aggregate data measure in which the value of each measurement can fall anywhere along
a continuous scale (e.g., the time [in minutes] from hospital arrival to administration of thrombolysis).
PC v2014A
249
continuous variable data elements Those data elements required to construct the measure as stated in the
section labeled “Continuous Variable Statement.”
contraindication A factor or condition that may render the administration of a drug or agent or the performance of
a procedure or other practice inadvisable, improper, and/or undesirable.
controllers Controllers are long term control medications for asthma. Controllers reduce airway inflammation and
prevent asthma exacerbations. Inhaled corticosteroids are the preferred medications for controlling mild, moderate,
and severe persistent asthma. Refer to Appendix C, Table 6.1 for a listing of controller medications.
corticosteroids Any of the hormones produced by the adrenal cortex or their synthetic equivalents, used to achieve
quick relief of asthma exacerbations or long term control of the swelling, inflammation and mucus production that
occurs when the airway are irritated. Corticosteroids are available in inhaled, topical, oral, and intravenous forms.
critical access hospital (CAH) A facility that meets the following criteria may be designated by CMS as a CAH:
Is located in a State that has established with CMS a Medicare rural hospital flexibility program; and
Has been designated by the State as a CAH; and
Is currently participating in Medicare as a rural public, non-profit or for-profit hospital; or was a participating
hospital that ceased operation during the 10-year period from November 29, 1989 to November 29, 1999; or
is a health clinic or health center that was downsized from a hospital; and
Is located in a rural area or is treated as rural; and Is located more than a 35-mile drive from any other hospital
or CAH (in mountainous terrain or in areas with only secondary roads available, the mileage criterion is 15
miles); and
Maintains no more than 25 inpatient beds; and
Maintains an annual average length of stay of 96 hours per patient for acute inpatient care; and
Complies with all CAH Conditions of Participation, including the requirements to make available 24-hour
emergency care services 7 days per week.
A CAH may also be granted “swing-bed” approval to provide post-hospital Skilled Nursing Facility-level care
in its inpatient beds. In the case of hospice care, a hospice may contract with a CAH to provide the Medicare
hospice hospital benefit. Reimbursement from Medicare is made to the hospice. The CAH may dedicate
beds to the hospice, but the beds must be counted toward the 25-bed maximum. However, the hospice
patient is not included in the calculation of the 96-hour annual average length of stay. The hospice patient can
be admitted to the CAH for any care involved in their treatment plan or for respite care. The CAH negotiates
reimbursement through an agreement with the hospice. In addition to the 25 inpatient CAH beds, a CAH may
also operate a psychiatric and/or a rehabilitation distinct part unit of up to 10 beds each. These units must
comply with the Hospital Conditions of Participation.
data collection The act or process of capturing raw or primary data from a single or number of sources. Also
called “data gathering.”
data collection effort The availability and accessibility of the required data elements, the relative effort required,
and associated cost of abstracting or collecting the data.
data element A discrete piece of data, such as patient birthdate or principal diagnosis. See also denominator
data elements, numerator data elements, continuous variable data elements, and risk adjustment data
elements.
data entry The process by which data are transcribed or transferred into an electronic format.
data quality The accuracy and completeness of measure data on performance in the context of the analytic
purposes for which they will be used.
data transmission The process by which data are electronically sent from one organization to another. For
example, a hospital sending patient-level data to their selected ORYX® Vendor, and the vendor sending measurelevel data to The Joint Commission or patient-level data to the QIO Clinical Warehouse.
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denominator The lower part of a fraction used to calculate a rate, proportion, or ratio. Also the population for a rate
based measure.
denominator data elements Those data elements required to construct the denominator.
depilatories Chemical-based lotions or creams used to dissolve hair at the skin’s surface.
disaster medical assistance team (DMAT) Provides emergency medical assistance following a catastrophic
disaster or other major emergency.
discrete variable See rate-based measure.
elective carotid endarterectomy Surgical procedure performed by choice, involving excision of atheromatous
segments of the endothelium and tunica media of the carotid artery, leaving a smooth tissue lining and facilitating
blood flow through the vessel; surgery done to prevent stroke.
elective carotid intervention Surgery (i.e., carotid endarterectomy) and other procedures (e.g., carotid
angioplasty, stenting) involving the carotid artery, performed due to the patient’s choice.
elective delivery Delivery of a newborn(s) when the mother was not in active labor or presented with spontaneous
ruptured membranes prior to medical induction and/or cesarean section.
electronic data interchange (EDI) An instance of data being sent electronically between parties, normally
according to predefined industry standards.
electrocardiogram (ECG) A graphic tracing of the heart’s electrical impulses.
elopement When a patient wanders away, walks away, runs away, escapes, or otherwise leaves the hospital
unsupervised, unnoticed, and/or prior to their scheduled discharge.
empiric antibiotic therapy Antibiotic treatment based on the clinician’s judgment and the patients signs and
symptoms and offered before a diagnosis has been confirmed.
episode of care (EOC) A patient or case-level record submitted to the database.
excluded populations Detailed information describing the populations that should not be included in the indicator.
For example, specific age groups, ICD-9-CM procedure or diagnostic codes, or certain time periods could be
excluded from the general population drawn upon by the indicator.
extranet A private network using the Internet protocol to securely share business information or operations with
vendors, customers, and/or other businesses. “The Joint Commission Connect TM” is the name given to the Joint
Commission’s extranet site.
event An occurrence of physical restraint or seclusion. Events that occur during the patient's stay do not define new
episodes of care.
fibrinolytic therapy Administration of a pharmacological agent intended to cause lysis of a thrombus (destruction
or dissolution of a blood clot). Refer to Appendix C, Table 1.5 for a listing of fibrinolytic agents.
format Specifies the character length of a specific data element; the type of information the data element contains:
numeric, decimal, number, date, time, character, or alphanumeric; and the frequency with which the data element
occurs.
general data elements Those data elements that have wide application and are collected for every patient that is
included in any measure population.
global Global is an umbrella term for all measure sets that share the same Initial Patient Population definition.
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health care-associated infection A localized or systemic condition resulting from an adverse reaction to the
presence of an infectious agent(s) or its toxin(s). There must be no evidence that the infection was present or
incubating at the time of admission to the care setting.
health care organization (HCO) The business entity which is participating in an ORYX Vendor (e.g., health care
organization level data describes information about the business entity).
health care organization (HCO) level data Aggregation of patient level data to summarize the performance of an
individual health care organization on a performance measure. This data is transmitted to The Joint Commission by
the hospital’s ORYX Vendor.
heart failure (HF) A clinical syndrome characterized by signs and symptoms resulting from disturbances in cardiac
output or from increased venous pressure, including fatigue, shortness of breath, or leg swelling. For purposes of
this measure, heart failure is identified by ICD-9-CM codes in Appendix A, Table 2.1.
hospital According to the American Hospital Association, hospitals are licensed institutions with at least six beds
whose primary function is to provide diagnostic and therapeutic patient services for medical conditions by an
organized physician staff, and have continuous nursing services under the supervision of registered nurses.
hospital-based inpatient psychiatric services (HBIPS) The Hospital-Based Inpatient Psychiatric Services
(HBIPS) is a national quality partnership of organizations focused on improving quality and performance in
impatient psychiatric settings through performance measurement utilizing 5 process measures in 3 separate
domains (assessment, patient safety, continuity/transition of care).
Hospital Inpatient Quality Reporting Program The Hospital Inpatient Quality Reporting Program, formerly known
as Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) program, initiative is intended to
empower consumers with quality of care information to make more informed decisions about their health care,
while encouraging hospitals and clinicians to improve the quality of inpatient care provided to all patients. The
hospital quality of care information gathered through the Hospital Inpatient Quality Reporting Program initiative is
available to consumers on the Hospital Compare website.
hospitalist A physician whose main practice provides care for hospitalized patients.
ICD-9-CM codes A two-part classification system in current use for coding patient medical information used in
abstracting systems and for classifying patients into diagnosis-related groups (DRGs). The first part is a
comprehensive list of diseases with corresponding codes compatible with the World Health Organization’s list of
disease codes. The second part contains procedure codes independent of the disease codes.
initial patient populations Detailed information describing the population(s) that the indicator intends to measure.
Details could include such information as specific age groups, diagnoses, ICD-9-CM diagnostic and procedure
codes, CPT codes, revenue codes, enrollment periods, insurance and health plan groups, etc.
infection module A set of evidence-based process measures designed to prevent postoperative infection in the
surgical patient.
inpatient mortality Any patient death occurring while admitted as an in-patient in the hospital.
inpatient prospective payment system (IPPS) rule A prospective payment system (PPS) under Medicare for
hospital acute inpatient services. Hospitals contract with Medicare to furnish acute inpatient care and are
reimbursed through pre-determined payment on a per discharge or per case basis for Medicare beneficiaries with
inpatient stays.
inpatient psychiatric services Inpatient psychiatric services include care provided to a patient for a mental
disorder while hospitalized in a psychiatric unit of an acute care hospital or a free-standing psychiatric hospital.
Services rendered to outpatients or “day treatment” patients are not considered inpatient psychiatric services.
intermittent pneumatic compression device Device that uses sequential and/or intermittent compression to
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counteract blood flow stasis by increasing peak flow velocity. As a result, less blood is allowed to pool in veins thus
decreasing chances for thrombus formation. In addition compression has an anticlotting effect by increasing
fibrolytic activity which in turn stimulates the release of plasminogen activator. These two physiological effects, in
combination with the mechanical movement of fluid in a proximal direction make the sequential devices effective in
preventing and treating VTE.
intracerebral hemorrhage (ICH) Non-traumatic abrupt onset of headache or altered level of consciousness
and/or focal neurological deficit that is associated with a focal collection of blood within the brain parenchyma on
CT scan and is not due to trauma or hemorrhagic conversion of a cerebral infarction.
invalid data Values for data elements that are required for calculating and/or risk adjusting a core measure that fall
outside of the acceptable range of values defined for that data element. Refer to the Missing and Invalid Data
section for further information.
IV thrombolytic therapy Intravenous administration of a thrombolytic agent, such as tissue plasminogen activator
(TPA), to dissolve an arterial clot.
“The Joint Commission Connect” The name given to the Joint Commission’s extranet site, a secured online
connection to The Joint Commission.
leave day An authorized or unauthorized absence from a facility, excluding discharges, during which the patient is
absent from the facility at the time of the daily census and is not under the direct supervision of facility staff while
absent.
low-density lipoprotein (LDL) Plasma protein provided by the liver, carrying relatively more cholesterol and
triglycerides than protein. The high cholesterol content may account for its greater atherogenic potential. Also known
as “bad cholesterol”.
mean A measure of central tendency for a continuous variable measure. The mean is the sum of the values divided
by the number of observations.
measure data elements Data elements used by one specific measure or several measures in two or more
measure sets, such as Clinical Trial.
measure information form Tool to provide specific clinical and technical information on a measure. The
information contained includes: measure set, performance measure name, description, rationale, type of measure,
improvement noted as, numerator/ denominator/continuous variable statements, included populations, excluded
populations, data elements, risk adjustment, data collection approach, data accuracy, measure analysis
suggestions, sampling, data reported as, and selected references.
measure of performance See performance measure.
measure-specific data elements Data elements used by one specific measure or several measures in one
specific measure set, such as Infection Prior to Anesthesia in the SCIP measures.
measurement system See performance measurement system.
median The value in a group of ranked observations that divides the data into two equal parts.
medical record (data source) Data obtained from the records or documentation maintained on a patient in any
health care setting (for example, hospital, home care, long term care, practitioner office). Includes automated and
paper medical record systems.
military time A 24 –hour period from midnight to midnight using a 4-digit number of which the first two digits
indicate the hour and the last two digits indicate the minute.
missing data No values present for one or more data elements that are required for calculating and/or risk
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adjusting a national quality measure. Refer to the Missing and Invalid Data section for further information.
mode The most frequently occurring response for that data element.
module A set of measures under a common group/topic area (e.g., infection module).
multiple antipsychotic medications Antipsychotic medications are drugs prescribed to treat certain mental
disorders; if two or more of these medications are routinely administered or prescribed this is considered multiple
antipsychotic medications.
national quality measure A standardized performance measure that meets the Centers for Medicare & Medicaid
Services and Joint Commission evaluation criteria, has precisely defined specifications, can be uniformly
embedded in extant systems, has standardized data collection protocols to permit uniform implementation by health
care organizations and permit comparisons of health care organization performance over time through the
establishment of a national comparative data base.
national quality measure set A unique grouping of performance measures carefully selected to provide, when
viewed together, a robust picture of the care provided in a given area (e.g., cardiovascular care, pregnancy).
neonatal intensive care unit (NICU) A hospital unit organized with personnel and equipment to provide
continuous life support and comprehensive care for extremely high-risk newborn infants and those with complex and
critical illness.
newborn A very young child from birth to one year who has not yet begun to walk or talk.
next level of care (see aftercare) Inpatient or outpatient care that the patient will receive after discharge from the
hospital.
non-core measure A performance measure defined by the ORYX Vendor that has undergone review against Joint
Commission established measure criteria and has been accepted for use in the ORYX initiative.
numerator The upper portion of a fraction used to calculate a rate, proportion, or ratio.
numerator data elements Those data elements necessary or required to construct the numerator.
observed rate The observed rate is the measure rate that is based on a hospital’s aggregated data for the
reporting period. This is calculated as the number of measure numerator cases for the reporting period divided by
the number of denominator cases. Observed rates are used to measure hospital performances.
oral antibiotics For the purposes of the SCIP measure set, refers to two different combinations of antibiotics by
the PO route, which can be given by mouth, NG tube, or PEG tube. Those combinations are either Neomycin and
Erythromycin or Neomycin and Flagyl (also called Metronidazole). These combinations are for use in prophylaxis
specifically for colon surgery patients.
ORYX® vendor An entity consisting of an automated database(s), that facilitates performance improvement in
health care organizations through the collection and dissemination of process and/or outcome measures of
performance. ORYX Vendors must be able to generate internal comparisons of organization performance over
time, and external comparisons of performance among participating organizations at comparable times.
outpatient prospective payment system (OPPS) Rule A prospective payment system (PPS) under Medicare for
hospital outpatient services, certain Part B services furnished to hospital inpatients that have no Part A coverage,
and partial hospitalization services furnished by community mental health centers. All services paid under the PPS
are classified into groups called Ambulatory Payment Classifications or APCs. A payment rate is established for
each APC. Depending on the services provided, hospitals may be paid for more than one APC for an encounter.
parenteral Not through the alimentary canal but rather by injection through some other route, as subcutaneous,
intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc.
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parity The state of having given birth to an infant or infants, weighing 500gm or more, alive or dead.
paroxysmal Occurring as sudden or periodic attacks or recurrences of symptoms of a disease; exacerbation.
patient level data Collection of data elements that depict the health care services provided to an individual
(patient). Patient level data are aggregated to generate hospital level data and comparison group data.
patient survey (data source) Survey data are exclusively obtained from patients and/or their family
members/significant others.
percentile A value on a scale of 100 that indicates the percentage of a distribution that is equal to or below it.
performance measure A quantitative tool (for example, rate, ratio, index, percentage) that provides an indication
of an organization’s performance in relation to a specified process or outcome. Refer to process measure and the
outcome measure in Appendix D.
performance measurement system’s extranet track (PET) An electronic information and message center
available to ORYX Vendors. Access to the Internet and a browser are necessary to connect to PET. Access to PET
is available by clicking on the “Joint Commission Connect ™” button on the Joint Commission’s home page
(www.jointcommission.org).
perinatal care (PC) The care and management of the fetus and newborn infant in the perinatal period before,
during, and after delivery.
physical restraint A physical restraint is any manual method or physical or mechanical device, material, or
equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body or head freely
when it is used as a restriction to manage a patient’s behavior or restrict the patient’s freedom of movement and is
not a standard treatment for the patient’s medical or psychiatric condition.
pneumonia (PN) Pneumonia is defined as an acute infection of the pulmonary parenchyma that is associated with
at least some symptoms of acute infection, accompanied by presence of acute infiltrate on chest radiograph or
auscultatory findings consistent with pneumonia (such as altered breath sounds and/or localized rales).
post discharge continuing care plan Communication from the hospital to the next level of care provider after a
patient is discharged from the hospital. The plan must contain the reason for hospitalization, main diagnosis at
discharge, a list of medications at discharge, and recommendations for the next level of care.
predicted value The statistically expected response or outcome for a patient after the risk adjustment model has
been applied and the patient’s unique set of risk factors have been taken into account.
P.R.N. Abbreviation for pro re nata, Latin term for "as needed".
prophylactic antibiotic An antibiotic used to prevent, rather than treat or cure, disease. For the purposes of SCIPInf-1-3, antibiotics given to prevent postoperative infection will be collected. Because the overuse of antibiotics can
lead to resistance, antibiotics taken to prevent infection should be used only for a short time.
process An interrelated series of events, activities, actions, mechanisms, or steps that transform inputs into
outputs.
process measure A measure which focuses on a process which leads to a certain outcome, meaning that a
scientific basis exists for believing that the process, when executed well, will increase the probability of achieving a
desired outcome.
proportion measure A measure which shows the number of occurrences over the entire group within which the
occurrence should take place (e.g., patients delivered by cesarean section over all deliveries).
protected (personal) health information (PHI) A subset of health information, including demographics, that
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identifies the individual or for which there is a reasonable basis to believe that it can be used to identify the
individual.
randomization A technique for selecting or assigning cases such that each case has an equal probability of being
selected or assigned. It is done to stimulate chance distribution, reduce the effects of confounding factors, and
produce unbiased statistical data.
range A measure of the spread of a data set. The difference between the smallest and largest observation.
rate Derived by dividing the numerator (e.g., cases that meet the criterion for good or poor care) by the
denominator (e.g., all cases to which the criterion applies) within a given time frame. In other words, the numerator
is a subset of the denominator.
rate based (measure) An aggregate data measure in which the value of each measurement is expressed as a
proportion or as a ratio. In a proportion, the numerator is expressed as a subset of the denominator (for example,
patients with cesarean section, divided by all patient who deliver). In a ratio, the numerator and denominator
measure different phenomena (for example, the number of patients with central lines who develop infections divided
by the number of central line days).
ratio A relationship between two counted sets of data, which may have a value of zero or greater. In a ratio, the
numerator is not necessarily a subset of the denominator (e.g., pints of blood transfused to number of patients
discharged).
reliability The ability of the indicator to accurately and consistently identify the events it was designed to identify
across multiple health care settings.
relievers Relievers are used to quickly alleviate bronchoconstriction. Relievers relax the bands of muscle that
surround the airways. Relievers are also known as rescue, quick relief, or short-acting medications of choice to
quickly relieve asthma exacerbations. Relievers include short acting beta2 agonists and anticholinergics. Refer to
Appendix C, Table 6.2 for a listing of reliever medications.
reporting period The defined time period which describes the patient’s end-of-service.
reperfusion Reestablishing blood flow in an obstructed coronary artery. It may be accomplished with thrombolytic
therapy or percutaneous coronary intervention.
risk adjusted measures Measures that are risk adjusted using statistical modeling or stratification methods.
risk adjusted rate A rate that takes into account differences in case mix to allow for more valid comparisons
between groups.
risk adjustment A statistical process for reducing, removing, or clarifying the influences of confounding factors that
differ among comparison groups (for example, logistic regression, stratification).
risk adjustment data elements Those data elements used to risk adjust a performance measure (e.g., reduce,
remove, or clarify the influences of confounding patient factors that differ among comparison groups). Such data
elements may be used exclusively for risk adjustment (e.g., not required to construct the numerator or denominator)
or may be required for numerator or denominator construction as well as risk adjustment.
risk adjustment model The statistical algorithm that specifies the numerical values and the sequence of
calculations used to risk adjust (e.g., reduce or remove the influence of confounding factors) performance
measures.
risk factor A factor that produces or influences a result. In statistics, an independent variable used to identify
membership of qualitatively different groups. Refer to Appendix B for risk factor definitions.
risk factor value A specific value assigned to a risk factor for a given episode of care (EOC) record.
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risk model The statistical algorithm that specifies the numerical values and the sequence of calculations used to
risk adjust (e.g., reduce or remove the influence of confounding factors) performance measures.
routinely scheduled medications Medications prescribed to be taken regularly after discharge from the hospital.
sampling frequency If a hospital chooses to sample, they may sample data on either a monthly or quarterly basis.
Refer to the “Sample Size Requirements” discussion in the Population and Sampling Specifications section for
further information.
sampling method Describes the process used to select a sample. Possible approaches to sampling include
simple random sampling, cluster sampling, systematic sampling and judgment sampling.
sample size The number of individuals or particular patients included in a study. Usually chosen so that the study
has a particular statistical power of detecting an effect of a particular size. For measure set specific "Sample Size
Requirements" refer to Measure Information section.
score A rating, usually expressed as a number, and based on the degree to which certain qualities or attributes are
present (e.g., Glascow coma, ASA scores).
seclusion Seclusion is the involuntary confinement of a patient alone in a room or an area where the patient is
physically prevented from leaving.
severity The degree of biomedical risk, or mortality of medical treatment.
simple random sample A process in which a sample of data is selected from the total population in such a way
that every case has the same chance of being selected and that the sample size is met. Refer to the “Sampling
Approaches” discussion in the Population and Sampling Specifications section for further information.
standard deviation A measure of variability that indicates the dispersion, spread, or variation in a distribution.
statin A class of pharmaceutical agents that modify LDL-cholesterol by blocking the action of an enzyme in the liver
which is needed to synthesize cholesterol, thereby decreasing the level of cholesterol circulating in the blood; HMGCoA reductase inhibitors.
stent Rod or threadlike device for supporting tubular structures during surgical anastamosis or for holding arteries
open during percutaneous angioplasty.
strata See stratified measure.
stratification A form of risk adjustment which involves classifying data into subgroups based on one or more
characteristics, variables, or other categories.
stratification based approach for risk adjustment The process of dividing or classifying subgroups known as
strata in order to facilitate more valid comparisons. For example, a measure’s outcome may be divided into type of
surgery-specific categories or strata.
stratified measure A performance measure that is classified into a number of subgroups to assist in analysis and
interpretation. The overall or un-stratified measure evaluates all subgroups together. The stratified measure
consists of a subset of the overall measure. For example, surgical patients who received a prophylactic antibiotic
within one hour prior to surgical incision can be reported as all surgical patients who received the prophylactic
antibiotic within one hour prior to surgical incision; however, the stratified measure(s) for SCIP-Inf-1 could be
reported by specific allowable values for the data element Infection Procedure of Interest, such as 1 – CABG (SCIPInf-1b) or 2 – Other Cardiac Surgery (SCIP-Inf-1c).
stratum See stratified measure.
stroke (STK) See definitions for acute ischemic stroke and acute hemorrhagic stroke.
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subarachnoid hemorrhage (SAH) Non-traumatic abrupt onset of headache or altered level of consciousness that
is associated with blood in the subarachnoid space on CT or a clinical history and exam consistent with SAH
(sudden onset of severe headache or altered level of consciousness) with xanthochromia and many red blood cells
in the cerebrospinal fluid.
sub-population A population that is part of a larger population. For example, the measure set Perinatal Care
evaluates the obstetrical population in the hospital. This measure set is broken into two distinct sub-populations,
mothers (PC-01, PC-02 and PC-03) and newborns (PC-04 and PC-05).
subset measure(s) A subset measure contains overlapping sets of patients. For example, the patients in the TOB2a measure are a subset of those in the TOB-2 measure, i.e., the two measures have overlapping populations. This
is distinctly different from measures that contain mutually exclusive sets of patients such as seen in the pneumonia
measure set. For PN-6, the ICU patients are entirely separate from the non-ICU patients.
surgical care improvement project (SCIP) The Surgical Care Improvement Project (SCIP) is a national quality
partnership of organizations focused on improving surgical care by significantly reducing surgical complications
through performance measurement. Utilizing ten process measures in three separate modules (infection, cardiac,
and VTE), the goal is to reduce the incidence of surgical complications nationally by 25 percent by the year 2010.
surgical infection prevention (SIP) In August of 2002, the Centers for Medicare & Medicaid Services and the
Centers for Disease Control and Prevention collaborated to develop the Surgical Infection Prevention project. The
Medicare Surgical Infection Prevention Project was started with the single objective - to decrease morbidity and
mortality associated with postoperative infection in the Medicare patient population. As of July 2006 discharges,
the three SIP measures become the first three SCIP infection measures.
systematic random sampling A process in which the starting case is selected randomly, and the next cases are
selected according to a fixed interval that is based upon the number of cases in the population. For example, the
starting case is the second patient that arrives at the hospital. This patient and every subsequent fifth patient
becomes part of the random sample until the sample size is reached. Refer to the “Sampling Approaches”
discussion in the Population and Sampling Specifications section for further information.
systemic corticosteroids Corticosteroids are hormones produced by the adrenal cortex or their synthetic
equivalents and are administered orally or intravenous. Corticosteroids are used to achieve quick relief of acute or
moderate to severe asthma exacerbations. Oral corticosteroids are also used for long term control of the swelling,
inflammation and mucus production in the airways. Refer to Appendix C, Table 2.15 for a listing of PN systemic
corticosteroid medications or Table 6.3 for a listing of CAC systemic corticosteroid medications.
thrombolytic therapy See fibrinolytic therapy
time last known well Time at which the patient was last known to be without the signs and symptoms of the current
stroke or at his or her prior baseline. Variation may exist if the signs and symptoms are not witnessed.
time-out The restriction of a patient for any period of time to a designated area from which the patient is not
physically prevented from leaving and for the purpose of providing the patient an opportunity to regain self-control.
tissue plasminogen activator (TPA) Clot-dissolving substance produced naturally by cells in the walls of blood
vessels, and also manufactured synthetically. TPA activates plasminogen to dissolve clots and is used
therapeutically to open occluded arteries.
transmission schedule The schedule of dates on which data are expected to be transmitted to The Joint
Commission and the QIO Clinical Warehouse.
unable to be determined (UTD) Each data element that is applicable per the algorithm for each of the measures
within a topic must be “touched” by the abstractor. While there is an expectation that all data elements are collected,
it is recognized that in certain situations information may not be available (i.e., dates, times, codes, etc.). If, after
due diligence, the abstractor determines that a value is not documented or is not able to determine the answer
value, the abstractor must select “Unable to Determine (UTD)” as the answer.
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vaccine A vaccine is a suspension of an attenuated (weakened) or killed microorganism, such as bacteria or virus,
administered for the prevention, amelioration, or treatment of infectious diseases.
validation The process by which the integrity and correctness of data are established. Validation processes can
occur immediately after a data item is collected or after a complete set of data are collected. The Centers for
Medicare & Medicaid Services (CMS) chart level validation will validate the data at several levels. There are
consistency and internal edit checks to assure the integrity of the submitted data; there are external edit checks to
verify expectations about the volume of the data received, and, there will be chart level audits to assure the reliability
of the submitted data. Information on these procedures is available on www.qualitynet.org.
validity Ability to identify opportunities for improvement in the quality of care; demonstration that the indicator use
results in improvements in outcomes and/or quality of care.
variance Equal to the square of the standard deviation.
venous thromboembolism (VTE) A term that includes deep vein thrombosis and/or pulmonary embolism.
verification The process used to ensure consistent implementation of core measure algorithms specified in this
manual across disparate ORYX Vendors .
Selected Sources:
Babbie, ER, The Practice of Social Research, 2nd edition, Belmont, CA: Wadsworth Publishing Company, 1979.
Everitt, BS, The Cambridge Dictionary of Statistics, Cambridge University Press, 1998.
Iezonni, LI, Foley, SM, Heeran, T, Daley, J, Duncan, CC, Fisher, ES, Hughes, J, “A Method for Screening the Quality
of Hospital Care Using Administrative Data: Preliminary Validation Results,” Quality Review Bulletin, November,
1992, 361 370.
Lexikon Second Edition, Oakbrook Terrace, IL: Joint Commission on Accreditation of Healthcare Organizations,
1998.
McHorney, CA, Kosinski, M, and Ware, Jr., JE, “Comparisons of the Cost and Quality of Norms for the SF 36
Health Survey Collected by Mail Versus Telephone Interview: Results From a National Survey,” Medical Care, 32,
(1994), 551 567.
Nichols, T and Earl, L, Basic ICD-9-CM Coding Handbook, Chicago, IL: American Health Information Management
Association, 1992.
ORYX® Technical Implementation Guide, Oakbrook Terrace, IL: Joint Commission on Accreditation of
Healthcare Organizations, current.
2006 Accreditation Manual(s), Oakbrook Terrace, IL: Joint Commission on Accreditation of Healthcare
Organizations, 2005.
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Appendix D
Overview of Measure Information Form and
Flowchart Formats for collected measures
Measure Information Form Introduction
Measure Set
The specific national hospital quality measure set to which an individual measure belongs (e.g., acute myocardial
infarction, pneumonia).
Set Measure ID #
A unique alpha-numeric identifier assigned to a measure. Information associated with a measure is identified by
this unique alpha-numeric number.
Performance Measure Name
A brief title that uniquely identifies the measure.
Description
A brief explanation of the measure’s focus, such as the activity or the area on which the measure centers attention
(e.g., pain management for terminally ill patients)
Rationale
The reason for performing a specified process to improve the quality of care outcomes. This may include specific
literature references, evidence based information, expert consensus, etc.
Type of Measure
Indicates whether the measure is used to examine a process or an outcome over time.
Process: A measure used to assess a goal directed, interrelated series of actions, events, mechanisms, or
steps, such as measure of performance that describes what is done to, for, or by patients, as in performance
of a procedure.
Outcome: A measure that indicates the result of performance (or non-performance) of a function(s) or
process(es).
Improvement Noted As
Describes how improvement would be indicated by the measure.
An increase in the rate/score/number of occurrences (for example, immunizations)
A decrease in the rate/score/number of occurrences (for example, surgical site infections)
Either an increase or a decrease in the rate/score/number of occurrences, depending upon the context of the
measure (for example, utilization)
Numerator Statement
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Represents the portion of the denominator population that satisfies the conditions of the performance measure to
be an indicator event.
Note: If the measure is reported as a rate (proportion or ratio), the Numerator and Denominator Statement are
completed. If a performance measure does not have both a numerator and a denominator, then a Continuous
Variable Statement is completed.
Included Population in Numerator Specific information describing the population(s) comprising the numerator,
not contained in the numerator statement, or not applicable
Excluded Population in Numerator Specific information describing the population(s) that should not be included
in the numerator, or none
Data Elements Those data elements necessary or required to determine (or establish) the numerator.
Denominator Statement
Represents the population evaluated by the performance measure.
Note: If measure is reported as a rate (proportion or ratio), the Numerator and Denominator Statement are
completed. If a performance measure does not have both a numerator and a denominator, then a Continuous
Variable Statement is completed.
Included Population in Denominator Specific information describing the population(s) comprising the
denominator, not contained in the denominator statement or not applicable
Excluded Population in Denominator Specific information describing the population(s) that should not be
included in the denominator, or none
Data Elements Those data elements required to determine (or establish) the denominator
Continuous Variable Statement
Describes an aggregate data measure in which the value of each measurement can fall anywhere along a
continuous scale.
Note: If measure is reported as a central tendency, Continuous Variable Statement is completed. This item is only
completed when the performance measure does not have numerator and denominator statements.
Included Population in Continuous Variable Specific information describing the population(s) comprising the
performance measure, not contained in the continuous variable statement or not applicable
Excluded Population in Continuous Variable Specific information describing the population(s) that should not
be included in the performance measure or none
Date Elements Those data elements required to determine (or establish) the measure for a continuous variable
Risk Adjustment
Indicates whether a measure is subject to the statistical process for reducing, removing, or clarifying the influences
of confounding factors to allow more useful comparisons.
Data Collection Approach
Recommended timing for when data should be collected for a measure. Data collection approaches include
retrospective, concurrent or prospective data collection. Retrospective data collection involves collecting data for
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events that have already occurred. Concurrent data collection is the process of gathering data on how a process
works or is working while a patient is in active treatment. Prospective data collection is data collection in
anticipation of an event or occurrence.
Data Accuracy
Recommendations to reduce identifiable data errors, to the extent possible.
Measure Analysis Suggestions
Recommendations to assist in the process of interpreting data and drawing valid conclusions.
Sampling
Indicates whether or not a measure can be sampled. Sampling is a process of selecting a representative part of a
population in order to estimate the organization’s performance, without collecting data for the entire population.
Data Reported As
Indicates how data will be reported for a measure.
Aggregate rate generated from count data reported as a proportion (for example, rate-based measures
which report summary data generated from the number of Cesarean sections as a proportion of deliveries)
Aggregate rate generated from count data reported as a ratio (e.g., bloodstream infection per 1,000 line
days).
Aggregate measures of central tendency (e.g., continuous variables which report means and medians such
as length of stay).
Calculation Model
A description of the steps or statistical calculations (computations) used to derive the numerator and denominator
or continuous variable values required for a measure. Measure Information Forms in this manual will include either
an algorithm or calculation model.
Selected References
Specific literature references that are used to support the importance of the performance measure.
Algorithm Introduction
Each measure’s initial patient population and the measure is described by a unique algorithm. An algorithm is a
predefined set of rules that help to break down complex processes into simple, repetitive steps.
Measure algorithms serve two purposes. First, they evaluate and identify which episode of care (EOC) records
contain missing and/or invalid data that will prohibit the ability to properly evaluate the measure. Second, they
determine if:
For rate-based measures, the patient’s EOC record belongs in the measure population of interest described
by the denominator, and if the patient experienced the event described in the numerator.
For continuous variable measures, the patient’s EOC record belongs in the patient population described in
the measure’s statement and, if so, to define and calculate the measurement value.
This section contains some standard flow-charting conventions used to develop each algorithm:
Flow lines are used to guide the reader to different parts of the algorithm, with arrows denoting the direction
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of movement. Generally, movement is from the top to the bottom of the chart.
Symbols used in each algorithm flow charts are described later in this section under Flow Chart Symbols.
Temporary variables within the algorithm are noted in the variable key at the top of each page.
Flowchart Symbols
Symbol
Explanation
Start/Stop denotes the beginning or end of an algorithm
Diamonds represent "If...Then" decision points for logic tests and comparisons. Two or
three flow lines exit the decision point to reflect alternative actions based upon an
evaluation of the condition(s) stated around the decision point.
Rectangles or process boxes show when computation or manipulation of the data are
required, such as a calculation or summarization.
Circle or "On-page: connectors, labeled with a letter, show a link to sections of the
algorithm which are continued on the same page.
Five-sided or "Off-page" connectors, labeled with a letter, show a link to sections of the
algorithm which are continued on different pages. Note: Both circular, On-page, fivesided, and Off-page Connectors containing the letters B, D, E, U, X, or Y lead to measure
Outcome Boxes.
Outcome Boxes represent the result of data passed through the algorithm. Connectors
extending from outcome boxes lead to the end of the algorithm, or to risk adjustment
procedures, where applicable. This symbol is also used to identify the strata within a
stratified measure.
Symbol to represent comments that should be taken into account when programming
flowchart.
This symbol is placed along side the Process box to which they are applicable. Comments
are used to expand upon information contained within the process box, such as how to
properly calculate age. Comments are never the sole location where processing logic is
provided.
Start/Return denotes the beginning and ending of a sub-routine. Algorithms that use this
symbol are called from another algorithm and the data processing flow returns to the
calling algorithm when the ‘Return’ is encountered. See the Initial Patient Population
Algorithms and Transmission Data Processing Flows for an example of the usage of this
symbol.
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Appendix E - Miscellaneous Tables
Table 2.6 Qualifiers and Modifiers Table
Note: These guideleines apply only to those data elements that refer to them in their Guidelines for Abstraction
Exclusion list(s)
Qualifiers
Modifiers
Qualifiers are words used as adjectives to indicate some Quantitative modifiers are adjectives that quantitatively
uncertainty about whether or not a condition really exists. describe a condition
The following qualifiers should be abstracted as negativeThe following quantitative modifiers should be abstracted
findings, unless otherwise specified - Consider this list as negative findings, unless otherwise specified Consider this list all-inclusive:
all-inclusive:
Borderline
Insignificant
Scant
Slight
Sub-clinical
Subtle
Trace
Trivial
And/or (+/-; e.g., "ST abnormalities consistent with
ischemia and/or injury"), except when comparing
only inclusions (e.g., "ST segment elevation and/or
STEMI")
Cannot exclude
Cannot rule out
Could be
Could have been
May be
May have
May have had
May indicate
Or, except when comparing only inclusions
Possible
Questionable (?)
Risk of
Rule out (r'd/o, r/o'd)
Suggestive of
Suspect
Suspicious
Vs., except when comparing only inclusions
Example: If the in-hospital echocardiogram report
documents "questionable LVSD", this should be
abstracted as a negative finding.
Table 2.7 Allowable Measure Set Combinations
Principal Procedure or Principal/Other Diagnosis
PC1
HBIPS1
Newborns - 0 to <=2 days
Mother - 8 to <65 years
>= 1 year
P/O Dx
Psychicatric Care
Setting = "y"
AMI
>= 18 years
P Dx
Yes for mothers age 18 or
greater
>= 18
HF
>= 18 years
P Dx
Yes for mothers age 18 or
greater
>= 18
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PN
>= 18 years
P Dx
Yes for mothers age 18 or
greater
>= 18
STK
>= 18 years
P Dx
Yes for mothers age 18 or
greater
>= 18
CAC1
2 to < 18 years
P Dx
Yes for mothers under age
18
2 to < 18
VTE-No
VTE
>= 18 years
P/O Dx
Yes for mothers age 18 or
greater
>= 18
VTE-ODX
VTE
>= 18 years
O Dx
Yes for mothers age 18 or
greater
>= 18
VTE-PDX
VTE
>= 18 years
P Dx
Yes for mothers age 18 or
greater
>= 18
PC1
Newborns: 0 to <=2
days Mother: 8 to <65
years
P/O Dx
N/A
Yes for Mothers
SCIP
No age limitation
P/O Px
Yes
>= 1
HBIPS1
>=1 year
Psychiatric Care
Setting = "Y"
Yes for mothers
N/A
ED
No age limitation
Lenght of Stay < 120
days
Yes
>= 1
IMM
>= 6 Mo old
Lenght of Stay < 120
days
Yes for Mothers
Patients age 1 year and
older
SUB
>= 18 years
Lenght of Stay < 120
days
Mothers age 18 years and
older
Patients age 18 years
and older
TOB
>= 18 years
Lenght of Stay < 120
days
Mothers age 18 years and
older
Patients age 18 years
and older
Can Combine
Cannot combine2
1 These measure sets are Joint Commission Only. The measure set combinations containing these sets are only applicable for the
transmission of data to The Joint Commission. The Measure Set combination for aligned measures is maintained in the NHQM
Specifications Manual.
2 "Cannot Combine" is a placeholder at this time, as the populations for the HBIPS and PC measure sets can currently be combined with
all other measure sets.
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Appendix F
Resources
The following are available resources to those using the Specifications Manual for National Quality Core Measures.
Healthcare Organizations
If you are a Joint Commission accredited healthcare organization with questions about National Quality Core
Measures, ORYX; requirements, etc., please contact Accreditation and Certification Operations at contact
Accreditation and Certification Operations at http://manual.jointcommission.org/
ORYX® Vendors
If you are an ORYX Vendor with questions about Joint Commission National Quality Core Measures, please contact
the Division of Quality Measurement and Research at http://manual.jointcommission.org/
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Appendix P
Preview Section
The preview section is intended to provide an overview of future updates. The information provided in this section is
not to be programmed or submitted. Placement in this appendix does not assume that the information listed will be
implemented in a future manual.
ICD-10 Code Tables
Please refer to the ICD-9 to ICD-10 crosswalks that correspond to the ICD-10 code tables in this appendix.
The Joint Commission invites public comment on the ICD-10 codes. Comments and questions can be submitted to
[email protected] through September 30, 2013.
ICD-10-CM Version of Code Tables
Table 10.01 Mental Disorders
Short Description
ICD-10-CM Code
F01.50
Vascular dementia without behavioral disturbance
F01.51
Vascular dementia with behavioral disturbance
F02.80
Dementia in oth diseases classd elswhr w/o behavrl disturb
F02.81
Dementia in oth diseases classd elswhr w behavioral disturb
F03.90
Unspecified dementia without behavioral disturbance
F03.91
Unspecified dementia with behavioral disturbance
F04
Amnestic disorder due to known physiological condition
F05
Delirium due to known physiological condition
F06.0
Psychotic disorder w hallucin due to known physiol condition
F06.1
Catatonic disorder due to known physiological condition
F06.2
Psychotic disorder w delusions due to known physiol cond
F06.30
Mood disorder due to known physiological condition, unsp
F06.31
Mood disorder due to known physiol cond w depressv features
F06.32
Mood disord d/t physiol cond w major depressive-like epsd
F06.33
Mood disorder due to known physiol cond w manic features
F06.34
ood disorder due to known physiol cond w mixed features
F06.4
Anxiety disorder due to known physiological condition
F06.8
Oth mental disorders due to known physiological condition
F07.0
Personality change due to known physiological condition
F07.81
Postconcussional syndrome
F07.89
Oth personality & behavrl disord due to known physiol cond
F07.9
Unsp personality & behavrl disord due to known physiol cond
F09
Unsp mental disorder due to known physiological condition
F10.920
Alcohol use, unspecified with intoxication, uncomplicated
F10.921
Alcohol use, unspecified with intoxication delirium
F10.929
Alcohol use, unspecified with intoxication, unspecified
F10.94
Alcohol use, unspecified with alcohol-induced mood disorder
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F10.950
F10.951
F10.959
F10.96
F10.97
F10.980
F10.981
F10.982
F10.988
F10.99
F11.920
F11.921
F11.922
F11.929
F11.93
F11.94
F11.950
F11.951
F11.959
F11.981
F11.982
F11.988
F11.99
F12.920
F12.921
F12.922
F12.929
F12.950
F12.951
F12.959
F12.980
F12.988
F12.99
F13.920
F13.921
F13.929
F13.930
F13.931
Alcohol use, unsp w alcoh-induce psych disorder w delusions
Alcohol use, unsp w alcoh-induce psych disorder w hallucin
Alcohol use, unsp w alcohol-induced psychotic disorder, unsp
Alcohol use, unsp w alcoh-induce persist amnestic disorder
Alcohol use, unsp with alcohol-induced persisting dementia
Alcohol use, unsp with alcohol-induced anxiety disorder
Alcohol use, unsp with alcohol-induced sexual dysfunction
Alcohol use, unspecified with alcohol-induced sleep disorder
Alcohol use, unspecified with other alcohol-induced disorder
Alcohol use, unsp with unspecified alcohol-induced disorder
Opioid use, unspecified with intoxication, uncomplicated
Opioid use, unspecified with intoxication delirium
Opioid use, unsp w intoxication with perceptual disturbance
Opioid use, unspecified with intoxication, unspecified
Opioid use, unspecified with withdrawal
Opioid use, unspecified with opioid-induced mood disorder
Opioid use, unsp w opioid-induc psych disorder w delusions
Opioid use, unsp w opioid-induc psych disorder w hallucin
Opioid use, unsp w opioid-induced psychotic disorder, unsp
Opioid use, unsp with opioid-induced sexual dysfunction
Opioid use, unspecified with opioid-induced sleep disorder
Opioid use, unspecified with other opioid-induced disorder
Opioid use, unsp with unspecified opioid-induced disorder
Cannabis use, unspecified with intoxication, uncomplicated
Cannabis use, unspecified with intoxication delirium
Cannabis use, unsp w intoxication w perceptual disturbance
Cannabis use, unspecified with intoxication, unspecified
Cannabis use, unsp with psychotic disorder with delusions
Cannabis use, unsp w psychotic disorder with hallucinations
Cannabis use, unsp with psychotic disorder, unspecified
Cannabis use, unspecified with anxiety disorder
Cannabis use, unsp with other cannabis-induced disorder
Cannabis use, unsp with unspecified cannabis-induced disorder
Sedatv/hyp/anxiolytc use, unsp w intoxication, uncomplicated
Sedatv/hyp/anxiolytc use, unsp w intoxication delirium
Sedatv/hyp/anxiolytc use, unsp w intoxication, unsp
Sedatv/hyp/anxiolytc use, unsp w withdrawal, uncomplicated
Sedatv/hyp/anxiolytc use, unsp w withdrawal delirium
F13.932
F13.939
F13.94
F13.950
F13.951
F13.959
F13.96
F13.97
F13.980
F13.981
F13.982
F13.988
F13.99
F14.920
Sedatv/hyp/anxiolytc use, unsp w w/drawal w perceptl disturb
Sedatv/hyp/anxiolytc use, unsp w withdrawal, unsp
Sedative, hypnotic or anxiolytic use, unsp w mood disorder
Sedatv/hyp/anxiolytc use, unsp w psychotic disorder
Sedatv/hyp/anxiolytc use, unsp w psych disorder w hallucin
Sedatv/hyp/anxiolytc use, unsp w psychotic disorder, unsp
Sedatv/hyp/anxiolytc use, unsp w persist amnestic disorder
Sedatv/hyp/anxiolytc use, unsp w persisting dementia
Sedatv/hyp/anxiolytc use, unsp w anxiety disorder
Sedatv/hyp/anxiolytc use, unsp w sexual dysfunction
Sedative, hypnotic or anxiolytic use, unsp w sleep disorder
Sedative, hypnotic or anxiolytic use, unsp w oth disorder
Sedative, hypnotic or anxiolytic use, unsp w unsp disorder
Cocaine use, unspecified with intoxication, uncomplicated
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F14.921
F14.922
F14.929
F14.94
F14.950
F14.951
F14.959
F14.980
F14.981
F14.982
F14.988
F14.99
F15.121
F15.122
F15.129
F15.14
F15.150
F15.151
F15.159
F15.180
F15.181
F15.182
F15.188
F15.19
F15.220
F15.920
F15.921
F15.922
F15.929
F15.93
F15.94
Cocaine use, unspecified with intoxication delirium
Cocaine use, unsp w intoxication with perceptual disturbance
Cocaine use, unspecified with intoxication, unspecified
Cocaine use, unspecified with cocaine-induced mood disorder
Cocaine use, unsp w cocaine-induc psych disorder w delusions
Cocaine use, unsp w cocaine-induc psych disorder w hallucin
Cocaine use, unsp w cocaine-induced psychotic disorder, unsp
Cocaine use, unsp with cocaine-induced anxiety disorder
Cocaine use, unsp with cocaine-induced sexual dysfunction
Cocaine use, unspecified with cocaine-induced sleep disorder
Cocaine use, unspecified with other cocaine-induced disorder
Cocaine use, unsp with unspecified cocaine-induced disorder
Other stimulant abuse with intoxication delirium
Oth stimulant abuse w intoxication w perceptual disturbance
Other stimulant abuse with intoxication, unspecified
Other stimulant abuse with stimulant-induced mood disorder
Oth stimulant abuse w stim-induce psych disorder w delusions
Oth stimulant abuse w stim-induce psych disorder w hallucin
Oth stimulant abuse w stim-induce psychotic disorder, unsp
Oth stimulant abuse with stimulant-induced anxiety disorder
Oth stimulant abuse w stimulant-induced sexual dysfunction
Other stimulant abuse with stimulant-induced sleep disorder
Other stimulant abuse with other stimulant-induced disorder
Other stimulant abuse with unspecified stimulant-induced disorder
Other stimulant dependence with intoxication, uncomplicated
Other stimulant use, unsp with intoxication, uncomplicated
Other stimulant use, unspecified with intoxication delirium
Oth stimulant use, unsp w intox w perceptual disturbance
Other stimulant use, unsp with intoxication, unspecified
Other stimulant use, unspecified with withdrawal
Oth stimulant use, unsp with stimulant-induced mood disorder
F15.950
F15.951
F15.959
F15.980
F15.981
F15.982
F15.988
F15.99
F16.920
F16.921
F16.929
F16.94
F16.950
F16.951
F16.959
F16.980
F16.983
F16.988
F16.99
F18.920
F18.921
Oth stim use, unsp w stim-induce psych disorder w delusions
Oth stim use, unsp w stim-induce psych disorder w delusions
Oth stimulant use, unsp w stim-induce psych disorder, unsp
Oth stimulant use, unsp w stimulant-induced anxiety disorder
Oth stimulant use, unsp w stim-induce sexual dysfunction
Oth stimulant use, unsp w stimulant-induced sleep disorder
Oth stimulant use, unsp with oth stimulant-induced disorder
Oth stimulant use, unsp with unsp stimulant-induced disorder
Hallucinogen use, unsp with intoxication, uncomplicated
Hallucinogen use, unsp with intoxication with delirium
Hallucinogen use, unspecified with intoxication, unspecified
Hallucinogen use, unsp w hallucinogen-induced mood disorder
Hallucinogen use, unsp w psychotic disorder w delusions
Hallucinogen use, unsp w psychotic disorder w hallucinations
Hallucinogen use, unsp w psychotic disorder, unsp
Hallucinogen use, unsp w anxiety disorder
Hallucign use, unsp w hallucign persist perception disorder
Hallucinogen use, unsp w oth hallucinogen-induced disorder
Hallucinogen use, unsp w unsp hallucinogen-induced disorder
Inhalant use, unspecified with intoxication, uncomplicated
Inhalant use, unspecified with intoxication with delirium
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F18.929
F18.94
F18.950
F18.951
F18.959
F18.97
F18.980
F18.988
F18.99
F19.920
F19.921
F19.922
F19.929
F19.930
F19.931
F19.932
F19.939
F19.94
F19.950
F19.951
F19.959
F19.96
F19.97
F19.980
Inhalant use, unspecified with intoxication, unspecified
Inhalant use, unsp with inhalant-induced mood disorder
Inhalant use, unsp w inhalnt-induce psych disord w delusions
Inhalant use, unsp w inhalnt-induce psych disord w hallucin
Inhalant use, unsp w inhalnt-induce psychotic disorder, unsp
Inhalant use, unsp with inhalant-induced persisting dementia
Inhalant use, unsp with inhalant-induced anxiety disorder
Inhalant use, unsp with other inhalant-induced disorder
Inhalant use, unsp with unsp inhalant-induced disorder
Oth psychoactive substance use, unsp w intoxication, uncomp
Oth psychoactive substance use, unsp w intox w delirium
Oth psychoactv sub use, unsp w intox w perceptl disturb
Oth psychoactive substance use, unsp with intoxication, unsp
Oth psychoactive substance use, unsp w withdrawal, uncomp
Oth psychoactive substance use, unsp w withdrawal delirium
Oth psychoactv sub use, unsp w w/drawal w perceptl disturb
Other psychoactive substance use, unsp with withdrawal, unsp
Oth psychoactive substance use, unsp w mood disorder
Oth psychoactv sub use, unsp w psych disorder w delusions
Oth psychoactv sub use, unsp w psych disorder w hallucin
Oth psychoactv substance use, unsp w psych disorder, unsp
Oth psychoactv sub use, unsp w persist amnestic disorder
Oth psychoactive substance use, unsp w persisting dementia
Oth psychoactive substance use, unsp w anxiety disorder
F19.981
F19.982
F19.988
F19.99
F20.0
F20.1
F20.2
F20.3
F20.5
F20.81
F20.89
F20.9
F21
F22
F23
F24
F25.0
F25.1
F25.8
F25.9
F28
F29
F30.10
F30.11
F30.12
F30.13
F30.2
F30.3
Oth psychoactive substance use, unsp w sexual dysfunction
Oth psychoactive substance use, unsp w sleep disorder
Oth psychoactive substance use, unsp w oth disorder
Oth psychoactive substance use, unsp w unsp disorder
Paranoid schizophrenia
Disorganized schizophrenia
Catatonic schizophrenia
Undifferentiated schizophrenia
Residual schizophrenia
Schizophreniform disorder
Other schizophrenia
Schizophrenia, unspecified
Schizotypal disorder
Delusional disorders
Brief psychotic disorder
Shared psychotic disorder
Schizoaffective disorder, bipolar type
Schizoaffective disorder, depressive type
Other schizoaffective disorders
Schizoaffective disorder, unspecified
Oth psych disorder not due to a sub or known physiol cond
Unsp psychosis not due to a substance or known physiol cond
Manic episode without psychotic symptoms, unspecified
Manic episode without psychotic symptoms, mild
Manic episode without psychotic symptoms, moderate
Manic episode, severe, without psychotic symptoms
Manic episode, severe with psychotic symptoms
Manic episode in partial remission
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F30.4
F30.8
F30.9
F31.0
F31.10
F31.11
F31.12
F31.13
F31.2
F31.30
F31.31
F31.32
F31.4
F31.5
F31.60
F31.61
F31.62
Manic episode in full remission
Other manic episodes
Manic episode, unspecified
Bipolar disorder, current episode hypomanic
Bipolar disorder, current episode manic without psychotic features, unspecified
Bipolar disord, crnt episode manic w/o psych features, mild
Bipolar disord, crnt episode manic w/o psych features, mod
Bipolar disord, crnt epsd manic w/o psych features, severe
Bipolar disord, crnt episode manic severe w psych features
Bipolar disord, crnt epsd depress, mild or mod severt, unsp
Bipolar disorder, current episode depressed, mild
Bipolar disorder, current episode depressed, moderate
Bipolar disord, crnt epsd depress, sev, w/o psych features
Bipolar disord, crnt epsd depress, severe, w psych features
Bipolar disorder, current episode mixed, unspecified
Bipolar disorder, current episode mixed, mild
Bipolar disorder, current episode mixed, moderate
F31.63
F31.64
F31.70
F31.71
F31.72
F31.73
F31.74
F31.75
F31.76
F31.77
F31.78
F31.81
F31.89
F31.9
F32.0
F32.1
F32.2
F32.3
F32.4
F32.5
F32.8
F32.9
F33.0
F33.1
F33.2
F33.3
F33.40
F33.41
F33.42
F33.8
F33.9
F34.0
F34.1
F34.8
F34.9
Bipolar disord, crnt epsd mixed, severe, w/o psych features
Bipolar disord, crnt episode mixed, severe, w psych features
Bipolar disord, currently in remis, most recent episode unsp
Bipolar disord, in partial remis, most recent epsd hypomanic
Bipolar disord, in full remis, most recent episode hypomanic
Bipolar disord, in partial remis, most recent episode manic
Bipolar disorder, in full remis, most recent episode manic
Bipolar disord, in partial remis, most recent epsd depress
Bipolar disorder, in full remis, most recent episode depress
Bipolar disord, in partial remis, most recent episode mixed
Bipolar disorder, in full remis, most recent episode mixed
Bipolar II disorder
Other bipolar disorder
Bipolar disorder, unspecified
Major depressive disorder, single episode, mild
Major depressive disorder, single episode, moderate
Major depressv disord, single epsd, sev w/o psych features
Major depressv disord, single epsd, severe w psych features
Major depressv disorder, single episode, in partial remis
Major depressive disorder, single episode, in full remission
Other depressive episodes
Major depressive disorder, single episode, unspecified
Major depressive disorder, recurrent, mild
Major depressive disorder, recurrent, moderate
Major depressv disorder, recurrent severe w/o psych features
Major depressv disorder, recurrent, severe w psych symptoms
Major depressive disorder, recurrent, in remission, unsp
Major depressive disorder, recurrent, in partial remission
Major depressive disorder, recurrent, in full remission
Other recurrent depressive disorders
Major depressive disorder, recurrent, unspecified
Cyclothymic disorder
Dysthymic disorder
Other persistent mood [affective] disorders
Persistent mood [affective] disorder, unspecified
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F39
F40.00
F40.01
F40.02
F40.10
F40.11
F40.210
F40.218
F40.220
F40.228
Unspecified mood [affective] disorder
Agoraphobia, unspecified
Agoraphobia with panic disorder
Agoraphobia without panic disorder
Social phobia, unspecified
Social phobia, generalized
Arachnophobia
Other animal type phobia
Fear of thunderstorms
Other natural environment type phobia
F40.230
F40.231
F40.232
F40.233
F40.240
F40.241
F40.242
F40.243
F40.248
F40.290
F40.291
F40.298
F40.8
F40.9
F41.0
F41.1
F41.3
F41.8
F41.9
F42
F43.0
F43.10
F43.11
F43.12
F43.20
F43.21
F43.22
F43.23
F43.24
F43.25
F43.29
F43.8
F43.9
F44.0
F44.1
F44.2
F44.4
F44.5
F44.6
F44.7
F44.81
F44.89
Fear of blood
Fear of injections and transfusions
Fear of other medical care
Fear of injury
Claustrophobia
Acrophobia
Fear of bridges
Fear of flying
Other situational type phobia
Androphobia
Gynephobia
Other specified phobia
Other phobic anxiety disorders
Phobic anxiety disorder, unspecified
Panic disorder [episodic paroxysmal anxiety] without agoraphobia
Generalized anxiety disorder
Other mixed anxiety disorders
Other specified anxiety disorders
Anxiety disorder, unspecified
Obsessive-compulsive disorder
Acute stress reaction
Post-traumatic stress disorder, unspecified
Post-traumatic stress disorder, acute
Post-traumatic stress disorder, chronic
Adjustment disorder, unspecified
Adjustment disorder with depressed mood
Adjustment disorder with anxiety
Adjustment disorder with mixed anxiety and depressed mood
Adjustment disorder with disturbance of conduct
Adjustment disorder with mixed disturbance of emotions and conduct
Adjustment disorder with other symptoms
Other reactions to severe stress
Reaction to severe stress, unspecified
Dissociative amnesia
Dissociative fugue
Dissociative stupor
Conversion disorder with motor symptom or deficit
Conversion disorder with seizures or convulsions
Conversion disorder with sensory symptom or deficit
Conversion disorder with mixed symptom presentation
Dissociative identity disorder
Other dissociative and conversion disorders
PC v2014A
272
F44.9
F45.0
F45.1
Dissociative and conversion disorder, unspecified
Somatization disorder
Undifferentiated somatoform disorder
F45.20
F45.21
F45.22
F45.29
F45.41
F45.42
F45.8
F45.9
F48.1
F48.2
F48.8
F48.9
F50.00
F50.01
F50.02
F50.2
F50.8
F50.9
F51.01
F51.02
F51.03
F51.09
F51.11
F51.12
F51.3
F51.4
F51.5
F51.8
F51.9
F52.0
F52.1
F52.21
F52.22
Hypochondriacal disorder, unspecified
Hypochondriasis
Body dysmorphic disorder
Other hypochondriacal disorders
Pain disorder exclusively related to psychological factors
Pain disorder with related psychological factors
Other somatoform disorders
Somatoform disorder, unspecified
Depersonalization-derealization syndrome
Pseudobulbar affect
Other specified nonpsychotic mental disorders
Nonpsychotic mental disorder, unspecified
Anorexia nervosa, unspecified
Anorexia nervosa, restricting type
Anorexia nervosa, binge eating/purging type
Bulimia nervosa
Other eating disorders
Eating disorder, unspecified
Primary insomnia
Adjustment insomnia
Paradoxical insomnia
Oth insomnia not due to a substance or known physiol cond
Primary hypersomnia
Insufficient sleep syndrome
Sleepwalking [somnambulism]
Sleep terrors [night terrors]
Nightmare disorder
Oth sleep disord not due to a sub or known physiol cond
Sleep disorder not due to a sub or known physiol cond, unsp
Hypoactive sexual desire disorder
Sexual aversion disorder
Male erectile disorder
Female sexual arousal disorder
F52.31
F52.32
F52.4
F52.5
F52.6
F52.8
F52.9
F53
F54
F59
F60.0
F60.1
F60.2
F60.3
F60.4
Female orgasmic disorder
Male orgasmic disorder
Premature ejaculation
Vaginismus not due to a substance or known physiol condition
Dyspareunia not due to a substance or known physiol cond
Oth sexual dysfnct not due to a sub or known physiol cond
Unsp sexual dysfnct not due to a sub or known physiol cond
Puerperal psychosis
Psych & behavrl factors assoc w disord or dis classd elswhr
Unsp behavrl synd assoc w physiol disturb and physcl factors
Paranoid personality disorder
Schizoid personality disorder
Antisocial personality disorder
Borderline personality disorder
Histrionic personality disorder
PC v2014A
273
F60.5
F60.6
F60.7
F60.81
F60.89
F60.9
F63.0
F63.1
F63.2
F63.3
F63.81
F63.89
F63.9
F64.1
F64.2
F64.8
F64.9
F65.0
F65.1
F65.2
F65.3
F65.4
F65.50
F65.51
F65.52
F65.81
F65.89
F65.9
F66
F68.10
Obsessive-compulsive personality disorder
Avoidant personality disorder
Dependent personality disorder
Narcissistic personality disorder
Other specific personality disorders
Personality disorder, unspecified
Pathological gambling
Pyromania
Kleptomania
Trichotillomania
Intermittent explosive disorder
Other impulse disorders
Impulse disorder, unspecified
Gender identity disorder in adolescence and adulthood
Gender identity disorder of childhood
Other gender identity disorders
Gender identity disorder, unspecified
Fetishism
Transvestic fetishism
Exhibitionism
Voyeurism
Pedophilia
Sadomasochism, unspecified
Sexual masochism
Sexual sadism
Frotteurism
Other paraphilias
Paraphilia, unspecified
Other sexual disorders
Factitious disorder, unspecified
F68.11
F68.12
F68.13
F68.8
F69
F70
F71
F72
F73
F78
F79
F80.0
F80.1
F80.2
F80.4
F80.81
F80.89
F80.9
F81.0
F81.2
F81.81
F81.89
Factitious disorder w predom psych signs and symptoms
Factitious disorder w predom physical signs and symptoms
Factitious disord w comb psych and physcl signs and symptoms
Other specified disorders of adult personality and behavior
Unspecified disorder of adult personality and behavior
Mild intellectual disabilities
Moderate intellectual disabilities
Severe intellectual disabilities
Profound intellectual disabilities
Other intellectual disabilities
Unspecified intellectual disabilities
Phonological disorder
Expressive language disorder
Mixed receptive-expressive language disorder
Speech and language development delay due to hearing loss
Childhood onset fluency disorder
Other developmental disorders of speech and language
Developmental disorder of speech and language, unspecified
Specific reading disorder
Mathematics disorder
Disorder of written expression
Other developmental disorders of scholastic skills
PC v2014A
274
F81.9
F82
F84.0
F84.3
F84.5
F84.8
F84.9
F88
F89
F90.0
F90.1
F90.2
F90.8
F90.9
F91.0
F91.1
F91.2
F91.3
F91.8
F91.9
Developmental disorder of scholastic skills, unspecified
Specific developmental disorder of motor function
Autistic disorder
Other childhood disintegrative disorder
Asperger's syndrome
Other pervasive developmental disorders
Pervasive developmental disorder, unspecified
Other disorders of psychological development
Unspecified disorder of psychological development
Attention-deficit hyperactivity disorder, predominantly inattentive type
Attention-deficit hyperactivity disorder, predominantly hyperactive type
Attention-deficit hyperactivity disorder, combined type
Attention-deficit hyperactivity disorder, other type
Attention-deficit hyperactivity disorder, unspecified type
Conduct disorder confined to family context
Conduct disorder, childhood-onset type
Conduct disorder, adolescent-onset type
Oppositional defiant disorder
Other conduct disorders
Conduct disorder, unspecified
F93.0
F93.8
F93.9
F94.0
F94.1
F94.2
F94.8
F94.9
F95.0
F95.1
F95.2
F95.8
F95.9
F98.0
F98.1
F98.21
F98.29
F98.3
F98.4
F98.5
F98.8
F98.9
F99
G44.209
H93.25
R37
R45.1
R45.2
R45.5
R45.6
R45.7
R4.581
Separation anxiety disorder of childhood
Other childhood emotional disorders
Childhood emotional disorder, unspecified
Selective mutism
Reactive attachment disorder of childhood
Disinhibited attachment disorder of childhood
Other childhood disorders of social functioning
Childhood disorder of social functioning, unspecified
Transient tic disorder
Chronic motor or vocal tic disorder
Tourette's disorder
Other tic disorders
Tic disorder, unspecified
Enuresis not due to a substance or known physiol condition
Encopresis not due to a substance or known physiol condition
Rumination disorder of infancy
Other feeding disorders of infancy and early childhood
Pica of infancy and childhood
Stereotyped movement disorders
Adult onset fluency disorder
Oth behav/emotn disord w onset usly occur in chldhd and adol
Unsp behav/emotn disord w onst usly occur in chldhd and adol
Mental disorder, not otherwise specified
Tension-type headache, unspecified, not intractable
Central auditory processing disorder
Sexual dysfunction, unspecified
Restlessness and agitation
Unhappiness
Hostility
Violent behavior
State of emotional shock and stress, unspecified
Low self-esteem
PC v2014A
275
R45.82
R48.0
Z87.890
Worries
Dyslexia and alexia
Personal history of sex reassignment
Table 11.01 Complication Mainly Related to Pregnancy
ICD-10-CM Code
Short Description
O09.41
Suprvsn of pregnancy w grand multiparity, first trimester
O09.42
Suprvsn of pregnancy w grand multiparity, second trimester
O09.43
Suprvsn of pregnancy w grand multiparity, third trimester
O09.511
Supervision of elderly primigravida, first trimester
O09.512
Supervision of elderly primigravida, second trimester
O09.513
Supervision of elderly primigravida, third trimester
O09.521
Supervision of elderly multigravida, first trimester
O09.522
Supervision of elderly multigravida, second trimester
O09.523
Supervision of elderly multigravida, third trimester
O10.011
Pre-existing hypertensive heart disease comp pregnancy
O10.012
Pre-existing hypertensive heart disease comp childbirth
O10.013
Pre-existing hypertensive heart disease comp the puerperium
O10.02
Pre-existing essential hypertension complicating childbirth
O10.111
Pre-exist hyp heart disease comp pregnancy, first trimester
O10.112
Pre-exist hyp heart disease comp pregnancy, second trimester
O10.113
Pre-exist hyp heart disease comp pregnancy, third trimester
O10.12
Pre-existing hypertensive heart disease comp childbirth
O10.211
Pre-exist hyp chronic kidney disease comp preg, first tri
O10.212
Pre-exist hyp chronic kidney disease comp preg, second tri
O10.213
Pre-exist hyp chronic kidney disease comp preg, third tri
O10.22
Pre-existing hyp chronic kidney disease comp childbirth
O10.311
Pre-exist hyp heart and chr kidney dis comp preg, first tri
O10.312
Pre-exist hyp heart and chr kidney dis comp preg, second tri
O10.313
Pre-exist hyp heart and chr kidney dis comp preg, third tri
O10.32
Pre-exist hyp heart and chronic kidney disease comp chldbrth
O10.411
Pre-existing secondary htn comp pregnancy, first trimester
O10.412
Pre-existing secondary htn comp pregnancy, second trimester
O10.413
Pre-existing secondary htn comp pregnancy, third trimester
O10.42
Pre-existing secondary hypertension complicating childbirth
O10.911
Unsp pre-existing htn comp pregnancy, first trimester
O10.912
Unsp pre-existing htn comp pregnancy, second trimester
O10.913
Unsp pre-existing htn comp pregnancy, third trimester
O10.92
Unsp pre-existing hypertension complicating childbirth
O11.1
Pre-existing hypertension w pre-eclampsia, first trimester
O11.2
Pre-existing hypertension w pre-eclampsia, second trimester
O11.3
Pre-existing hypertension w pre-eclampsia, third trimester
O12.01
Gestational edema, first trimester
O12.02
Gestational edema, second trimester
O12.03
Gestational edema, third trimester
O12.11
Gestational proteinuria, first trimester
O12.12
Gestational proteinuria, second trimester
O12.13
Gestational proteinuria, third trimester
O12.21
Gestational edema with proteinuria, first trimester
O12.22
Gestational edema with proteinuria, second trimester
O12.23
Gestational edema with proteinuria, third trimester
PC v2014A
276
O13.1
O13.2
O13.3
O14.02
O14.03
O14.12
O14.13
O14.22
O14.23
O14.92
O14.93
O15.02
O15.03
O15.1
O15.2
O16.1
O16.2
O16.3
O22.01
O22.02
O22.03
O22.11
O22.12
O22.13
O22.21
O22.22
O22.23
O22.31
O22.32
O22.33
O22.41
O22.42
O22.43
O22.51
O22.52
O22.53
O22.8X1
O22.8X2
O22.8X3
O22.91
O22.92
O22.93
O23.01
O23.02
O23.03
O23.11
O23.12
O23.13
O23.21
O23.22
O23.23
O23.31
O23.32
PC v2014A
Gestational htn w/o significant proteinuria, first trimester
Gestational htn w/o significant proteinuria, second trimester
Gestational htn w/o significant proteinuria, third trimester
Mild to moderate pre-eclampsia, second trimester
Mild to moderate pre-eclampsia, third trimester
Severe pre-eclampsia, second trimester
Severe pre-eclampsia, third trimester
HELLP syndrome (HELLP), second trimester
HELLP syndrome (HELLP), third trimester
Unspecified pre-eclampsia, second trimester
Unspecified pre-eclampsia, third trimester
Eclampsia in pregnancy, second trimester
Eclampsia in pregnancy, third trimester
Eclampsia in labor
Eclampsia in the puerperium
Unspecified maternal hypertension, first trimester
Unspecified maternal hypertension, second trimester
Unspecified maternal hypertension, third trimester
Varicose veins of lower extremity in pregnancy, first trimester
Varicose veins of lower extremity in pregnancy, second trimester
Varicose veins of lower extremity in pregnancy, third trimester
Genital varices in pregnancy, first trimester
Genital varices in pregnancy, second trimester
Genital varices in pregnancy, third trimester
Superficial thrombophlebitis in pregnancy, first trimester
Superficial thrombophlebitis in pregnancy, second trimester
Superficial thrombophlebitis in pregnancy, third trimester
Deep phlebothrombosis in pregnancy, first trimester
Deep phlebothrombosis in pregnancy, second trimester
Deep phlebothrombosis in pregnancy, third trimester
Hemorrhoids in pregnancy, first trimester
Hemorrhoids in pregnancy, second trimester
Hemorrhoids in pregnancy, third trimester
Cerebral venous thrombosis in pregnancy, first trimester
Cerebral venous thrombosis in pregnancy, second trimester
Cerebral venous thrombosis in pregnancy, third trimester
Other venous complications in pregnancy, first trimester
Other venous complications in pregnancy, second trimester
Other venous complications in pregnancy, third trimester
Venous complication in pregnancy, unsp, first trimester
Venous complication in pregnancy, unsp, second trimester
Venous complication in pregnancy, unsp, third trimester
Infections of kidney in pregnancy, first trimester
Infections of kidney in pregnancy, second trimester
Infections of kidney in pregnancy, third trimester
Infections of bladder in pregnancy, first trimester
Infections of bladder in pregnancy, second trimester
Infections of bladder in pregnancy, third trimester
Infections of urethra in pregnancy, first trimester
Infections of urethra in pregnancy, second trimester
Infections of urethra in pregnancy, third trimester
Infect of prt urinary tract in pregnancy, first trimester
Infect of prt urinary tract in pregnancy, second trimester
277
O23.33
O23.41
O23.42
O23.43
O23.511
O23.512
O23.513
O23.521
O23.522
O23.523
O23.591
O23.592
O23.593
O23.91
O23.92
O23.93
O24.011
O24.012
O24.013
O24.02
O24.111
O24.112
O24.113
O24.12
O24.311
O24.312
O24.313
O24.32
O24.410
O24.414
O24.419
O24.420
O24.424
O24.429
O24.811
O24.812
O24.813
O24.82
O24.911
O24.912
O24.913
O24.92
O24.93
O25.11
O25.12
O25.13
O25.2
O26.01
O26.02
O26.03
O26.11
O26.12
PC v2014A
Infect of prt urinary tract in pregnancy, third trimester
Unsp infct of urinary tract in pregnancy, first trimester
Unsp infct of urinary tract in pregnancy, second trimester
Unsp infct of urinary tract in pregnancy, third trimester
Infections of cervix in pregnancy, first trimester
Infections of cervix in pregnancy, second trimester
Infections of cervix in pregnancy, third trimester
Salpingo-oophoritis in pregnancy, first trimester
Salpingo-oophoritis in pregnancy, second trimester
Salpingo-oophoritis in pregnancy, third trimester
Infection oth prt genitl trct in pregnancy, first trimester
Infection oth prt genitl trct in pregnancy, second trimester
Infection oth prt genitl trct in pregnancy, third trimester
Unsp GU tract infection in pregnancy, first trimester
Unsp GU tract infection in pregnancy, second trimester
Unsp GU tract infection in pregnancy, third trimester
Pre-existing diabetes mellitus, type 1, in pregnancy, first trimester
Pre-existing diabetes mellitus, type 1, in pregnancy, second trimester
Pre-existing diabetes mellitus, type 1, in pregnancy, third trimester
Pre-existing diabetes mellitus, type 1, in childbirth
Pre-existing diabetes mellitus, type 2, in pregnancy, first trimester
Pre-existing diabetes mellitus, type 2, in pregnancy, second trimester
Pre-existing diabetes mellitus, type 2, in pregnancy, third trimester
Pre-existing diabetes mellitus, type 2, in childbirth
Unsp pre-existing diabetes in pregnancy, first trimester
Unsp pre-existing diabetes in pregnancy, second trimester
Unsp pre-existing diabetes in pregnancy, third trimester
Unspecified pre-existing diabetes mellitus in childbirth
Gestational diabetes mellitus in pregnancy, diet controlled
Gestational diabetes mellitus in pregnancy, insulin controlled
Gestational diabetes mellitus in pregnancy, unspecified control
Gestational diabetes mellitus in childbirth, diet controlled
Gestational diabetes mellitus in childbirth, insulin controlled
Gestational diabetes mellitus in childbirth, unsp control
Other pre-existing diabetes mellitus in pregnancy, first trimester
Other pre-existing diabetes mellitus in pregnancy, second trimester
Other pre-existing diabetes mellitus in pregnancy, third trimester
Other pre-existing diabetes mellitus in childbirth
Unspecified diabetes mellitus in pregnancy, first trimester
Unspecified diabetes mellitus in pregnancy, second trimester
Unspecified diabetes mellitus in pregnancy, third trimester
Unspecified diabetes mellitus in childbirth
Unspecified diabetes mellitus in the puerperium
Malnutrition in pregnancy, first trimester
Malnutrition in pregnancy, second trimester
Malnutrition in pregnancy, third trimester
Malnutrition in childbirth
Excessive weight gain in pregnancy, first trimester
Excessive weight gain in pregnancy, second trimester
Excessive weight gain in pregnancy, third trimester
Low weight gain in pregnancy, first trimester
Low weight gain in pregnancy, second trimester
278
O26.13
O26.21
O26.22
O26.23
O26.31
O26.32
O26.33
O26.41
O26.42
O26.43
O26.51
O26.52
O26.53
O26.611
O26.612
O26.613
O26.62
O26.711
O26.712
O26.713
O26.72
O26.811
O26.812
O26.813
O26.821
O26.822
O26.823
O26.831
O26.832
O26.833
O26.841
O26.842
O26.843
O26.851
O26.852
O26.853
O26.86
O26.891
O26.892
O26.893
O26.91
O26.92
O26.93
O29.011
O29.012
O29.013
O29.021
O29.022
O29.023
O29.091
O29.092
O29.093
PC v2014A
Low weight gain in pregnancy, third trimester
Preg care for patient w recurrent preg loss, first trimester
Preg care for patient w recur preg loss, second trimester
Preg care for patient w recurrent preg loss, third trimester
Retained uterin contracep dev in pregnancy, first trimester
Retained uterin contracep dev in pregnancy, second trimester
Retained uterin contracep dev in pregnancy, third trimester
Herpes gestationis, first trimester
Herpes gestationis, second trimester
Herpes gestationis, third trimester
Maternal hypotension syndrome, first trimester
Maternal hypotension syndrome, second trimester
Maternal hypotension syndrome, third trimester
Liver and biliary tract disord in pregnancy, first trimester
Liver and biliary tract disord in preg, second trimester
Liver and biliary tract disord in pregnancy, third trimester
Liver and biliary tract disorders in childbirth
Sublux of symphysis (pubis) in pregnancy, first trimester
Sublux of symphysis (pubis) in pregnancy, second trimester
Sublux of symphysis (pubis) in pregnancy, third trimester
Subluxation of symphysis (pubis) in childbirth
Pregnancy related exhaustion and fatigue, first trimester
Pregnancy related exhaustion and fatigue, second trimester
Pregnancy related exhaustion and fatigue, third trimester
Pregnancy related peripheral neuritis, first trimester
Pregnancy related peripheral neuritis, second trimester
Pregnancy related peripheral neuritis, third trimester
Pregnancy related renal disease, first trimester
Pregnancy related renal disease, second trimester
Pregnancy related renal disease, third trimester
Uterine size-date discrepancy, first trimester
Uterine size-date discrepancy, second trimester
Uterine size-date discrepancy, third trimester
Spotting complicating pregnancy, first trimester
Spotting complicating pregnancy, second trimester
Spotting complicating pregnancy, third trimester
Pruritic urticarial papules and plaques of pregnancy (PUPPP)
Oth specified pregnancy related conditions, first trimester
Oth specified pregnancy related conditions, second trimester
Oth specified pregnancy related conditions, third trimester
Pregnancy related conditions, unspecified, first trimester
Pregnancy related conditions, unspecified, second trimester
Pregnancy related conditions, unspecified, third trimester
Aspirat pneumonitis due to anesth during preg, first tri
Aspirat pneumonitis due to anesth during preg, second tri
Aspirat pneumonitis due to anesth during preg, third tri
Pressr collapse of lung due to anesth during preg, first tri
Pressr collapse of lung d/t anesth during preg, second tri
Pressr collapse of lung due to anesth during preg, third tri
Oth pulmonary comp of anesth during preg, first trimester
Oth pulmonary comp of anesth during preg, second trimester
Oth pulmonary comp of anesth during preg, third trimester
279
O29.111
O29.112
O29.113
O29.121
O29.122
O29.123
O29.191
O29.192
O29.193
O29.211
O29.212
O29.213
O29.291
O29.292
O29.293
O29.3X1
O29.3X2
O29.3X3
O29.41
O29.42
O29.43
O29.5X1
O29.5X2
O29.5X3
O29.61
O29.62
O29.63
O29.8X1
O29.8X2
O29.8X3
O29.91
O29.92
O29.93
O3.123X9
O3.22XX0
O3.22XX1
O3.22XX2
O3.22XX3
O3.22XX4
O3.22XX5
O30.001
O30.002
O30.003
O30.011
O30.012
O30.013
O30.031
O30.032
O30.033
O30.041
O30.042
O30.043
Cardiac arrest due to anesth during preg, first trimester
Cardiac arrest due to anesth during preg, second trimester
Cardiac arrest due to anesth during preg, third trimester
Cardiac failure due to anesth during preg, first trimester
Cardiac failure due to anesth during preg, second trimester
Cardiac failure due to anesth during preg, third trimester
Oth cardiac comp of anesth during pregnancy, first trimester
Oth cardiac comp of anesth during pregnancy, second trimester
Oth cardiac comp of anesth during pregnancy, third trimester
Cerebral anoxia due to anesth during preg, first trimester
Cerebral anoxia due to anesth during preg, second trimester
Cerebral anoxia due to anesth during preg, third trimester
Oth cnsl comp of anesth during pregnancy, first trimester
Oth cnsl comp of anesth during pregnancy, second trimester
Oth cnsl comp of anesth during pregnancy, third trimester
Toxic reaction to local anesth during preg, first trimester
Toxic reaction to local anesth during preg, second trimester
Toxic reaction to local anesth during preg, third trimester
Spinal and epidur anesth induce hdache dur preg, first tri
Spinal and epidur anesth induce hdache dur preg, second tri
Spinal and epidur anesth induce hdache dur preg, third tri
Oth comp of spinal and epidur anesth during preg, first tri
Oth comp of spinal and epidur anesth during preg, second tri
Oth comp of spinal and epidur anesth during preg, third tri
Fail or difficult intubation for anesth dur preg, first tri
Fail or difficult intubation for anesth dur preg, second tri
Fail or difficult intubation for anesth dur preg, third tri
Oth comp of anesthesia during pregnancy, first trimester
Oth comp of anesthesia during pregnancy, second trimester
Oth comp of anesthesia during pregnancy, third trimester
Unsp comp of anesthesia during pregnancy, first trimester
Unsp comp of anesthesia during pregnancy, second trimester
Unsp comp of anesthesia during pregnancy, third trimester
Continuing pregnancy after intrauterine death of one fetus or more, third trimester, other fetus
Maternal care for transverse and oblique lie, not applicable or unspecified
Maternal care for transverse and oblique lie, fetus 1
Maternal care for transverse and oblique lie, fetus 2
Maternal care for transverse and oblique lie, fetus 3
Maternal care for transverse and oblique lie, fetus 4
Maternal care for transverse and oblique lie, fetus 5
Twin preg, unsp num plcnta & amnio sacs, first trimester
Twin preg, unsp num plcnta & amnio sacs, second trimester
Twin preg, unsp num plcnta & amnio sacs, third trimester
Twin pregnancy, monochorionic/monoamniotic, first trimester
Twin pregnancy, monochorionic/monoamniotic, second trimester
Twin pregnancy, monochorionic/monoamniotic, third trimester
Twin pregnancy, monochorionic/diamniotic, first trimester
Twin pregnancy, monochorionic/diamniotic, second trimester
Twin pregnancy, monochorionic/diamniotic, third trimester
Twin pregnancy, dichorionic/diamniotic, first trimester
Twin pregnancy, dichorionic/diamniotic, second trimester
Twin pregnancy, dichorionic/diamniotic, third trimester
O30.091
Twin preg, unable to dtrm num plcnta & amnio sacs, first tri
PC v2014A
280
O30.092
O30.093
O30.101
O30.102
O30.103
O30.111
O30.112
O30.113
O30.121
O30.122
O30.123
O30.191
O30.192
O30.193
O30.201
O30.202
O30.203
O30.211
O30.212
O30.213
O30.221
O30.222
O30.223
O30.291
O30.292
O30.293
O30.801
O30.802
O30.803
O30.811
O30.812
O30.813
O30.821
O30.822
O30.823
O30.891
O30.892
O30.893
O30.91
O30.92
O30.93
O31.01X0
O31.01X1
O31.01X2
O31.01X3
O31.01X4
O31.01X5
O31.01X9
O31.02X0
O31.02X1
O31.02X2
O31.02X3
O31.02X4
PC v2014A
Twin preg, unable to dtrm num plcnta & amnio sacs, second tri
Twin preg, unable to dtrm num plcnta & amnio sacs, third tri
Triplet preg, unsp num plcnta & amnio sacs, first trimester
Triplet preg, unsp num plcnta & amnio sacs, second trimester
Triplet preg, unsp num plcnta & amnio sacs, third trimester
Triplet preg w two or more monochorionic fetuses, first tri
Triplet preg w two or more monochorionic fetuses, second tri
Triplet preg w two or more monochorionic fetuses, third tri
Triplet preg w two or more monoamnio fetuses, first tri
Triplet preg w two or more monoamnio fetuses, second tri
Triplet preg w two or more monoamnio fetuses, third tri
Trp preg, unable to dtrm num plcnta & amnio sacs, first tri
Trp preg, unable to dtrm num plcnta & amnio sacs, second tri
Trp preg, unable to dtrm num plcnta & amnio sacs, third tri
Quad preg, unsp num plcnta & amnio sacs, first trimester
Quad preg, unsp num plcnta & amnio sacs, second trimester
Quad preg, unsp num plcnta & amnio sacs, third trimester
Quad preg w two or more monochorionic fetuses, first tri
Quad preg w two or more monochorionic fetuses, second tri
Quad preg w two or more monochorionic fetuses, third tri
Quad preg w two or more monoamnio fetuses, first trimester
Quad preg w two or more monoamnio fetuses, second trimester
Quad preg w two or more monoamnio fetuses, third trimester
Quad preg, unable to dtrm num plcnta & amnio sacs, first tri
Quad preg, unable to dtrm num plcnta & amnio sacs, 2nd tri
Quad preg, unable to dtrm num plcnta & amnio sacs, third tri
Oth multiple gest, unsp num plcnta & amnio sacs, first tri
Oth multiple gest, unsp num plcnta & amnio sacs, second tri
Oth multiple gest, unsp num plcnta & amnio sacs, third tri
Oth mult gest w two or more monochorionic fetuses, first tri
Oth mult gest w two or more monochorionic fetuses, second tri
Oth mult gest w two or more monochorionic fetuses, third tri
Oth multiple gest w two or more monoamnio fetuses, first tri
Oth mult gest w two or more monoamnio fetuses, second tri
Oth multiple gest w two or more monoamnio fetuses, third tri
Oth mult gest, unab to dtrm num plcnta & amnio sacs, 1st tri
Oth mult gest, unab to dtrm num plcnta & amnio sacs, 2nd tri
Oth mult gest, unab to dtrm num plcnta & amnio sacs, 3rd tri
Multiple gestation, unspecified, first trimester
Multiple gestation, unspecified, second trimester
Multiple gestation, unspecified, third trimester
Papyraceous fetus, unsp trimester, not applicable or unsp
Papyraceous fetus, first trimester, fetus 1
Papyraceous fetus, first trimester, fetus 2
Papyraceous fetus, first trimester, fetus 3
Papyraceous fetus, first trimester, fetus 4
Papyraceous fetus, first trimester, fetus 5
Papyraceous fetus, first trimester, other fetus
Papyraceous fetus, second trimester, not applicable or unsp
Papyraceous fetus, second trimester, fetus 1
Papyraceous fetus, second trimester, fetus 2
Papyraceous fetus, second trimester, fetus 3
Papyraceous fetus, second trimester, fetus 4
281
O31.02X5
O31.02X9
O31.03X0
O31.03X1
O31.03X2
O31.03X3
O31.03X4
O31.03X5
O31.03X9
O31.10X0
O31.10X1
O31.10X2
O31.10X3
O31.10X4
O31.10X5
O31.10X9
O31.13X0
O31.13X1
O31.13X2
O31.13X3
O31.13X4
O31.13X5
O31.13X9
O31.20X0
O31.20X0
O31.20X1
O31.20X1
O31.20X2
O31.20X2
O31.20X3
O31.20X3
O31.20X4
O31.20X4
O31.20X5
O31.20X5
O31.20X9
O31.20X9
O31.22X0
O31.22X1
O31.22X2
O31.22X3
O31.22X4
O31.22X5
O31.22X9
O31.23X0
O31.23X1
O31.23X2
O31.23X3
O31.23X4
O31.23X5
O31.23X9
Papyraceous fetus, second trimester, fetus 5
Papyraceous fetus, second trimester, other fetus
Papyraceous fetus, third trimester, not applicable or unspecified
Papyraceous fetus, third trimester, fetus 1
Papyraceous fetus, third trimester, fetus 2
Papyraceous fetus, third trimester, fetus 3
Papyraceous fetus, third trimester, fetus 4
Papyraceous fetus, third trimester, fetus 5
Papyraceous fetus, third trimester, other fetus
Cont preg aft spon abort of one fts or more, unsp tri, unsp
Cont preg aft spon abort of one fts or more, unsp tri, fts1
Cont preg aft spon abort of one fts or more, unsp tri, fts2
Cont preg aft spon abort of one fts or more, unsp tri, fts3
Cont preg aft spon abort of one fts or more, unsp tri, fts4
Cont preg aft spon abort of one fts or more, unsp tri, fts5
Cont preg aft spon abort of one fetus or more, unsp tri, oth
Cont preg aft spon abort of one fts or more, third tri,
Cont preg aft spon abort of one fts or more, third tri, fts1
Cont preg aft spon abort of one fts or more, third tri, fts2
Cont preg aft spon abort of one fts or more, third tri, fts3
Cont preg aft spon abort of one fts or more, third tri, fts4
Cont preg aft spon abort of one fts or more, third tri, fts5
Cont preg aft spon abort of one fts or more, third tri, oth
Cont preg aft uterin dth of one fts or more, unsp tri, unsp
Cont preg aft uterin dth of one fts or more, unsp tri, unsp
Cont preg aft uterin dth of one fts or more, unsp tri, fts1
Cont preg aft uterin dth of one fts or more, unsp tri, fts1
Cont preg aft uterin dth of one fts or more, unsp tri, fts2
Cont preg aft uterin dth of one fts or more, unsp tri, fts2
Cont preg aft uterin dth of one fts or more, unsp tri, fts3
Cont preg aft uterin dth of one fts or more, unsp tri, fts3
Cont preg aft uterin dth of one fts or more, unsp tri, fts4
Cont preg aft uterin dth of one fts or more, unsp tri, fts4
Cont preg aft uterin dth of one fts or more, unsp tri, fts5
Cont preg aft uterin dth of one fts or more, unsp tri, fts5
Cont preg aft uterin dth of one fetus or more, unsp tri
Cont preg aft uterin dth of one fetus or more, unsp tri, oth
Cont preg aft uterin dth of one fetus or more, 2nd tri, unsp
Cont preg aft uterin dth of one fetus or more, 2nd tri, fts1
Cont preg aft uterin dth of one fetus or more, 2nd tri, fts2
Cont preg aft uterin dth of one fetus or more, 2nd tri, fts3
Cont preg aft uterin dth of one fetus or more, 2nd tri, fts4
Cont preg aft uterin dth of one fetus or more, 2nd tri, fts5
Cont preg aft uterin dth of one fetus or more, 2nd tri, oth
Cont preg aft uterin dth of one fts or more, third tri, unsp
Cont preg aft uterin dth of one fts or more, third tri, fts1
Cont preg aft uterin dth of one fts or more, third tri, fts2
Cont preg aft uterin dth of one fts or more, third tri, fts3
Cont preg aft uterin dth of one fts or more, third tri, fts4
Cont preg aft uterin dth of one fts or more, third tri, fts5
Cont preg aft uterin dth of one fts or more, third tri, oth
O31.30X0
Cont preg aft elctv fetl rdct of 1 fts or more,unsp tri,unsp
PC v2014A
282
O31.30X1
O31.30X2
O31.30X3
O31.30X4
O31.30X5
O31.30X9
O31.32X0
O31.32X1
O31.32X2
O31.32X3
O31.32X4
O31.32X5
O31.32X9
O31.33X0
O31.33X1
O31.33X2
O31.33X3
O31.33X4
O31.33X5
O31.33X9
O31.8X10
O31.8X11
O31.8X12
O31.8X13
O31.8X14
O31.8X15
O31.8X19
O31.8X20
O31.8X21
O31.8X22
O31.8X23
O31.8X24
O31.8X25
O31.8X29
O31.8X30
O31.8X31
O31.8X32
O31.8X33
O31.8X34
O31.8X35
O31.8X39
O32.0XX0
O32.0XX1
O32.0XX2
O32.0XX3
O32.0XX4
O32.0XX5
O32.0XX9
O32.1XX0
O32.1XX1
O32.1XX2
O32.1XX3
Cont preg aft elctv fetl rdct of 1 fts or more,unsp tri,fts1
Cont preg aft elctv fetl rdct of 1 fts or more,unsp tri,fts2
Cont preg aft elctv fetl rdct of 1 fts or more,unsp tri,fts3
Cont preg aft elctv fetl rdct of 1 fts or more,unsp tri,fts4
Cont preg aft elctv fetl rdct of 1 fts or more,unsp tri,fts5
Cont preg aft elctv fetl rdct of 1 fts or more,unsp tri, oth
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, unsp
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts1
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts2
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts3
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts4
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts5
Cont preg aft elctv fetl rdct of 1 fts or more, 2nd tri, oth
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, unsp
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts1
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts2
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts3
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts4
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts5
Cont preg aft elctv fetl rdct of 1 fts or more, 3rd tri, oth
Oth comp specific to multiple gest, first trimester, unsp
Oth comp specific to multiple gest, first trimester, fetus 1
Oth comp specific to multiple gest, first trimester, fetus 2
Oth comp specific to multiple gest, first trimester, fetus 3
Oth comp specific to multiple gest, first trimester, fetus 4
Oth comp specific to multiple gest, first trimester, fetus 5
Oth comp specific to multiple gest, first trimester, oth
Oth comp specific to multiple gest, second trimester, unsp
Oth comp specific to multiple gest, second tri, fetus 1
Oth comp specific to multiple gest, second tri, fetus 2
Oth comp specific to multiple gest, second tri, fetus 3
Oth comp specific to multiple gest, second tri, fetus 4
Oth comp specific to multiple gest, second tri, fetus 5
Oth comp specific to multiple gest, second trimester, oth
Oth comp specific to multiple gest, third trimester, unsp
Oth comp specific to multiple gest, third trimester, fetus 1
Oth comp specific to multiple gest, third trimester, fetus 2
Oth comp specific to multiple gest, third trimester, fetus 3
Oth comp specific to multiple gest, third trimester, fetus 4
Oth comp specific to multiple gest, third trimester, fetus 5
Oth comp specific to multiple gest, third trimester, oth
Maternal care for unstable lie, not applicable or unsp
Maternal care for unstable lie, fetus 1
Maternal care for unstable lie, fetus 2
Maternal care for unstable lie, fetus 3
Maternal care for unstable lie, fetus 4
Maternal care for unstable lie, fetus 5
Maternal care for unstable lie, other fetus
Maternal care for breech presentation, not applicable or unsp
Maternal care for breech presentation, fetus 1
Maternal care for breech presentation, fetus 2
Maternal care for breech presentation, fetus 3
O32.1XX4
Maternal care for breech presentation, fetus 4
PC v2014A
283
O32.1XX5
O32.1XX9
O32.2XX0
O32.3XX0
O32.3XX1
O32.3XX2
O32.3XX3
O32.3XX4
O32.3XX5
O32.3XX9
O32.4XX0
O32.4XX1
O32.4XX2
O32.4XX3
O32.4XX4
O32.4XX5
O32.4XX9
O32.6XX0
O32.6XX1
O32.6XX2
O32.6XX3
O32.6XX4
O32.6XX5
O32.6XX9
O32.8XX0
O32.8XX1
O32.8XX2
O32.8XX3
O32.8XX4
O32.8XX5
O32.8XX9
O32.9XX0
O32.9XX1
O32.9XX2
O32.9XX3
O32.9XX4
O32.9XX5
O32.9XX9
O33.0
O33.1
O33.2
O33.3XX0
O33.3XX1
O33.3XX2
O33.3XX3
O33.3XX4
O33.3XX5
O33.3XX9
O33.4XX0
O33.4XX1
O33.4XX2
O33.4XX3
O33.4XX4
PC v2014A
Maternal care for breech presentation, fetus 5
Maternal care for breech presentation, other fetus
Maternal care for transverse and oblique lie, other fetus
Maternal care for face, brow and chin presentation, unsp
Maternal care for face, brow and chin presentation, fetus 1
Maternal care for face, brow and chin presentation, fetus 2
Maternal care for face, brow and chin presentation, fetus 3
Maternal care for face, brow and chin presentation, fetus 4
Maternal care for face, brow and chin presentation, fetus 5
Maternal care for face, brow and chin presentation, other fetus
Maternal care for high head at term, not applicable or unsp
Maternal care for high head at term, fetus 1
Maternal care for high head at term, fetus 2
Maternal care for high head at term, fetus 3
Maternal care for high head at term, fetus 4
Maternal care for high head at term, fetus 5
Maternal care for high head at term, other fetus
Maternal care for compound presentation, unsp
Maternal care for compound presentation, fetus 1
Maternal care for compound presentation, fetus 2
Maternal care for compound presentation, fetus 3
Maternal care for compound presentation, fetus 4
Maternal care for compound presentation, fetus 5
Maternal care for compound presentation, other fetus
Maternal care for oth malpresentation of fetus, unsp
Maternal care for other malpresentation of fetus, fetus 1
Maternal care for other malpresentation of fetus, fetus 2
Maternal care for other malpresentation of fetus, fetus 3
Maternal care for other malpresentation of fetus, fetus 4
Maternal care for other malpresentation of fetus, fetus 5
Maternal care for oth malpresentation of fetus, other fetus
Maternal care for malpresentation of fetus, unsp, unsp
Maternal care for malpresentation of fetus, unsp, fetus 1
Maternal care for malpresentation of fetus, unsp, fetus 2
Maternal care for malpresentation of fetus, unsp, fetus 3
Maternal care for malpresentation of fetus, unsp, fetus 4
Maternal care for malpresentation of fetus, unsp, fetus 5
Maternal care for malpresentation of fetus, unsp, oth fetus
Matern care for disproprtn d/t deformity of matern pelv bone
Matern care for disproprtn d/t generally contracted pelvis
Maternal care for disproprtn due to inlet contrctn of pelvis
Matern care for disproprtn d/t outlet contrctn of pelv, unsp
Matern care for disproprtn d/t outlet contrctn of pelv, fts1
Matern care for disproprtn d/t outlet contrctn of pelv, fts2
Matern care for disproprtn d/t outlet contrctn of pelv, fts3
Matern care for disproprtn d/t outlet contrctn of pelv, fts4
Matern care for disproprtn d/t outlet contrctn of pelv, fts5
Matern care for disproprtn d/t outlet contrctn of pelv, oth
Matern care for disproprtn of mix matern & fetl origin, unsp
Matern care for disproprtn of mix matern & fetl origin, fts1
Matern care for disproprtn of mix matern & fetl origin, fts2
Matern care for disproprtn of mix matern & fetl origin, fts3
Matern care for disproprtn of mix matern & fetl origin, fts4
284
O33.4XX5
O33.4XX9
O33.5XX0
O33.5XX1
O33.5XX2
O33.5XX3
O33.5XX4
O33.5XX5
O33.5XX9
O33.6XX0
O33.6XX1
O33.6XX2
O33.6XX3
O33.6XX4
O33.6XX5
O33.6XX9
O33.7
O33.8
O33.9
O34.01
O34.02
O34.03
O34.11
O34.12
O34.13
O34.21
O34.29
O34.31
O34.32
O34.33
O34.41
O34.42
O34.43
O34.511
O34.512
O34.513
O34.521
O34.522
O34.523
O34.531
O34.532
O34.533
O34.591
O34.592
O34.593
O34.61
O34.62
O34.63
O34.71
O34.72
Matern care for disproprtn of mix matern & fetl origin, fts5
Matern care for disproprtn of mix matern & fetl origin, oth
Matern care for disproprtn d/t unusually large fetus, unsp
Matern care for disproprtn d/t unusually large fetus, fts1
Matern care for disproprtn d/t unusually large fetus, fts2
Matern care for disproprtn d/t unusually large fetus, fts3
Matern care for disproprtn d/t unusually large fetus, fts4
Matern care for disproprtn d/t unusually large fetus, fts5
Matern care for disproprtn due to unusually large fetus, oth
Matern care for disproprtn due to hydrocephalic fetus, unsp
Matern care for disproprtn due to hydrocephalic fetus, fts1
Matern care for disproprtn due to hydrocephalic fetus, fts2
Matern care for disproprtn due to hydrocephalic fetus, fts3
Matern care for disproprtn due to hydrocephalic fetus, fts4
Matern care for disproprtn due to hydrocephalic fetus, fts5
Maternal care for disproprtn due to hydrocephalic fetus, oth
Maternal care for disproportion due to oth fetal deformities
Maternal care for disproportion of other origin
Maternal care for disproportion, unspecified
Maternal care for unsp congen malform of uterus, first tri
Maternal care for unsp congen malform of uterus, second tri
Maternal care for unsp congen malform of uterus, third tri
Maternal care for benign tumor of corpus uteri, first tri
Maternal care for benign tumor of corpus uteri, second tri
Maternal care for benign tumor of corpus uteri, third tri
Maternal care for scar from previous cesarean delivery
Maternal care due to uterine scar from oth previous surgery
Maternal care for cervical incompetence, first trimester
Maternal care for cervical incompetence, second trimester
Maternal care for cervical incompetence, third trimester
Maternal care for oth abnlt of cervix, first trimester
Maternal care for oth abnlt of cervix, second trimester
Maternal care for oth abnlt of cervix, third trimester
Maternal care for incarceration of gravid uterus, first tri
Maternal care for incarceration of gravid uterus, second tri
Maternal care for incarceration of gravid uterus, third tri
Maternal care for prolapse of gravid uterus, first trimester
Maternal care for prolapse of gravid uterus, second tri
Maternal care for prolapse of gravid uterus, third trimester
Maternal care for retroversion of gravid uterus, first tri
Maternal care for retroversion of gravid uterus, second tri
Maternal care for retroversion of gravid uterus, third tri
Maternal care for oth abnlt of gravid uterus, first tri
Maternal care for oth abnlt of gravid uterus, second tri
Maternal care for oth abnlt of gravid uterus, third tri
Maternal care for abnormality of vagina, first trimester
Maternal care for abnormality of vagina, second trimester
Maternal care for abnormality of vagina, third trimester
Maternal care for abnlt of vulva and perineum, first tri
Maternal care for abnlt of vulva and perineum, second tri
O34.73
O34.81
Maternal care for abnlt of vulva and perineum, third tri
Maternal care for oth abnlt of pelvic organs, first tri
PC v2014A
285
O34.82
O34.83
O34.91
O34.92
O34.93
O35.0XX0
O35.0XX1
O35.0XX2
O35.0XX3
O35.0XX4
O35.0XX5
O35.0XX9
O35.1XX0
O35.1XX1
O35.1XX2
O35.1XX3
O35.1XX4
O35.1XX5
O35.1XX9
O35.2XX0
O35.2XX1
O35.2XX2
O35.2XX3
O35.2XX4
O35.2XX5
O35.2XX9
O35.3XX0
O35.3XX1
O35.3XX2
O35.3XX3
O35.3XX4
O35.3XX5
O35.3XX9
O35.4XX0
O35.4XX1
O35.4XX2
O35.4XX3
O35.4XX4
O35.4XX5
O35.4XX9
O35.5XX0
O35.5XX1
O35.5XX2
O35.5XX3
O35.5XX4
O35.5XX5
O35.5XX9
O35.6XX0
O35.6XX1
O35.6XX2
O35.6XX3
Maternal care for oth abnlt of pelvic organs, second tri
Maternal care for oth abnlt of pelvic organs, third tri
Maternal care for abnlt of pelvic organ, unsp, first tri
Maternal care for abnlt of pelvic organ, unsp, second tri
Maternal care for abnlt of pelvic organ, unsp, third tri
Maternal care for (suspected) cnsl malform in fetus, unsp
Maternal care for (suspected) cnsl malform in fetus, fetus 1
Maternal care for (suspected) cnsl malform in fetus, fetus 2
Maternal care for (suspected) cnsl malform in fetus, fetus 3
Maternal care for (suspected) cnsl malform in fetus, fetus 4
Maternal care for (suspected) cnsl malform in fetus, fetus 5
Maternal care for (suspected) cnsl malform in fetus, oth
Maternal care for chromosomal abnormality in fetus, unsp
Maternal care for chromosomal abnormality in fetus, fetus 1
Maternal care for chromosomal abnormality in fetus, fetus 2
Maternal care for chromosomal abnormality in fetus, fetus 3
Maternal care for chromosomal abnormality in fetus, fetus 4
Maternal care for chromosomal abnormality in fetus, fetus 5
Maternal care for chromosomal abnormality in fetus, oth
Maternal care for hereditary disease in fetus, unsp
Maternal care for hereditary disease in fetus, fetus 1
Maternal care for hereditary disease in fetus, fetus 2
Maternal care for hereditary disease in fetus, fetus 3
Maternal care for hereditary disease in fetus, fetus 4
Maternal care for hereditary disease in fetus, fetus 5
Maternal care for hereditary disease in fetus, oth
Matern care for damag to fts from viral dis in mother, unsp
Matern care for damag to fts from viral dis in mother, fts1
Matern care for damag to fts from viral dis in mother, fts2
Matern care for damag to fts from viral dis in mother, fts3
Matern care for damag to fts from viral dis in mother, fts4
Matern care for damag to fts from viral dis in mother, fts5
Matern care for damag to fts from viral dis in mother, oth
Maternal care for damage to fetus from alcohol, unsp
Maternal care for (suspected) damage to fetus from alcohol, fetus 1
Maternal care for (suspected) damage to fetus from alcohol, fetus 2
Maternal care for (suspected) damage to fetus from alcohol, fetus 3
Maternal care for (suspected) damage to fetus from alcohol, fetus 4
Maternal care for (suspected) damage to fetus from alcohol, fetus 5
Maternal care for (suspected) damage to fetus from alcohol, oth
Maternal care for (suspected) damage to fetus by drugs, unsp
Maternal care for (suspected) damage to fetus by drugs, fetus 1
Maternal care for (suspected) damage to fetus by drugs, fetus 2
Maternal care for (suspected) damage to fetus by drugs, fetus 3
Maternal care for (suspected) damage to fetus by drugs, fetus 4
Maternal care for (suspected) damage to fetus by drugs, fetus 5
Maternal care for (suspected) damage to fetus by drugs, oth
Maternal care for (suspected) damage to fetus by radiation, unsp
Maternal care for (suspected) damage to fetus by radiation, fetus 1
Maternal care for (suspected) damage to fetus by radiation, fetus 2
Maternal care for (suspected) damage to fetus by radiation, fetus 3
O35.6XX4
O35.6XX5
Maternal care for (suspected) damage to fetus by radiation, fetus 4
Maternal care for (suspected) damage to fetus by radiation, fetus 5
PC v2014A
286
O35.6XX9
O35.8XX0
O35.8XX1
O35.8XX2
O35.8XX3
O35.8XX4
O35.8XX5
O35.8XX9
O35.9XX0
O35.9XX1
O35.9XX2
O35.9XX3
O35.9XX4
O35.9XX5
O35.9XX9
O36.0110
O36.0110
O36.0111
O36.0111
O36.0112
O36.0112
O36.0113
O36.0113
O36.0114
O36.0114
O36.0115
O36.0115
O36.0119
O36.0120
O36.0120
O36.0121
O36.0121
O36.0122
O36.0122
O36.0123
O36.0123
O36.0124
O36.0124
O36.0125
O36.0125
O36.0129
O36.0130
O36.0131
O36.0131
O36.0132
O36.0133
O36.0134
O36.0135
O36.0139
O36.0190
O36.0191
O36.0192
O36.0193
PC v2014A
Maternal care for (suspected) damage to fetus by radiation, oth
Maternal care for oth fetal abnormality and damage, unsp
Maternal care for oth fetal abnormality and damage, fetus 1
Maternal care for oth fetal abnormality and damage, fetus 2
Maternal care for oth fetal abnormality and damage, fetus 3
Maternal care for oth fetal abnormality and damage, fetus 4
Maternal care for oth fetal abnormality and damage, fetus 5
Maternal care for oth fetal abnormality and damage, oth
Maternal care for fetal abnormality and damage, unsp, unsp
Maternal care for fetal abnlt and damage, unsp, fetus 1
Maternal care for fetal abnlt and damage, unsp, fetus 2
Maternal care for fetal abnlt and damage, unsp, fetus 3
Maternal care for fetal abnlt and damage, unsp, fetus 4
Maternal care for fetal abnlt and damage, unsp, fetus 5
Maternal care for fetal abnlt and damage, unsp, oth
Maternal care for anti-D antibodies, first trimester, unsp
Maternal care for anti-D antibodies, first trimester, unsp
Maternal care for anti-D antibodies, first tri, fetus 1
Maternal care for anti-D antibodies, first tri, fetus 1
Maternal care for anti-D antibodies, first tri, fetus 2
Maternal care for anti-D antibodies, first tri, fetus 2
Maternal care for anti-D antibodies, first tri, fetus 3
Maternal care for anti-D antibodies, first tri, fetus 3
Maternal care for anti-D antibodies, first tri, fetus 4
Maternal care for anti-D antibodies, first tri, fetus 4
Maternal care for anti-D antibodies, first tri, fetus 5
Maternal care for anti-D antibodies, first tri, oth
Maternal care for anti-D antibodies, first trimester, oth
Maternal care for anti-D antibodies, second trimester, unsp
Maternal care for anti-D antibodies, second trimester, unsp
Maternal care for anti-D antibodies, second tri, fetus 1
Maternal care for anti-D antibodies, second tri, fetus 1
Maternal care for anti-D antibodies, second tri, fetus 2
Maternal care for anti-D antibodies, second tri, fetus 2
Maternal care for anti-D antibodies, second tri, fetus 3
Maternal care for anti-D antibodies, second tri, fetus 3
Maternal care for anti-D antibodies, second tri, fetus 4
Maternal care for anti-D antibodies, second tri, fetus 4
Maternal care for anti-D antibodies, second tri, fetus 5
Maternal care for anti-D antibodies, second tri, fetus 5
Maternal care for anti-D antibodies, second tri, oth
Maternal care for anti-D antibodies, third trimester, unsp
Maternal care for anti-D antibodies, third tri, fetus 1
Maternal care for anti-D antibodies, third tri, fetus 1
Maternal care for anti-D antibodies, third tri, fetus 2
Maternal care for anti-D antibodies, third tri, fetus 3
Maternal care for anti-D antibodies, third tri, fetus 4
Maternal care for anti-D antibodies, third tri, fetus 5
Maternal care for anti-D antibodies, third trimester, oth
Maternal care for anti-D antibodies, unsp trimester, unsp
Maternal care for anti-D antibodies, unsp trimester, fetus 1
Maternal care for anti-D antibodies, unsp trimester, fetus 2
Maternal care for anti-D antibodies, unsp trimester, fetus 3
287
O36.0194
O36.0195
O36.0199
O36.0910
O36.0911
O36.0912
O36.0913
O36.0914
O36.0915
O36.0919
O36.0920
O36.0921
O36.0922
O36.0923
O36.0924
O36.0925
O36.0929
O36.0930
O36.0931
O36.0932
O36.0933
O36.0934
O36.0935
O36.0939
O36.20X0
O36.20X1
O36.20X2
O36.20X3
O36.20X4
O36.20X5
O36.20X9
O36.21x0
O36.21x1
O36.21X2
O36.21X3
O36.21X4
O36.21X5
O36.21X9
O36.22x0
O36.22x1
O36.22x2
O36.22x3
O36.22x4
O36.22x5
O36.22x9
O36.22X9
O36.23X0
O36.23X1
O36.23X2
Maternal care for anti-D antibodies, unsp trimester, fetus 4
Maternal care for anti-D antibodies, unsp trimester, fetus 5
Maternal care for anti-D antibodies, unsp trimester, oth
Maternal care for oth rhesus isoimmun, first trimester, unsp
Maternal care for oth rhesus isoimmun, first tri, fetus 1
Maternal care for oth rhesus isoimmun, first tri, fetus 2
Maternal care for oth rhesus isoimmun, first tri, fetus 3
Maternal care for oth rhesus isoimmun, first tri, fetus 4
Maternal care for oth rhesus isoimmun, first tri, fetus 5
Maternal care for other rhesus isoimmunization, first trimester, oth
Maternal care for oth rhesus isoimmun, second tri, unsp
Maternal care for oth rhesus isoimmun, second tri, fetus 1
Maternal care for oth rhesus isoimmun, second tri, fetus 2
Maternal care for oth rhesus isoimmun, second tri, fetus 3
Maternal care for oth rhesus isoimmun, second tri, fetus 4
Maternal care for oth rhesus isoimmun, second tri, fetus 5
Maternal care for oth rhesus isoimmun, second trimester, oth
Maternal care for oth rhesus isoimmun, third trimester, unsp
Maternal care for oth rhesus isoimmun, third tri, fetus 1
Maternal care for oth rhesus isoimmun, third tri, fetus 2
Maternal care for oth rhesus isoimmun, third tri, fetus 3
Maternal care for oth rhesus isoimmun, third tri, fetus 4
Maternal care for oth rhesus isoimmun, third tri, fetus 5
Maternal care for oth rhesus isoimmun, third tri, oth
Maternal care for hydrops fetalis, unsp trimester, unsp
Maternal care for hydrops fetalis, unsp trimester, fetus 1
Maternal care for hydrops fetalis, unsp trimester, fetus 2
Maternal care for hydrops fetalis, unsp trimester, fetus 3
Maternal care for hydrops fetalis, unsp trimester, fetus 4
Maternal care for hydrops fetalis, unsp trimester, fetus 5
Maternal care for hydrops fetalis, unsp trimester, oth fetus
Maternal care for hydrops fetalis, first trimester, unsp
Maternal care for hydrops fetalis, first trimester, fetus 1
Maternal care for hydrops fetalis, first trimester, fetus 2
Maternal care for hydrops fetalis, first trimester, fetus 3
Maternal care for hydrops fetalis, first trimester, fetus 4
Maternal care for hydrops fetalis, first trimester, fetus 5
Maternal care for hydrops fetalis, first trimester, oth
Maternal care for hydrops fetalis, second trimester, unsp
Maternal care for hydrops fetalis, second trimester, fetus 1
Maternal care for hydrops fetalis, second trimester, fetus 2
Maternal care for hydrops fetalis, second trimester, fetus 3
Maternal care for hydrops fetalis, second trimester, fetus 4
Maternal care for hydrops fetalis, second trimester, fetus 5
Maternal care for hydrops fetalis, second trimester, oth
Maternal care for hydrops fetalis, second trimester, other fetus
Maternal care for hydrops fetalis, third trimester, unsp
Maternal care for hydrops fetalis, third trimester, fetus 1
Maternal care for hydrops fetalis, third trimester, fetus 2
O36.23X3
O36.23X4
O36.23X5
Maternal care for hydrops fetalis, third trimester, fetus 3
Maternal care for hydrops fetalis, third trimester, fetus 4
Maternal care for hydrops fetalis, third trimester, fetus 5
PC v2014A
288
O36.23X9
O36.4XX0
O36.4XX1
O36.4XX2
O36.4XX3
O36.4XX4
O36.4XX5
O36.4XX9
O36.5110
O36.5111
O36.5112
O36.5113
O36.5114
O36.5115
O36.5119
O36.5120
O36.5121
O36.5122
O36.5123
O36.5124
O36.5125
O36.5129
O36.5130
O36.5131
O36.5132
O36.5133
O36.5134
O36.5135
O36.5139
O36.5190
O36.5191
O36.5192
O36.5193
O36.5194
O36.5195
O36.5199
O36.5920
O36.5921
O36.5922
O36.5923
O36.5924
O36.5925
O36.5929
O36.5930
O36.5931
O36.5932
O36.5933
O36.5934
O36.5935
Maternal care for hydrops fetalis, third trimester, other fetus
Maternal care for intrauterine death, not applicable or unsp
Maternal care for intrauterine death, fetus 1
Maternal care for intrauterine death, fetus 2
Maternal care for intrauterine death, fetus 3
Maternal care for intrauterine death, fetus 4
Maternal care for intrauterine death, fetus 5
Maternal care for intrauterine death, other fetus
Matern care for known or susp placntl insuff, 1st tri, unsp
Matern care for known or susp placntl insuff, 1st tri, fts1
Matern care for known or susp placntl insuff, 1st tri, fts2
Matern care for known or susp placntl insuff, 1st tri, fts3
Matern care for known or susp placntl insuff, 1st tri, fts4
Matern care for known or susp placntl insuff, 1st tri, fts5
Matern care for known or susp placntl insuff, first tri, oth
Matern care for known or susp placntl insuff, 2nd tri, unsp
Matern care for known or susp placntl insuff, 2nd tri, fts1
Matern care for known or susp placntl insuff, 2nd tri, fts2
Matern care for known or susp placntl insuff, 2nd tri, fts3
Matern care for known or susp placntl insuff, 2nd tri, fts4
Matern care for known or susp placntl insuff, 2nd tri, fts5
Matern care for known or susp placntl insuff, 2nd tri, oth
Matern care for or susp placntl insuff, third tri, unsp
Matern care for or susp placntl insuff, third tri, fts1
Matern care for or susp placntl insuff, third tri, fts2
Matern care for or susp placntl insuff, third tri, fts3
Matern care for or susp placntl insuff, third tri, fts4
Matern care for or susp placntl insuff, third tri, fts5
Matern care for or susp placntl insuff, third tri, oth
Matern care for known or susp placntl insuff, unsp tri, unsp
Matern care for known or susp placntl insuff, unsp tri, fts1
Matern care for known or susp placntl insuff, unsp tri, fts2
Matern care for known or susp placntl insuff, unsp tri, fts3
Matern care for known or susp placntl insuff, unsp tri, fts4
Matern care for known or susp placntl insuff, unsp tri, fts5
Matern care for known or susp placntl insuff, unsp tri, oth
Matern care for oth or susp poor fetl grth, 2nd tri, unsp
Matern care for oth or susp poor fetl grth, 2nd tri, fts1
Matern care for oth or susp poor fetl grth, 2nd tri, fts2
Matern care for oth or susp poor fetl grth, 2nd tri, fts3
Matern care for oth or susp poor fetl grth, 2nd tri, fts4
Matern care for oth or susp poor fetl grth, 2nd tri, fts5
Matern care for oth or susp poor fetl grth, 2nd tri, oth
Matern care for oth or susp poor fetl grth, third tri, unsp
Matern care for oth or susp poor fetl grth, third tri, fts1
Matern care for oth or susp poor fetl grth, third tri, fts2
Matern care for oth or susp poor fetl grth, third tri, fts3
Matern care for oth or susp poor fetl grth, third tri, fts4
Matern care for oth or susp poor fetl grth, third tri, fts5
O36.5939
O36.61X0
O36.61X1
Matern care for oth or susp poor fetl grth, third tri, oth
Maternal care for excess fetal growth, first trimester, unsp
Maternal care for excess fetal growth, first tri, fetus 1
PC v2014A
289
O36.61X2
O36.61X3
O36.61X4
O36.61X5
O36.61X9
O36.62X0
O36.62X1
O36.62X2
O36.62X3
O36.62X4
O36.62X5
O36.62X9
O36.63X0
O36.63X1
O36.63X2
O36.63X3
O36.63X4
O36.63X5
O36.63X9
O36.71X0
O36.71X1
O36.71X2
O36.71X3
O36.71X4
O36.71X5
O36.71X9
O36.72X0
O36.72X1
O36.72X2
O36.72X3
O36.72X4
O36.72X5
O36.72X9
O36.73X0
O36.73X1
O36.73X2
O36.73X3
O36.73X4
O36.73X5
O36.73X9
O36.8120
O36.8121
O36.8122
O36.8123
O36.8124
O36.8125
O36.8129
O36.8130
O36.8131
O36.8132
Maternal care for excess fetal growth, first tri, fetus 2
Maternal care for excess fetal growth, first tri, fetus 3
Maternal care for excess fetal growth, first tri, fetus 4
Maternal care for excess fetal growth, first tri, fetus 5
Maternal care for excess fetal growth, first trimester, oth
Maternal care for excess fetal growth, second tri, unsp
Maternal care for excess fetal growth, second tri, fetus 1
Maternal care for excess fetal growth, second tri, fetus 2
Maternal care for excess fetal growth, second tri, fetus 3
Maternal care for excess fetal growth, second tri, fetus 4
Maternal care for excess fetal growth, second tri, fetus 5
Maternal care for excess fetal growth, second trimester, oth
Maternal care for excess fetal growth, third trimester, unsp
Maternal care for excess fetal growth, third tri, fetus 1
Maternal care for excess fetal growth, third tri, fetus 2
Maternal care for excess fetal growth, third tri, fetus 3
Maternal care for excess fetal growth, third tri, fetus 4
Maternal care for excess fetal growth, third tri, fetus 5
Maternal care for excess fetal growth, third trimester, oth
Maternal care for viable fetus in abd preg, first tri, unsp
Matern care for viable fetus in abd preg, first tri, fetus 1
Matern care for viable fetus in abd preg, first tri, fetus 2
Matern care for viable fetus in abd preg, first tri, fetus 3
Matern care for viable fetus in abd preg, first tri, fetus 4
Matern care for viable fetus in abd preg, first tri, fetus 5
Maternal care for viable fetus in abd preg, first tri, oth
Maternal care for viable fetus in abd preg, second tri, unsp
Matern care for viable fetus in abd preg, second tri, fts1
Matern care for viable fetus in abd preg, second tri, fts2
Matern care for viable fetus in abd preg, second tri, fts3
Matern care for viable fetus in abd preg, second tri, fts4
Matern care for viable fetus in abd preg, second tri, fts5
Maternal care for viable fetus in abd preg, second tri, oth
Maternal care for viable fetus in abd preg, third tri, unsp
Matern care for viable fetus in abd preg, third tri, fetus 1
Matern care for viable fetus in abd preg, third tri, fetus 2
Matern care for viable fetus in abd preg, third tri, fetus 3
Matern care for viable fetus in abd preg, third tri, fetus 4
Matern care for viable fetus in abd preg, third tri, fetus 5
Maternal care for viable fetus in abd preg, third tri, oth
Decreased fetal movements, second trimester, unsp
Decreased fetal movements, second trimester, fetus 1
Decreased fetal movements, second trimester, fetus 2
Decreased fetal movements, second trimester, fetus 3
Decreased fetal movements, second trimester, fetus 4
Decreased fetal movements, second trimester, fetus 5
Decreased fetal movements, second trimester, other fetus
Decreased fetal movements, third trimester, not applicable or unspecified
Decreased fetal movements, third trimester, fetus 1
Decreased fetal movements, third trimester, fetus 2
O36.8133
O36.8134
Decreased fetal movements, third trimester, fetus 3
Decreased fetal movements, third trimester, fetus 4
PC v2014A
290
O36.8135
O36.8139
O36.8910
O36.8911
O36.8912
O36.8913
O36.8914
O36.8915
O36.8919
O36.8920
O36.8921
O36.8922
O36.8923
O36.8924
O36.8925
O36.8929
O36.8930
O36.8931
O36.8932
O36.8933
O36.8934
O36.8935
O36.8939
O36.91X0
O36.91X1
O36.91X2
O36.91X3
O36.91X4
O36.91X5
O36.91X9
O36.92X0
O36.92X1
O36.92X2
O36.92X3
O36.92X4
O36.92X5
O36.92X9
O36.93X0
O36.93X1
O36.93X2
O36.93X3
O36.93X4
O36.93X5
O36.93X9
O40.1XX0
O40.1XX1
O40.1XX2
O40.1XX3
O40.1XX4
O40.1XX5
Decreased fetal movements, third trimester, fetus 5
Decreased fetal movements, third trimester, other fetus
Maternal care for oth fetal problems, first trimester, unsp
Maternal care for oth fetal problems, first tri, fetus 1
Maternal care for oth fetal problems, first tri, fetus 2
Maternal care for oth fetal problems, first tri, fetus 3
Maternal care for oth fetal problems, first tri, fetus 4
Maternal care for oth fetal problems, first tri, fetus 5
Maternal care for oth fetal problems, first trimester, oth
Maternal care for oth fetal problems, second trimester, unsp
Maternal care for oth fetal problems, second tri, fetus 1
Maternal care for oth fetal problems, second tri, fetus 2
Maternal care for oth fetal problems, second tri, fetus 3
Maternal care for oth fetal problems, second tri, fetus 4
Maternal care for oth fetal problems, second tri, fetus 5
Maternal care for oth fetal problems, second trimester, oth
Maternal care for oth fetal problems, third trimester, unsp
Maternal care for oth fetal problems, third tri, fetus 1
Maternal care for oth fetal problems, third tri, fetus 2
Maternal care for oth fetal problems, third tri, fetus 3
Maternal care for oth fetal problems, third tri, fetus 4
Maternal care for oth fetal problems, third tri, fetus 5
Maternal care for oth fetal problems, third trimester, oth
Maternal care for fetal problem, unsp, first trimester, unsp
Maternal care for fetal problem, unsp, first tri, fetus 1
Maternal care for fetal problem, unsp, first tri, fetus 2
Maternal care for fetal problem, unsp, first tri, fetus 3
Maternal care for fetal problem, unsp, first tri, fetus 4
Maternal care for fetal problem, unsp, first tri, fetus 5
Maternal care for fetal problem, unsp, first trimester, oth
Maternal care for fetal problem, unsp, second tri, unsp
Maternal care for fetal problem, unsp, second tri, fetus 1
Maternal care for fetal problem, unsp, second tri, fetus 2
Maternal care for fetal problem, unsp, second tri, fetus 3
Maternal care for fetal problem, unsp, second tri, fetus 4
Maternal care for fetal problem, unsp, second tri, fetus 5
Maternal care for fetal problem, unsp, second trimester, oth
Maternal care for fetal problem, unsp, third trimester, unsp
Maternal care for fetal problem, unsp, third tri, fetus 1
Maternal care for fetal problem, unsp, third tri, fetus 2
Maternal care for fetal problem, unsp, third tri, fetus 3
Maternal care for fetal problem, unsp, third tri, fetus 4
Maternal care for fetal problem, unsp, third tri, fetus 5
Maternal care for fetal problem, unsp, third trimester, oth
Polyhydramnios, first trimester, not applicable or unsp
Polyhydramnios, first trimester, fetus 1
Polyhydramnios, first trimester, fetus 2
Polyhydramnios, first trimester, fetus 3
Polyhydramnios, first trimester, fetus 4
Polyhydramnios, first trimester, fetus 5
O40.1XX9
O40.2XX0
Polyhydramnios, first trimester, other fetus
Polyhydramnios, second trimester, not applicable or unsp
PC v2014A
291
O40.2XX1
O40.2XX2
O40.2XX3
O40.2XX4
O40.2XX5
O40.2XX9
O40.3XX0
O40.3XX1
O40.3XX2
O40.3XX3
O40.3XX4
O40.3XX5
O40.3XX9
O41.01X0
O41.01X1
O41.01X2
O41.01X3
O41.01X4
O41.01X5
O41.01X9
O41.02X0
O41.02X1
O41.02X2
O41.02X3
O41.02X4
O41.02X5
O41.02X9
O41.03X0
O41.03X1
O41.03X2
O41.03X3
O41.03X4
O41.03X5
O41.03X9
O41.1010
O41.1011
O41.1012
O41.1013
O41.1014
O41.1015
O41.1019
O41.1020
O41.1021
O41.1022
O41.1023
O41.1024
O41.1025
O41.1029
O41.1030
O41.1031
O41.1032
Polyhydramnios, second trimester, fetus 1
Polyhydramnios, second trimester, fetus 2
Polyhydramnios, second trimester, fetus 3
Polyhydramnios, second trimester, fetus 4
Polyhydramnios, second trimester, fetus 5
Polyhydramnios, second trimester, other fetus
Polyhydramnios, third trimester, not applicable or unsp
Polyhydramnios, third trimester, fetus 1
Polyhydramnios, third trimester, fetus 2
Polyhydramnios, third trimester, fetus 3
Polyhydramnios, third trimester, fetus 4
Polyhydramnios, third trimester, fetus 5
Polyhydramnios, third trimester, other fetus
Oligohydramnios, first trimester, not applicable or unsp
Oligohydramnios, first trimester, fetus 1
Oligohydramnios, first trimester, fetus 2
Oligohydramnios, first trimester, fetus 3
Oligohydramnios, first trimester, fetus 4
Oligohydramnios, first trimester, fetus 5
Oligohydramnios, first trimester, other fetus
Oligohydramnios, second trimester, not applicable or unsp
Oligohydramnios, second trimester, fetus 1
Oligohydramnios, second trimester, fetus 2
Oligohydramnios, second trimester, fetus 3
Oligohydramnios, second trimester, fetus 4
Oligohydramnios, second trimester, fetus 5
Oligohydramnios, second trimester, other fetus
Oligohydramnios, third trimester, not applicable or unspecified
Oligohydramnios, third trimester, fetus 1
Oligohydramnios, third trimester, fetus 2
Oligohydramnios, third trimester, fetus 3
Oligohydramnios, third trimester, fetus 4
Oligohydramnios, third trimester, fetus 5
Oligohydramnios, third trimester, other fetus
Infct of amniotic sac and membrns, unsp, first tri, unsp
Infct of amniotic sac and membrns, unsp, first tri, fetus 1
Infct of amniotic sac and membrns, unsp, first tri, fetus 2
Infct of amniotic sac and membrns, unsp, first tri, fetus 3
Infct of amniotic sac and membrns, unsp, first tri, fetus 4
Infct of amniotic sac and membrns, unsp, first tri, fetus 5
Infct of amniotic sac and membrns, unsp, first tri, oth
Infct of amniotic sac and membrns, unsp, second tri, unsp
Infct of amniotic sac and membrns, unsp, second tri, fetus 1
Infct of amniotic sac and membrns, unsp, second tri, fetus 2
Infct of amniotic sac and membrns, unsp, second tri, fetus 3
Infct of amniotic sac and membrns, unsp, second tri, fetus 4
Infct of amniotic sac and membrns, unsp, second tri, fetus 5
Infct of amniotic sac and membrns, unsp, second tri, oth
Infct of amniotic sac and membrns, unsp, third tri, unsp
Infct of amniotic sac and membrns, unsp, third tri, fetus 1
Infct of amniotic sac and membrns, unsp, third tri, fetus 2
O41.1033
O41.1034
Infct of amniotic sac and membrns, unsp, third tri, fetus 3
Infct of amniotic sac and membrns, unsp, third tri, fetus 4
PC v2014A
292
O41.1035
O41.1039
O41.1210
O41.1211
O41.1212
O41.1213
O41.1214
O41.1215
O41.1219
O41.1220
O41.1221
O41.1222
O41.1223
O41.1224
O41.1225
O41.1229
O41.1230
O41.1231
O41.1232
O41.1233
O41.1234
O41.1235
O41.1239
O41.1410
O41.1411
O41.1412
O41.1413
O41.1414
O41.1415
O41.1419
O41.1420
O41.1421
O41.1422
O41.1423
O41.1424
O41.1425
O41.1429
O41.1430
O41.1431
O41.1432
O41.1433
O41.1434
O41.1435
O41.1439
O41.8X10
O41.8X11
O41.8X12
O41.8X13
O41.8X14
O41.8X15
O41.8X19
O41.8X20
O41.8X21
PC v2014A
Infct of amniotic sac and membrns, unsp, third tri, fetus 5
Infct of amniotic sac and membrns, unsp, third tri, oth
Chorioamnionitis, first trimester, not applicable or unsp
Chorioamnionitis, first trimester, fetus 1
Chorioamnionitis, first trimester, fetus 2
Chorioamnionitis, first trimester, fetus 3
Chorioamnionitis, first trimester, fetus 4
Chorioamnionitis, first trimester, fetus 5
Chorioamnionitis, first trimester, other fetus
Chorioamnionitis, second trimester, not applicable or unsp
Chorioamnionitis, second trimester, fetus 1
Chorioamnionitis, second trimester, fetus 2
Chorioamnionitis, second trimester, fetus 3
Chorioamnionitis, second trimester, fetus 4
Chorioamnionitis, second trimester, fetus 5
Chorioamnionitis, second trimester, other fetus
Chorioamnionitis, third trimester, not applicable or unsp
Chorioamnionitis, third trimester, fetus 1
Chorioamnionitis, third trimester, fetus 2
Chorioamnionitis, third trimester, fetus 3
Chorioamnionitis, third trimester, fetus 4
Chorioamnionitis, third trimester, fetus 5
Chorioamnionitis, third trimester, other fetus
Placentitis, first trimester, not applicable or unspecified
Placentitis, first trimester, fetus 1
Placentitis, first trimester, fetus 2
Placentitis, first trimester, fetus 3
Placentitis, first trimester, fetus 4
Placentitis, first trimester, fetus 5
Placentitis, first trimester, other fetus
Placentitis, second trimester, not applicable or unspecified
Placentitis, second trimester, fetus 1
Placentitis, second trimester, fetus 2
Placentitis, second trimester, fetus 3
Placentitis, second trimester, fetus 4
Placentitis, second trimester, fetus 5
Placentitis, second trimester, other fetus
Placentitis, third trimester, not applicable or unspecified
Placentitis, third trimester, fetus 1
Placentitis, third trimester, fetus 2
Placentitis, third trimester, fetus 3
Placentitis, third trimester, fetus 4
Placentitis, third trimester, fetus 5
Placentitis, third trimester, other fetus
Oth disrd of amniotic fluid and membrns, first tri, unsp
Oth disrd of amniotic fluid and membrns, first tri, fetus 1
Oth disrd of amniotic fluid and membrns, first tri, fetus 2
Oth disrd of amniotic fluid and membrns, first tri, fetus 3
Oth disrd of amniotic fluid and membrns, first tri, fetus 4
Oth disrd of amniotic fluid and membrns, first tri, fetus 5
Oth disrd of amniotic fluid and membrns, first tri, oth
Oth disrd of amniotic fluid and membrns, second tri, unsp
Oth disrd of amniotic fluid and membrns, second tri, fetus 1
293
O41.8X22
O41.8X23
O41.8X24
O41.8X25
O41.8X29
O41.8X30
O41.8X31
O41.8X32
O41.8X33
O41.8X34
O41.8X35
O41.8X39
O41.91X0
O41.91X1
O41.91X2
O41.91X3
O41.91X4
O41.91X5
O41.91X9
O41.92X0
O41.92X1
O41.92X2
O41.92X3
O41.92X4
O41.92X5
O41.92X9
O41.93X0
O41.93X1
O41.93X2
O41.93X3
O41.93X4
O41.93X5
O41.93X9
O42.011
O42.012
O42.013
O42.02
O42.111
O42.112
O42.113
O42.12
O42.911
O42.912
O42.913
O42.92
O43.011
O43.012
O43.013
O43.021
O43.022
Oth disrd of amniotic fluid and membrns, second tri, fetus
Oth disrd of amniotic fluid and membrns, second tri, fetus 3
Oth disrd of amniotic fluid and membrns, second tri, fetus 4
Oth disrd of amniotic fluid and membrns, second tri, fetus 5
Oth disrd of amniotic fluid and membrns, second tri, oth
Oth disrd of amniotic fluid and membrns, third tri, unsp
Oth disrd of amniotic fluid and membrns, third tri, fetus 1
Oth disrd of amniotic fluid and membrns, third tri, fetus 2
Oth disrd of amniotic fluid and membrns, third tri, fetus 3
Oth disrd of amniotic fluid and membrns, third tri, fetus 4
Oth disrd of amniotic fluid and membrns, third tri, fetus 5
Oth disrd of amniotic fluid and membrns, third tri, oth
Disorder of amnio fluid and membrns, unsp, first tri, unsp
Disord of amnio fluid and membrns, unsp, first tri, fetus 1
Disord of amnio fluid and membrns, unsp, first tri, fetus 2
Disord of amnio fluid and membrns, unsp, first tri, fetus 3
Disord of amnio fluid and membrns, unsp, first tri, fetus 4
Disord of amnio fluid and membrns, unsp, first tri, fetus 5
Disorder of amniotic fluid and membrns, unsp, first tri, oth
Disorder of amnio fluid and membrns, unsp, second tri, unsp
Disord of amnio fluid and membrns, unsp, second tri, fetus 1
Disord of amnio fluid and membrns, unsp, second tri, fetus 2
Disord of amnio fluid and membrns, unsp, second tri, fetus 3
Disord of amnio fluid and membrns, unsp, second tri, fetus 4
Disord of amnio fluid and membrns, unsp, second tri, fetus 5
Disorder of amnio fluid and membrns, unsp, second tri, oth
Disorder of amnio fluid and membrns, unsp, third tri, unsp
Disord of amnio fluid and membrns, unsp, third tri, fetus 1
Disord of amnio fluid and membrns, unsp, third tri, fetus 2
Disord of amnio fluid and membrns, unsp, third tri, fetus 3
Disord of amnio fluid and membrns, unsp, third tri, fetus 4
Disord of amnio fluid and membrns, unsp, third tri, fetus 5
Disorder of amniotic fluid and membrns, unsp, third tri, oth
Pretrm prem ROM, onset labor w/n 24 hours of rupt, first tri
Pretrm prem ROM, onset labor w/n 24 hours of rupt, 2nd tri
Pretrm prem ROM, onset labor w/n 24 hours of rupt, third tri
Full-term prem ROM, onset labor within 24 hours of rupture
Pretrm prem ROM, onset labor > 24 hours fol rupt, first tri
Pretrm prem ROM, onset labor > 24 hours fol rupt, second tri
Pretrm prem ROM, onset labor > 24 hours fol rupt, third tri
Full-term premature ROM, onset labor > 24 hours fol rupture
Pretrm prem ROM, unsp time betw rupt and onset labr, 1st tri
Pretrm prem ROM, unsp time betw rupt and onset labr, 2nd tri
Pretrm prem ROM, unsp time betw rupt and onst labr, 3rd tri
Full-term prem ROM, unsp time betw rupture and onset labor
Fetomaternal placental transfusion syndrome, first trimester
Fetomaternal placental transfuse syndrome, second trimester
Fetomaternal placental transfusion syndrome, third trimester
Fetus-to-fetus placental transfuse syndrome, first trimester
Fetus-to-fetus placntl transfuse syndrome, second trimester
O43.023
O43.101
Fetus-to-fetus placental transfuse syndrome, third trimester
Malformation of placenta, unspecified, first trimester
PC v2014A
294
O43.102
O43.103
O43.111
O43.112
O43.113
O43.121
O43.122
O43.123
O43.191
O43.192
O43.193
O43.211
O43.212
O43.213
O43.221
O43.222
O43.223
O43.231
O43.232
O43.233
O43.811
O43.812
O43.813
O43.891
O43.892
O43.893
O43.91
O43.92
O43.93
O44.01
O44.02
O44.03
O44.11
O44.12
O44.13
O45.001
O45.002
O45.003
O45.011
O45.012
O45.013
O45.021
O45.022
O45.023
O45.091
O45.092
O45.093
O45.8X1
O45.8X2
O45.8X3
O45.91
Malformation of placenta, unspecified, second trimester
Malformation of placenta, unspecified, third trimester
Circumvallate placenta, first trimester
Circumvallate placenta, second trimester
Circumvallate placenta, third trimester
Velamentous insertion of umbilical cord, first trimester
Velamentous insertion of umbilical cord, second trimester
Velamentous insertion of umbilical cord, third trimester
Other malformation of placenta, first trimester
Other malformation of placenta, second trimester
Other malformation of placenta, third trimester
Placenta accreta, first trimester
Placenta accreta, second trimester
Placenta accreta, third trimester
Placenta increta, first trimester
Placenta increta, second trimester
Placenta increta, third trimester
Placenta percreta, first trimester
Placenta percreta, second trimester
Placenta percreta, third trimester
Placental infarction, first trimester
Placental infarction, second trimester
Placental infarction, third trimester
Other placental disorders, first trimester
Other placental disorders, second trimester
Other placental disorders, third trimester
Unspecified placental disorder, first trimester
Unspecified placental disorder, second trimester
Unspecified placental disorder, third trimester
Placenta previa specified as w/o hemorrhage, first trimester
Placenta previa specified as w/o hemor, second trimester
Placenta previa specified as w/o hemorrhage, third trimester
Placenta previa with hemorrhage, first trimester
Placenta previa with hemorrhage, second trimester
Placenta previa with hemorrhage, third trimester
Prem separtn of placenta w coag defect, unsp, first tri
Prem separtn of placenta w coag defect, unsp, second tri
Prem separtn of placenta w coag defect, unsp, third tri
Prem separtn of placenta w afibrinogenemia, first trimester
Prem separtn of placenta w afibrinogenemia, second trimester
Prem separtn of placenta w afibrinogenemia, third trimester
Prem separtn of placenta w dissem intravasc coag, first tri
Prem separtn of placenta w dissem intravasc coag, second tri
Prem separtn of placenta w dissem intravasc coag, third tri
Prem separtn of placenta w oth coag defect, first trimester
Prem separtn of placenta w oth coag defect, second trimester
Prem separtn of placenta w oth coag defect, third trimester
Other premature separation of placenta, first trimester
Other premature separation of placenta, second trimester
Other premature separation of placenta, third trimester
Premature separation of placenta, unsp, first trimester
O45.92
O45.93
Premature separation of placenta, unsp, second trimester
Premature separation of placenta, unsp, third trimester
PC v2014A
295
O46.001
O46.002
O46.003
O46.011
O46.012
O46.013
O46.021
O46.022
O46.023
O46.091
O46.092
O46.093
O46.8X1
O46.8X2
O46.8X3
O46.91
O46.92
O46.93
O48.0
O60.12X0
O60.12X1
O60.12X2
O60.12X3
O60.12X4
O60.12X5
O60.12X9
O60.13X0
O60.13X1
O60.13X2
O60.13X3
O60.13X4
O60.13X5
O60.13X9
O60.14X0
O60.14X1
O60.14X2
O60.14X3
O60.14X4
O60.14X5
O60.14X9
O60.22X0
O60.22X1
O60.22X2
O60.22X3
O60.22X4
O60.22X5
O60.22X9
O60.23X0
O60.23X1
O60.23X2
Antepartum hemorrhage w coag defect, unsp, first trimester
Antepartum hemorrhage w coag defect, unsp, second trimester
Antepartum hemorrhage w coag defect, unsp, third trimester
Antepartum hemorrhage with afibrinogenemia, first trimester
Antepartum hemorrhage with afibrinogenemia, second trimester
Antepartum hemorrhage with afibrinogenemia, third trimester
Antepart hemorrhage w dissem intravasc coag, first trimester
Antepart hemor w dissem intravasc coag, second trimester
Antepart hemorrhage w dissem intravasc coag, third trimester
Antepartum hemorrhage w oth coag defect, first trimester
Antepartum hemorrhage w oth coag defect, second trimester
Antepartum hemorrhage w oth coag defect, third trimester
Other antepartum hemorrhage, first trimester
Other antepartum hemorrhage, second trimester
Other antepartum hemorrhage, third trimester
Antepartum hemorrhage, unspecified, first trimester
Antepartum hemorrhage, unspecified, second trimester
Antepartum hemorrhage, unspecified, third trimester
Post-term pregnancy
Preterm labor second tri w preterm delivery second tri, unsp
Preterm labor second tri w preterm del second tri, fetus 1
Preterm labor second tri w preterm del second tri, fetus 2
Preterm labor second tri w preterm del second tri, fetus 3
Preterm labor second tri w preterm del second tri, fetus 4
Preterm labor second tri w preterm del second tri, fetus 5
Preterm labor second tri w preterm delivery second tri, oth
Preterm labor second tri w preterm delivery third tri, unsp
Preterm labor second tri w preterm del third tri, fetus 1
Preterm labor second tri w preterm del third tri, fetus 2
Preterm labor second tri w preterm del third tri, fetus 3
Preterm labor second tri w preterm del third tri, fetus 4
Preterm labor second tri w preterm del third tri, fetus 5
Preterm labor second tri w preterm delivery third tri, oth
Preterm labor third tri w preterm delivery third tri, unsp
Preterm labor third tri w preterm del third tri, fetus 1
Preterm labor third tri w preterm del third tri, fetus 2
Preterm labor third tri w preterm del third tri, fetus 3
Preterm labor third tri w preterm del third tri, fetus 4
Preterm labor third tri w preterm del third tri, fetus 5
Preterm labor third tri w preterm delivery third tri, oth
Term delivery w preterm labor, second trimester, unsp
Term delivery with preterm labor, second trimester, fetus 1
Term delivery with preterm labor, second trimester, fetus 2
Term delivery with preterm labor, second trimester, fetus 3
Term delivery with preterm labor, second trimester, fetus 4
Term delivery with preterm labor, second trimester, fetus 5
Term delivery with preterm labor, second trimester, other fetus
Term delivery w preterm labor, third trimester, unsp
Term delivery with preterm labor, third trimester, fetus 1
Term delivery with preterm labor, third trimester, fetus 2
O60.23X3
O60.23X4
Term delivery with preterm labor, third trimester, fetus 3
Term delivery with preterm labor, third trimester, fetus 4
PC v2014A
296
O60.23X5
O60.23X9
O61.0
O61.1
O61.8
O61.9
O62.0
O62.1
O62.2
O62.3
O62.4
O62.8
O62.9
O63.0
O63.1
O63.2
O63.9
O64.0XX0
O64.0XX1
O64.0XX2
O64.0XX3
O64.0XX4
O64.0XX5
O64.0XX9
O64.1XX0
O64.1XX1
O64.1XX2
O64.1XX3
O64.1XX4
O64.1XX5
O64.1XX9
O64.2XX0
O64.2XX1
O64.2XX2
O64.2XX3
O64.2XX4
O64.2XX5
O64.2XX9
O64.3XX0
O64.3XX1
O64.3XX2
O64.3XX3
O64.3XX4
O64.3XX5
O64.3XX9
O64.4XX0
O64.4XX1
O64.4XX2
O64.4XX3
O64.4XX4
Term delivery with preterm labor, third trimester, fetus 5
Term delivery with preterm labor, third trimester, oth fetus
Failed medical induction of labor
Failed instrumental induction of labor
Other failed induction of labor
Failed induction of labor, unspecified
Primary inadequate contractions
Secondary uterine inertia
Other uterine inertia
Precipitate labor
Hypertonic, incoordinate, and prolonged uterine contractions
Other abnormalities of forces of labor
Abnormality of forces of labor, unspecified
Prolonged first stage (of labor)
Prolonged second stage (of labor)
Delayed delivery of second twin, triplet, etc.
Long labor, unspecified
Obstructed labor due to incmpl rotation of fetal head, unsp
Obst labor due to incmpl rotation of fetal head, fetus 1
Obst labor due to incmpl rotation of fetal head, fetus 2
Obst labor due to incmpl rotation of fetal head, fetus 3
Obst labor due to incmpl rotation of fetal head, fetus 4
Obst labor due to incmpl rotation of fetal head, fetus 5
Obstructed labor due to incmpl rotation of fetal head, oth
Obstructed labor due to breech presentation, unsp
Obstructed labor due to breech presentation, fetus 1
Obstructed labor due to breech presentation, fetus 2
Obstructed labor due to breech presentation, fetus 3
Obstructed labor due to breech presentation, fetus 4
Obstructed labor due to breech presentation, fetus 5
Obstructed labor due to breech presentation, other fetus
Obstructed labor due to face presentation, unspec
Obstructed labor due to face presentation, fetus 1
Obstructed labor due to face presentation, fetus 2
Obstructed labor due to face presentation, fetus 3
Obstructed labor due to face presentation, fetus 4
Obstructed labor due to face presentation, fetus 5
Obstructed labor due to face presentation, other fetus
Obstructed labor due to brow presentation, unsp
Obstructed labor due to brow presentation, fetus 1
Obstructed labor due to brow presentation, fetus 2
Obstructed labor due to brow presentation, fetus 3
Obstructed labor due to brow presentation, fetus 4
Obstructed labor due to brow presentation, fetus 5
Obstructed labor due to brow presentation, other fetus
Obstructed labor due to shoulder presentation, unsp
Obstructed labor due to shoulder presentation, fetus 1
Obstructed labor due to shoulder presentation, fetus 2
Obstructed labor due to shoulder presentation, fetus 3
Obstructed labor due to shoulder presentation, fetus 4
O64.4XX5
O64.4XX9
Obstructed labor due to shoulder presentation, fetus 5
Obstructed labor due to shoulder presentation, other fetus
PC v2014A
297
O64.5XX0
O64.5XX1
O64.5XX2
O64.5XX3
O64.5XX4
O64.5XX5
O64.5XX9
O64.8XX0
O64.8XX1
O64.8XX2
O64.8XX3
O64.8XX4
O64.8XX5
O64.8XX9
O64.9XX0
O64.9XX1
O64.9XX2
O64.9XX3
O64.9XX4
O64.9XX5
O64.9XX9
O65.0
O65.1
O65.2
O65.3
O65.4
O65.5
O65.8
O65.9
O66.0
O66.1
O66.2
O66.3
O66.40
O66.41
O66.5
O66.6
O66.8
O66.9
O67.0
O67.8
O67.9
O68
O69.0XX0
O69.0XX1
O69.0XX2
O69.0XX3
O69.0XX4
O69.0XX5
O69.0XX9
O69.1XX0
Obstructed labor due to compound presentation, unsp
Obstructed labor due to compound presentation, fetus 1
Obstructed labor due to compound presentation, fetus 2
Obstructed labor due to compound presentation, fetus 3
Obstructed labor due to compound presentation, fetus 4
Obstructed labor due to compound presentation, fetus 5
Obstructed labor due to compound presentation, other fetus
Obstructed labor due to other malposition and malpresentation, unsp
Obstructed labor due to oth malpos and malpresent, fetus 1
Obstructed labor due to oth malpos and malpresent, fetus 2
Obstructed labor due to oth malpos and malpresent, fetus 3
Obstructed labor due to oth malpos and malpresent, fetus 4
Obstructed labor due to oth malpos and malpresent, fetus 5
Obstructed labor due to oth malposition and malpresent, oth
Obstructed labor due to malpos and malpresent, unsp, unsp
Obstructed labor due to malpos and malpresent, unsp, fetus 1
Obstructed labor due to malpos and malpresent, unsp, fetus 2
Obstructed labor due to malpos and malpresent, unsp, fetus 3
Obstructed labor due to malpos and malpresent, unsp, fetus 4
Obstructed labor due to malpos and malpresent, unsp, fetus 5
Obstructed labor due to malpos and malpresent, unsp, oth
Obstructed labor due to deformed pelvis
Obstructed labor due to generally contracted pelvis
Obstructed labor due to pelvic inlet contraction
Obst labor due to pelvic outlet and mid-cavity contrctn
Obstructed labor due to fetopelvic disproportion, unsp
Obstructed labor due to abnlt of maternal pelvic organs
Obstructed labor due to other maternal pelvic abnormalities
Obstructed labor due to maternal pelvic abnormality, unsp
Obstructed labor due to shoulder dystocia
Obstructed labor due to locked twins
Obstructed labor due to unusually large fetus
Obstructed labor due to other abnormalities of fetus
Failed trial of labor, unspecified
Failed attempt vaginal birth after previous cesarean del
Attempted application of vacuum extractor and forceps
Obstructed labor due to other multiple fetuses
Other specified obstructed labor
Obstructed labor, unspecified
Intrapartum hemorrhage with coagulation defect
Other intrapartum hemorrhage
Intrapartum hemorrhage, unspecified
Labor and delivery complicated by abnormality of fetal acid-base balance
Labor and delivery complicated by prolapse of cord, unsp
Labor and delivery complicated by prolapse of cord, fetus 1
Labor and delivery complicated by prolapse of cord, fetus 2
Labor and delivery complicated by prolapse of cord, fetus 3
Labor and delivery complicated by prolapse of cord, fetus 4
Labor and delivery complicated by prolapse of cord, fetus 5
Labor and delivery complicated by prolapse of cord, oth
Labor and delivery comp by cord around neck, w comprsn, unsp
O69.1XX1
Labor and del comp by cord around neck, w comprsn, fetus 1
PC v2014A
298
O69.1XX2
O69.1XX3
O69.1XX4
O69.1XX5
O69.1XX9
O69.2XX0
O69.2XX1
O69.2XX2
O69.2XX3
O69.2XX4
O69.2XX5
O69.2XX9
O69.3XX0
O69.3XX1
O69.3XX2
O69.3XX3
O69.3XX4
O69.3XX5
O69.3XX9
O69.4XX0
O69.4XX1
O69.4XX2
O69.4XX3
O69.4XX4
O69.4XX5
O69.4XX9
O69.5XX0
O69.5XX1
O69.5XX2
O69.5XX3
O69.5XX4
O69.5XX5
O69.5XX9
O69.81X0
O69.81X1
O69.81X2
O69.81X3
O69.81X4
O69.81X5
O69.81X9
O69.82X0
O69.82X1
O69.82X2
O69.82X3
O69.82X4
O69.82X5
O69.82X9
O69.89X0
O69.89X1
O69.89X2
O69.89X3
O69.89X4
Labor and del comp by cord around neck, w comprsn, fetus 2
Labor and del comp by cord around neck, w comprsn, fetus 3
Labor and del comp by cord around neck, w comprsn, fetus 4
Labor and del comp by cord around neck, w comprsn, fetus 5
Labor and delivery comp by cord around neck, w comprsn, oth
Labor and del comp by oth cord entangle, w comprsn, unsp
Labor and del comp by oth cord entangle, w comprsn, fetus 1
Labor and del comp by oth cord entangle, w comprsn, fetus 2
Labor and del comp by oth cord entangle, w comprsn, fetus 3
Labor and del comp by oth cord entangle, w comprsn, fetus 4
Labor and del comp by oth cord entangle, w comprsn, fetus 5
Labor and delivery comp by oth cord entangle, w comprsn, oth
Labor and delivery complicated by short cord, unsp
Labor and delivery complicated by short cord, fetus 1
Labor and delivery complicated by short cord, fetus 2
Labor and delivery complicated by short cord, fetus 3
Labor and delivery complicated by short cord, fetus 4
Labor and delivery complicated by short cord, fetus 5
Labor and delivery complicated by short cord, other fetus
Labor and delivery complicated by vasa previa, not applicable or unspecified
Labor and delivery complicated by vasa previa, fetus 1
Labor and delivery complicated by vasa previa, fetus 2
Labor and delivery complicated by vasa previa, fetus 3
Labor and delivery complicated by vasa previa, fetus 4
Labor and delivery complicated by vasa previa, fetus 5
Labor and delivery complicated by vasa previa, other fetus
Labor and delivery comp by vascular lesion of cord, unsp
Labor and delivery comp by vascular lesion of cord, fetus 1
Labor and delivery comp by vascular lesion of cord, fetus 2
Labor and delivery comp by vascular lesion of cord, fetus 3
Labor and delivery comp by vascular lesion of cord, fetus 4
Labor and delivery comp by vascular lesion of cord, fetus 5
Labor and delivery comp by vascular lesion of cord, oth
Labor and del comp by cord around neck, w/o comprsn, unsp
Labor and del comp by cord around neck, w/o comprsn, fetus 1
Labor and del comp by cord around neck, w/o comprsn, fetus 2
Labor and del comp by cord around neck, w/o comprsn, fetus 3
Labor and del comp by cord around neck, w/o comprsn, fetus 4
Labor and del comp by cord around neck, w/o comprsn, fetus 5
Labor and del comp by cord around neck, w/o comprsn, oth
Labor and del comp by oth cord entangle, w/o comprsn, unsp
Labor and del comp by oth cord entangle, w/o comprsn, fts1
Labor and del comp by oth cord entangle, w/o comprsn, fts2
Labor and del comp by oth cord entangle, w/o comprsn, fts3
Labor and del comp by oth cord entangle, w/o comprsn, fts4
Labor and del comp by oth cord entangle, w/o comprsn, fts5
Labor and del comp by oth cord entangle, w/o comprsn, oth
Labor and delivery complicated by oth cord comp, unsp
Labor and delivery complicated by oth cord comp, fetus 1
Labor and delivery complicated by oth cord comp, fetus 2
Labor and delivery complicated by oth cord comp, fetus 3
Labor and delivery complicated by oth cord comp, fetus 4
O69.89X5
Labor and delivery complicated by oth cord comp, fetus 5
PC v2014A
299
O69.89X9
O69.9XX0
O69.9XX1
O69.9XX2
O69.9XX3
O69.9XX4
O69.9XX5
O69.9XX9
O70.0
O70.1
O70.2
O70.3
O70.9
O71.02
O71.03
O71.1
O71.2
O71.3
O71.4
O71.5
O71.6
O71.7
O71.81
O71.82
O71.89
O71.9
O72.0
O72.1
O72.2
O72.3
O73.0
O73.1
O74.0
O74.1
O74.2
O74.3
O74.4
O74.5
O74.6
O74.7
O74.8
O74.9
O75.0
O75.1
O75.2
O75.3
O75.4
O75.5
O75.81
O75.89
O75.9
Labor and delivery complicated by oth cord comp, oth
Labor and delivery complicated by cord comp, unsp, unsp
Labor and delivery complicated by cord comp, unsp, fetus 1
Labor and delivery complicated by cord comp, unsp, fetus 2
Labor and delivery complicated by cord comp, unsp, fetus 3
Labor and delivery complicated by cord comp, unsp, fetus 4
Labor and delivery complicated by cord comp, unsp, fetus 5
Labor and delivery complicated by cord comp, unsp, oth
First degree perineal laceration during delivery
Second degree perineal laceration during delivery
Third degree perineal laceration during delivery
Fourth degree perineal laceration during delivery
Perineal laceration during delivery, unspecified
Rupture of uterus before onset of labor, second trimester
Rupture of uterus before onset of labor, third trimester
Rupture of uterus during labor
Postpartum inversion of uterus
Obstetric laceration of cervix
Obstetric high vaginal laceration alone
Other obstetric injury to pelvic organs
Obstetric damage to pelvic joints and ligaments
Obstetric hematoma of pelvis
Laceration of uterus, not elsewhere classified
Other specified trauma to perineum and vulva
Other specified obstetric trauma
Obstetric trauma, unspecified
Third-stage hemorrhage
Other immediate postpartum hemorrhage
Delayed and secondary postpartum hemorrhage
Postpartum coagulation defects
Retained placenta without hemorrhage
Retained portions of placenta and membranes, w/o hemorrhage
Aspirat pneumonitis due to anesth during labor and delivery
Oth pulmonary comp of anesthesia during labor and delivery
Cardiac comp of anesthesia during labor and delivery
Cnsl complications of anesthesia during labor and delivery
Toxic reaction to local anesthesia during labor and delivery
Spinal and epidur anesthesia-induced hdache dur labr and del
Oth comp of spinal and epidural anesth during labor and del
Failed or difficult intubation for anesth dur labor and del
Other complications of anesthesia during labor and delivery
Complication of anesthesia during labor and delivery, unsp
Maternal distress during labor and delivery
Shock during or following labor and delivery
Pyrexia during labor, not elsewhere classified
Other infection during labor
Other complications of obstetric surgery and procedures
Delayed delivery after artificial rupture of membranes
Maternal exhaustion complicating labor and delivery
Other specified complications of labor and delivery
Complication of labor and delivery, unspecified
O76
Abnlt in fetal heart rate and rhythm comp labor and delivery
PC v2014A
300
O77.0
O77.1
O77.8
O77.9
O80
O82
O85
O86.0
O86.12
O86.4
O86.81
O86.89
O87.0
O87.1
O87.2
O87.3
O87.4
O87.8
O87.9
O88.011
O88.012
O88.013
O88.02
O88.03
O88.111
O88.112
O88.113
O88.12
O88.13
O88.211
O88.212
O88.213
O88.22
O88.23
O88.311
O88.312
O88.313
O88.32
O88.33
O88.811
O88.812
O88.813
O88.82
O88.83
O89.09
O89.8
O89.9
O90.0
O90.1
O90.2
O90.4
Labor and delivery complicated by meconium in amniotic fluid
Fetal stress in labor or delivery due to drug administration
Labor and delivery comp by oth evidence of fetal stress
Labor and delivery complicated by fetal stress, unspecified
Encounter for full-term uncomplicated delivery
Encounter for cesarean delivery without indication
Puerperal sepsis
Infection of obstetric surgical wound
Endometritis following delivery
Pyrexia of unknown origin following delivery
Puerperal septic thrombophlebitis
Other specified puerperal infections
Superficial thrombophlebitis in the puerperium
Deep phlebothrombosis in the puerperium
Hemorrhoids in the puerperium
Cerebral venous thrombosis in the puerperium
Varicose veins of lower extremity in the puerperium
Other venous complications in the puerperium
Venous complication in the puerperium, unspecified
Air embolism in pregnancy, first trimester
Air embolism in pregnancy, second trimester
Air embolism in pregnancy, third trimester
Air embolism in childbirth
Air embolism in the puerperium
Amniotic fluid embolism in pregnancy, first trimester
Amniotic fluid embolism in pregnancy, second trimester
Amniotic fluid embolism in pregnancy, third trimester
Amniotic fluid embolism in childbirth
Amniotic fluid embolism in the puerperium
Thromboembolism in pregnancy, first trimester
Thromboembolism in pregnancy, second trimester
Thromboembolism in pregnancy, third trimester
Thromboembolism in childbirth
Thromboembolism in the puerperium
Pyemic and septic embolism in pregnancy, first trimester
Pyemic and septic embolism in pregnancy, second trimester
Pyemic and septic embolism in pregnancy, third trimester
Pyemic and septic embolism in childbirth
Pyemic and septic embolism in the puerperium
Other embolism in pregnancy, first trimester
Other embolism in pregnancy, second trimester
Other embolism in pregnancy, third trimester
Other embolism in childbirth
Other embolism in the puerperium
Oth pulmonary comp of anesthesia during the puerperium
Other complications of anesthesia during the puerperium
Complication of anesthesia during the puerperium, unsp
Disruption of cesarean delivery wound
Disruption of perineal obstetric wound
Hematoma of obstetric wound
Postpartum acute kidney failure
O90.5
O90.6
Postpartum thyroiditis
Postpartum mood disturbance
PC v2014A
301
O90.89
O90.9
O91.011
O91.012
O91.013
O91.02
O91.111
O91.112
O91.113
O91.12
O91.211
O91.212
O91.213
O91.22
O91.23
O92.011
O92.012
O92.013
O92.03
O92.111
O92.112
O92.113
O92.13
O92.20
O92.29
O92.3
O92.5
O92.6
O92.70
O92.79
O98.011
O98.012
O98.013
O98.02
O98.03
O98.111
O98.112
O98.113
O98.12
O98.13
O98.211
O98.212
O98.213
O98.22
O98.23
O98.311
O98.312
O98.313
O98.32
O98.33
Oth complications of the puerperium, NEC
Complication of the puerperium, unspecified
Infection of nipple associated w pregnancy, first trimester
Infection of nipple associated w pregnancy, second trimester
Infection of nipple associated with pregnancy, third trimester
Infection of nipple associated with the puerperium
Abscess of breast associated with pregnancy, first trimester
Abscess of breast associated w pregnancy, second trimester
Abscess of breast associated with pregnancy, third trimester
Abscess of breast associated with the puerperium
Nonpurulent mastitis associated w pregnancy, first trimester
Nonpurulent mastitis assoc w pregnancy, second trimester
Nonpurulent mastitis associated w pregnancy, third trimester
Nonpurulent mastitis associated with the puerperium
Nonpurulent mastitis associated with lactation
Retracted nipple associated with pregnancy, first trimester
Retracted nipple associated with pregnancy, second trimester
Retracted nipple associated with pregnancy, third trimester
Retracted nipple associated with lactation
Cracked nipple associated with pregnancy, first trimester
Cracked nipple associated with pregnancy, second trimester
Cracked nipple associated with pregnancy, third trimester
Cracked nipple associated with lactation
Unsp disorder of breast assoc w pregnancy and the puerperium
Oth disorders of breast assoc w pregnancy and the puerperium
Agalactia
Suppressed lactation
Galactorrhea
Unspecified disorders of lactation
Other disorders of lactation
Tuberculosis complicating pregnancy, first trimester
Tuberculosis complicating pregnancy, second trimester
Tuberculosis complicating pregnancy, third trimester
Tuberculosis complicating childbirth
Tuberculosis complicating the puerperium
Syphilis complicating pregnancy, first trimester
Syphilis complicating pregnancy, second trimester
Syphilis complicating pregnancy, third trimester
Syphilis complicating childbirth
Syphilis complicating the puerperium
Gonorrhea complicating pregnancy, first trimester
Gonorrhea complicating pregnancy, second trimester
Gonorrhea complicating pregnancy, third trimester
Gonorrhea complicating childbirth
Gonorrhea complicating the puerperium
Oth infect w sexl mode of transmiss comp preg, first tri
Oth infect w sexl mode of transmiss comp preg, second tri
Oth infect w sexl mode of transmiss comp preg, third tri
Oth infections w sexl mode of transmiss comp childbirth
Oth infections w sexl mode of transmiss comp the puerperium
O98.411
O98.412
O98.413
Viral hepatitis complicating pregnancy, first trimester
Viral hepatitis complicating pregnancy, second trimester
Viral hepatitis complicating pregnancy, third trimester
PC v2014A
302
O98.42
O98.43
O98.511
O98.512
O98.513
O98.52
O98.53
O98.611
O98.612
O98.613
O98.62
O98.63
O98.711
O98.712
O98.713
O98.72
O98.811
O98.812
O98.813
O98.82
O98.83
O98.911
O98.912
O98.913
O98.92
O98.93
O99.011
O99.012
O99.013
O99.02
O99.03
O99.111
O99.112
O99.113
O99.12
O99.211
O99.212
O99.213
O99.214
O99.215
O99.281
O99.282
O99.283
O99.284
O99.311
O99.312
O99.313
O99.314
O99.321
O99.322
O99.323
O99.324
O99.325
PC v2014A
Viral hepatitis complicating childbirth
Viral hepatitis complicating the puerperium
Other viral diseases complicating pregnancy, first trimester
Oth viral diseases complicating pregnancy, second trimester
Other viral diseases complicating pregnancy, third trimester
Other viral diseases complicating childbirth
Other viral diseases complicating the puerperium
Protozoal diseases complicating pregnancy, first trimester
Protozoal diseases complicating pregnancy, second trimester
Protozoal diseases complicating pregnancy, third trimester
Protozoal diseases complicating childbirth
Protozoal diseases complicating the puerperium
Human immunodef virus disease comp preg, first trimester
Human immunodef virus disease comp preg, second trimester
Human immunodef virus disease comp preg, third trimester
Human immunodeficiency virus [HIV] disease complicating childbirth
Oth maternal infec/parastc diseases comp preg, first tri
Oth maternal infec/parastc diseases comp preg, second tri
Oth maternal infec/parastc diseases comp preg, third tri
Oth maternal infec/parastc diseases complicating childbirth
Oth maternal infec/parastc diseases comp the puerperium
Unsp maternal infec/parastc disease comp preg, first tri
Unsp maternal infec/parastc disease comp preg, second tri
Unsp maternal infec/parastc disease comp preg, third tri
Unsp maternal infec/parastc disease complicating childbirth
Unsp maternal infec/parastc disease comp the puerperium
Anemia complicating pregnancy, first trimester
Anemia complicating pregnancy, second trimester
Anemia complicating pregnancy, third trimester
Anemia complicating childbirth
Anemia complicating the puerperium
Oth dis of bld/bld-form org/immun mechnsm comp preg, 1st tri
Oth dis of bld/bld-form org/immun mechnsm comp preg, 2nd tri
Oth dis of bld/bld-form org/immun mechnsm comp preg, 3rd tri
Oth dis of the bld/bld-form org/immun mechnsm comp chldbrth
Obesity complicating pregnancy, first trimester
Obesity complicating pregnancy, second trimester
Obesity complicating pregnancy, third trimester
Obesity complicating childbirth
Obesity complicating the puerperium
Endo, nutritional and metab diseases comp preg, first tri
Endo, nutritional and metab diseases comp preg, second tri
Endo, nutritional and metab diseases comp preg, third tri
Endocrine, nutritional and metabolic diseases comp chldbrth
Alcohol use complicating pregnancy, first trimester
Alcohol use complicating pregnancy, second trimester
Alcohol use complicating pregnancy, third trimester
Alcohol use complicating childbirth
Drug use complicating pregnancy, first trimester
Drug use complicating pregnancy, second trimester
Drug use complicating pregnancy, third trimester
Drug use complicating childbirth
Drug use complicating the puerperium
303
O99.331
O99.332
O99.333
O99.334
O99.335
O99.341
O99.342
O99.343
O99.344
O99.345
O99.351
O99.352
O99.353
O99.354
O99.355
O99.411
O99.412
O99.413
O99.42
O99.511
O99.512
O99.513
O99.52
O99.611
O99.612
O99.613
O99.62
O99.711
O99.712
O99.713
O99.72
O99.810
O99.814
O99.815
O99.824
O99.830
O99.834
O99.841
O99.842
O99.843
O99.844
O99.845
O9A.111
O9A.112
O9A.113
O9A.12
O9A.211
O9A.212
O9A.213
Smoking (tobacco) complicating pregnancy, first trimester
Smoking (tobacco) complicating pregnancy, second trimester
Smoking (tobacco) complicating pregnancy, third trimester
Smoking (tobacco) complicating childbirth
Smoking (tobacco) complicating the puerperium
Oth mental disorders complicating pregnancy, first trimester
Oth mental disorders comp pregnancy, second trimester
Oth mental disorders complicating pregnancy, third trimester
Other mental disorders complicating childbirth
Other mental disorders complicating the puerperium
Diseases of the nervous sys comp pregnancy, first trimester
Diseases of the nervous sys comp pregnancy, second trimester
Diseases of the nervous sys comp pregnancy, third trimester
Diseases of the nervous system complicating childbirth
Diseases of the nervous system complicating the puerperium
Diseases of the circ sys comp pregnancy, first trimester
Diseases of the circ sys comp pregnancy, second trimester
Diseases of the circ sys comp pregnancy, third trimester
Diseases of the circulatory system complicating childbirth
Diseases of the resp sys comp pregnancy, first trimester
Diseases of the resp sys comp pregnancy, second trimester
Diseases of the resp sys comp pregnancy, third trimester
Diseases of the respiratory system complicating childbirth
Diseases of the dgstv sys comp pregnancy, first trimester
Diseases of the dgstv sys comp pregnancy, second trimester
Diseases of the dgstv sys comp pregnancy, third trimester
Diseases of the digestive system complicating childbirth
Diseases of the skin, subcu comp pregnancy, first trimester
Diseases of the skin, subcu comp pregnancy, second trimester
Diseases of the skin, subcu comp pregnancy, third trimester
Diseases of the skin, subcu complicating childbirth
Abnormal glucose complicating pregnancy
Abnormal glucose complicating childbirth
Abnormal glucose complicating the puerperium
Streptococcus B carrier state complicating childbirth
Other infection carrier state complicating pregnancy
Other infection carrier state complicating childbirth
Bariatric surgery status comp pregnancy, first trimester
Bariatric surgery status comp pregnancy, second trimester
Bariatric surgery status comp pregnancy, third trimester
Bariatric surgery status complicating childbirth
Bariatric surgery status complicating the puerperium
Malignant neoplasm complicating pregnancy, first trimester
Malignant neoplasm complicating pregnancy, second trimester
Malignant neoplasm complicating pregnancy, third trimester
Malignant neoplasm complicating childbirth
Inj/poisn/oth conseq of external causes comp preg, first tri
Inj/poisn/oth conseq of extrn causes comp preg, second tri
Inj/poisn/oth conseq of external causes comp preg, third tri
O9A.22
O9A.311
O9A.312
Inj/poisn/oth conseq of external causes comp childbirth
Physical abuse complicating pregnancy, first trimester
Physical abuse complicating pregnancy, second trimester
PC v2014A
304
O9A.313
O9A.32
O9A.411
O9A.412
O9A.413
O9A.42
O9A.511
O9A.512
O9A.513
O9A.52
P36.0
P36.10
P36.19
P36.2
P36.30
P36.39
P36.4
P36.5
P36.8
P36.9
R78.81
Physical abuse complicating pregnancy, third trimester
Physical abuse complicating childbirth
Sexual abuse complicating pregnancy, first trimester
Sexual abuse complicating pregnancy, second trimester
Sexual abuse complicating pregnancy, third trimester
Sexual abuse complicating childbirth
Psychological abuse complicating pregnancy, first trimester
Psychological abuse complicating pregnancy, second trimester
Psychological abuse complicating pregnancy, third trimester
Psychological abuse complicating childbirth
Sepsis of newborn due to streptococcus, group B
Sepsis of newborn due to unspecified streptococci
Sepsis of newborn due to other streptococci
Sepsis of newborn due to Staphylococcus aureus
Sepsis of newborn due to unspecified staphylococci
Sepsis of newborn due to other staphylococci
Sepsis of newborn due to Escherichia coli
Sepsis of newborn due to anaerobes
Other bacterial sepsis of newborn
Bacterial sepsis of newborn, unspecified
Bacteremia
Table 11.02 Normal Delivery and Other Indications for Care
Short Description
ICD-10-CM Code
043.021
Fetus-to-fetus placental transfuse syndrome, first trimester
043.022
Fetus-to-fetus placental transfuse syndrome, second trimester
043.023
Fetus-to-fetus placental transfuse syndrome, third trimester
O09.511
Supervision of elderly primigravida, first trimester
O09.512
Supervision of elderly primigravida, second trimester
O09.513
Supervision of elderly primigravida, third trimester
O09.521
O09.522
O09.523
O09.941
O09.942
O09.943
O30.001
O30.002
O30.003
O30.011
O30.012
O30.013
O30.031
O30.032
O30.033
O30.041
O30.042
O30.043
O30.091
O30.092
Supervision of elderly multigravida, first trimester
Supervision of elderly multigravida, second trimester
Supervision of elderly multigravida, third trimester
Suprvsn of pregnancy w grand multiparity, first trimester
Suprvsn of pregnancy w grand multiparity, second trimester
Suprvsn of pregnancy w grand multiparity, third trimester
Twin preg, unsp num plcnta & amnio sacs, first trimester
Twin preg, unsp num plcnta & amnio sacs, second trimester
Twin preg, unsp num plcnta & amnio sacs, third trimester
Twin pregnancy, monochorionic/monoamniotic, first trimester
Twin pregnancy, monochorionic/monoamniotic, second trimester
Twin pregnancy, monochorionic/monoamniotic, third trimester
Twin pregnancy, monochorionic/diamniotic, first trimester
Twin pregnancy, monochorionic/diamniotic, second trimester
Twin pregnancy, monochorionic/diamniotic, third trimester
Twin pregnancy, dichorionic/diamniotic, first trimester
Twin pregnancy, dichorionic/diamniotic, second trimester
Twin pregnancy, dichorionic/diamniotic, third trimester
Twin preg, unable to dtrm num plcnta & amnio sacs, first tri
Twin preg, unable to dtrm num plcnta & amnio sacs, 2nd tri
PC v2014A
305
O30.093
O30.101
O30.102
O30.103
O30.111
O30.112
O30.113
O30.121
O30.122
O30.123
O30.13X2
O30.13X3
O30.13X4
O30.13X5
Twin preg, unable to dtrm num plcnta & amnio sacs, third tri
Triplet preg, unsp num plcnta & amnio sacs, first trimester
Triplet preg, unsp num plcnta & amnio sacs, second trimester
Triplet preg, unsp num plcnta & amnio sacs, third trimester
Triplet preg w two or more monochorionic fetuses, first trimester
Triplet preg w two or more monochorionic fetuses, second trimester
Triplet preg w two or more monochorionic fetuses, third trimester
Triplet preg w two or more monoamniotic fetuses, first trimester
Triplet preg w two or more monoamniotic fetuses, second trimester
Triplet preg w two or more monoamniotic fetuses, third trimester
Cont preg aft spon abort of one fts or more, 3rd tri, fts2
Cont preg aft spon abort of one fts or more, 3rd tri, fts3
Cont preg aft spon abort of one fts or more, 3rd tri, fts4
Cont preg aft spon abort of one fts or more, 3rd tri, fts5
O30.13X9
O30.191
O30.192
O30.193
O30.201
O30.202
O30.203
O30.211
O30.212
O30.213
O30.221
O30.222
O30.223
O30.291
O30.292
O30.293
O30.801
O30.802
O30.803
O30.811
O30.812
O30.813
O30.821
O30.822
O30.823
O30.891
O30.892
O30.893
O30.91
Cont preg aft spon abort of one fts or more, 3rd tri, oth fts
Triplet preg, unable to dtrm num plcnta & amnio sacs, first trimester
Triplet preg, unable to dtrm num plcnta & amnio sacs, second trimester
Triplet preg, unable to dtrm num plcnta & amnio sacs, third trimester
Quad preg, unsp num plcnta & amnio sacs, first trimester
Quad preg, unsp num plcnta & amnio sacs, second trimester
Quad preg, unsp num plcnta & amnio sacs, third trimester
Quad preg w two or more monochorionic fetuses, first trimester
Quad preg w two or more monochorionic fetuses, second trimester
Quad preg w two or more monochorionic fetuses, third trimester
Quad preg w two or more monoamniotic fetuses, first trimester
Quad preg w two or more monoamniotic fetuses, second trimester
Quad preg w two or more monoamniotic fetuses, third trimester
Quad preg, unable to dtrm num plcnta & amnio sacs, first trimester
Quad preg, unable to dtrm num plcnta & amnio sacs, second trimester
Quad preg, unable to dtrm num plcnta & amnio sacs, third trimester
Oth multiple gest, unsp num plcnta and amnio sacs, first tri
Oth multiple gest, unsp num plcnta and amnio sacs, second tri
Oth multiple gest, unsp num plcnta and amnio sacs, third tri
Oth mult gest w two or more monochorionic fetuses, first tri
Oth mult gest w two or more monochorionic fetuses, 2nd tri
Oth mult gest w two or more monochorionic fetuses, third tri
Oth mult gest w two or more monoamniotic fetuses, first tri
Oth mult gest w two or more monoamniotic fetuses, second tri
Oth mult gest w two or more monoamniotic fetuses, third tri
Oth multiple gest, unable to dtrm num plcnta and amnio sacs, 1st tri
Oth multiple gest, unable to dtrm num plcnta and amnio sacs, 2nd tri
Oth multiple gest, unable to dtrm num plcnta and amnio sacs, 3rd tri
Multiple gestation, unspecified, first trimester
O30.92
O30.93
O31.11X0
O31.11X0
O31.11X0
O31.11X1
O31.11X1
O31.11X2
O31.11X2
Multiple gestation, unspecified, second trimester
Multiple gestation, unspecified, third trimester
Cont preg aft spon abort of one fts or more, first tri, unsp
Cont preg aft spon abort of one fts or more, first tri, unsp
Cont preg aft spon abort of one fts or more, first tri, unsp
Cont preg aft spon abort of one fts or more, first tri, fts1
Cont preg aft spon abort of one fts or more, first tri, fts1
Cont preg aft spon abort of one fts or more, first tri, fts2
Cont preg aft spon abort of one fts or more, first tri, fts2
PC v2014A
306
O31.11X3
O31.11X4
O31.11X5
O31.11X9
O31.12X0
O31.12X0
O31.12X1
O31.12X1
O31.12X2
O31.12X3
O31.12X4
O31.12X5
O31.12X9
O31.13X0
O31.13X1
O31.13X2
O31.21X0
O31.21X1
Cont preg aft spon abort of one fts or more, first tri, fts3
Cont preg aft spon abort of one fts or more, first tri, fts4
Cont preg aft spon abort of one fts or more, first tri, fts5
Cont preg aft spon abort of one fts or more, first tri, oth fts
Cont preg aft spon abort of one fetus or more, 2nd tri, unsp
Cont preg aft spon abort of one fts or more, 2nd tri, unsp
Cont preg aft spon abort of one fetus or more, 2nd tri, fts1
Cont preg aft spon abort of one fts or more, 2nd tri, fts1
Cont preg aft spon abort of one fetus or more, 2nd tri, fts2
Cont preg aft spon abort of one fts or more, 2nd tri, fts3
Cont preg aft spon abort of one fts or more, 2nd tri, fts4
Cont preg aft spon abort of one fts or more, 2nd tri, fts5
Cont preg aft spon abort of one fts or more, 2nd tri, oth fts
Cont preg aft spon abort of one fts or more, third tri, unsp
Cont preg aft spon abort of one fts or more, 3rd tri, fts1
Cont preg aft spon abort of one fts or more, third tri, fts2
Cont preg aft uterin dth of one fts or more, first tri, unsp
Cont preg aft uterin dth of one fts or more, first tri, fts1
O31.21X2
O31.21X3
O31.21X4
O31.21X5
O31.21X9
O31.22X0
O31.22X1
O31.22X2
O31.22X3
O31.22X4
O31.22X5
O31.22X9
O31.23X0
O31.23X0
O31.23X1
O31.23X2
O31.23X3
O31.23X4
O31.23X5
Cont preg aft uterin dth of one fts or more, first tri, fts2
Cont preg aft uterin dth of one fts or more, first tri, fts3
Cont preg aft uterin dth of one fts or more, first tri, fts4
Cont preg aft uterin dth of one fts or more, first tri, fts5
Cont preg aft uterin dth of one fts or more, first tri, oth fts
Cont preg aft uterin dth of one fts or more, 2nd tri, unsp
Cont preg aft uterin dth of one fetus or more, 2nd tri, fts1
Cont preg aft uterin dth of one fts or more, 2nd tri, fts2
Cont preg aft uterin dth of one fts or more, 2nd tri, fts3
Cont preg aft uterin dth of one fts or more, 2nd tri, fts4
Cont preg aft uterin dth of one fts or more, 2nd tri, fts5
Cont preg aft uterin dth of one fts or more, 2nd tri, oth fts
Cont preg aft uterin dth of one fts or more, third tri, unsp
Cont preg aft uterin dth of one fts or more, 3rd tri, unsp
Cont preg aft uterin dth of one fts or more, 3rd tri, fts1
Cont preg aft uterin dth of one fts or more, third tri, fts2
Cont preg aft uterin dth of one fts or more, 3rd tri, fts3
Cont preg aft uterin dth of one fts or more, 3rd tri, fts4
Cont preg aft uterin dth of one fts or more, 3rd tri, fts5
O31.23X9
O31.31X0
O31.31X1
O31.31X2
O31.31X3
O31.31X4
O31.31X5
O31.31X9
O31.32X0
O31.32X1
O31.32X2
O31.32X3
O31.32X4
O31.32X5
O31.32X9
Cont preg aft uterin dth of one fts or more, 3rd tri, oth fts
Cont preg aft elctv fetl rdct of 1 fts or more,1st tri, unsp
Cont preg aft elctv fetl rdct of 1 fts or more,1st tri, fts1
Cont preg aft elctv fetl rdct of 1 fts or more,1st tri, fts2
Cont preg aft elctv fetl rdct of 1 fts or more,1st tri, fts3
Cont preg aft elctv fetl rdct of 1 fts or more,1st tri, fts4
Cont preg aft elctv fetl rdct of 1 fts or more,1st tri, fts5
Cont preg aft elctv fetl rdct of 1 fts or more, 1st tri, oth
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, unsp
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts1
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts2
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts3
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts4
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts5
Cont preg aft elctv fetl rdct of 1 fts or more, 2nd tri, oth
PC v2014A
307
O31.33X0
O31.33X1
O31.33X2
O31.33X3
O31.33X4
O31.33X5
O31.33X9
O31.8X10
O31.8X11
O31.8X12
O31.8X13
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, unsp
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts1
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts2
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts3
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts4
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts5
Cont preg aft elctv fetl rdct of 1 fts or more, 3rd tri, oth
Oth comp specific to multiple gest, first tri, unsp
Oth comp specific to multiple gest, first trimester, fts1
Oth comp specific to multiple gest, first trimester, fts2
Oth comp specific to multiple gest, first trimester, fts3
O31.8X14
O31.8X15
O31.8X19
O31.8X20
O31.8X21
O31.8X22
O31.8X23
O31.8X24
O31.8X25
O31.8X29
O31.8X30
O31.8X31
O31.8X32
O31.8X33
O31.8X34
O31.8X35
O31.8X39
O32.0XX0
O32.0XX1
O32.0XX2
O32.0XX3
O32.0XX4
O32.0XX5
O32.0XX9
O32.1XX0
O32.1XX0
O32.1XX1
O32.1XX2
O32.1XX3
O32.1XX4
O32.1XX5
O32.1XX9
O32.2XX0
O32.2XX1
O32.2XX2
O32.2XX3
O32.2XX4
O32.2XX5
O32.2XX9
O32.3xx0
O32.3xx1
Oth comp specific to multiple gest, first trimester, fts4
Oth comp specific to multiple gest, first trimester, fts5
Oth comp specific to multiple gest, first trimester, oth fts
Oth comp specific to multiple gest, second tri, unsp
Oth comp specific to multiple gest, second tri, fetus 1
Oth comp specific to multiple gest, second tri, fetus 2
Oth comp specific to multiple gest, second tri, fetus 3
Oth comp specific to multiple gest, second tri, fetus 4
Oth comp specific to multiple gest, second tri, fetus 5
Oth comp specific to multiple gest, second trimester, oth
Oth comp specific to multiple gest, third trimester, unsp
Oth comp specific to multiple gest, third trimester, fetus 1
Oth comp specific to multiple gest, third trimester, fetus 2
Oth comp specific to multiple gest, third trimester, fetus 3
Oth comp specific to multiple gest, third trimester, fetus 4
Oth comp specific to multiple gest, third trimester, fetus 5
Oth comp specific to multiple gest, third trimester, oth
Maternal care for unstable lie, not applicable or unsp
Maternal care for unstable lie, fetus 1
Maternal care for unstable lie, fetus 2
Maternal care for unstable lie, fetus 3
Maternal care for unstable lie, fetus 4
Maternal care for unstable lie, fetus 5
Maternal care for unstable lie, other fetus
Maternal care for breech presentation, unsp
Maternal care for breech presentation, unsp
Maternal care for breech presentation, fetus 1
Maternal care for breech presentation, fetus 2
Maternal care for breech presentation, fetus 3
Maternal care for breech presentation, fetus 4
Maternal care for breech presentation, fetus 5
Maternal care for breech presentation, other fetus
Maternal care for transverse and oblique lie, unsp
Maternal care for transverse and oblique lie, fetus 1
Maternal care for transverse and oblique lie, fetus 2
Maternal care for transverse and oblique lie, fetus 3
Maternal care for transverse and oblique lie, fetus 4
Maternal care for transverse and oblique lie, fetus 5
Maternal care for transverse and oblique lie, other fetus
Maternal care for face, brow and chin presentation, unsp
Maternal care for face, brow and chin presentation, fetus 1
PC v2014A
308
O32.3xx2
O32.3xx3
O32.3xx4
O32.3xx5
Maternal care for face, brow and chin presentation, fetus 2
Maternal care for face, brow and chin presentation, fetus 3
Maternal care for face, brow and chin presentation, fetus 4
Maternal care for face, brow and chin presentation, fetus 5
O32.3xx9
O32.4XX0
O32.4XX1
O32.4XX2
O32.4XX3
O32.4XX4
O32.4XX5
O32.4XX9
O32.6XX0
O32.6XX1
O32.6XX2
O32.6XX3
O32.6XX4
O32.6XX5
O32.6XX9
O32.8XX0
O32.8XX1
O32.8XX2
O32.8XX3
O32.8XX4
O32.8XX5
O32.8XX9
O32.9XX0
O32.9XX1
O32.9XX2
O32.9XX3
O32.9XX4
O32.9XX5
O32.9XX9
O32.9XX9
O33.0
O33.1
O33.2
O33.3XX0
O33.3XX1
O33.3XX2
O33.3XX3
O33.3XX4
O33.3XX5
O33.3XX9
O33.4XX0
O33.4XX1
O33.4XX2
O33.4XX3
O33.4XX4
Maternal care for face, brow and chin presentation, oth
Maternal care for high head at term, not applicable or unsp
Maternal care for high head at term, fetus 1
Maternal care for high head at term, fetus 2
Maternal care for high head at term, fetus 3
Maternal care for high head at term, fetus 4
Maternal care for high head at term, fetus 5
Maternal care for high head at term, other fetus
Maternal care for compound presentation, unsp
Maternal care for compound presentation, fetus 1
Maternal care for compound presentation, fetus 2
Maternal care for compound presentation, fetus 3
Maternal care for compound presentation, fetus 4
Maternal care for compound presentation, fetus 5
Maternal care for compound presentation, other fetus
Maternal care for oth malpresentation of fetus, unsp
Maternal care for other malpresentation of fetus, fetus 1
Maternal care for other malpresentation of fetus, fetus 2
Maternal care for other malpresentation of fetus, fetus 3
Maternal care for other malpresentation of fetus, fetus 4
Maternal care for other malpresentation of fetus, fetus 5
Maternal care for oth malpresentation of fetus, other fetus
Maternal care for malpresentation of fetus, unsp, unsp
Maternal care for malpresentation of fetus, unsp, fetus 1
Maternal care for malpresentation of fetus, unsp, fetus 2
Maternal care for malpresentation of fetus, unsp, fetus 3
Maternal care for malpresentation of fetus, unsp, fetus 4
Maternal care for malpresentation of fetus, unsp, fetus 5
Maternal care for malpresentation of fetus, unsp, oth fetus
Maternal care for malpresentation of fetus, unsp, oth fetus
Matern care for disproprtn d/t deformity of matern pelv bone
Matern care for disproprtn d/t generally contracted pelvis
Maternal care for disproprtn due to inlet contrctn of pelvis
Maternal care for disproprtn d/t outlet contrctn of pelv, unsp
Maternal care for disproprtn d/t outlet contrctn of pelv, fts1
Maternal care for disproprtn d/t outlet contrctn of pelv, fts2
Maternal care for disproprtn d/t outlet contrctn of pelv, fts3
Maternal care for disproprtn d/t outlet contrctn of pelv, fts4
Maternal care for disproprtn d/t outlet contrctn of pelv, fts5
Maternal care for disproprtn d/t outlet contrctn of pelv, oth fts
Matern care for disproprtn of mix matern & fetl origin, unsp
Matern care for disproprtn of mix matern & fetl origin, fts1
Matern care for disproprtn of mix matern & fetl origin, fts2
Matern care for disproprtn of mix matern & fetl origin, fts3
Matern care for disproprtn of mix matern & fetl origin, fts4
O33.4XX5
O33.4XX9
O33.5XX0
Matern care for disproprtn of mix matern & fetl origin, fts5
Matern care for disproprtn of mix matern & fetl origin, oth
Matern care for disproprtn d/t unusually large fetus, unsp
PC v2014A
309
O33.5XX1
O33.5XX2
O33.5XX3
O33.5XX4
O33.5XX5
O33.5XX9
O33.6XX0
O33.6XX1
O33.6XX2
O33.6XX3
O33.6XX4
O33.6XX5
O33.6XX9
O33.7
O33.8
O33.9
O34.01
O34.01
Matern care for disproprtn d/t unusually large fetus, fts1
Matern care for disproprtn d/t unusually large fetus, fts2
Matern care for disproprtn d/t unusually large fetus, fts3
Matern care for disproprtn d/t unusually large fetus, fts4
Matern care for disproprtn d/t unusually large fetus, fts5
Matern care for disproprtn due to unusually large fetus, oth
Matern care for disproprtn due to hydrocephalic fetus, unsp
Matern care for disproprtn due to hydrocephalic fetus, fts1
Matern care for disproprtn due to hydrocephalic fetus, fts2
Matern care for disproprtn due to hydrocephalic fetus, fts3
Matern care for disproprtn due to hydrocephalic fetus, fts4
Matern care for disproprtn due to hydrocephalic fetus, fts5
Maternal care for disproprtn due to hydrocephalic fetus, oth
Maternal care for disproportion due to oth fetal deformities
Maternal care for disproportion of other origin
Maternal care for disproportion, unspecified
Maternal care for unsp congen malform of uterus, first tri
Maternal care for unsp congen malform of uterus, first tri
O34.02
O34.02
O34.03
O34.03
O34.11
O34.11
O34.12
O34.13
O34.21
O34.29
O34.31
O34.32
O34.33
O34.33
O34.41
O34.42
O34.43
O34.511
O34.512
O34.513
O34.521
O34.522
O34.523
O34.531
O34.532
O34.533
O34.591
O34.592
O34.593
O34.61
O34.62
O34.63
O34.71
O34.72
Maternal care for unsp congen malform of uterus, second tri
Maternal care for unsp congen malform of uterus, second tri
Maternal care for unsp congen malform of uterus, third tri
Maternal care for unsp congen malform of uterus, third tri
Maternal care for benign tumor of corpus uteri, first tri
Maternal care for benign tumor of corpus uteri, first tri
Maternal care for benign tumor of corpus uteri, second tri
Maternal care for benign tumor of corpus uteri, third tri
Maternal care for scar from previous cesarean delivery
Maternal care due to uterine scar from oth previous surgery
Maternal care for cervical incompetence, first trimester
Maternal care for cervical incompetence, second trimester
Maternal care for cervical incompetence, third trimester
Maternal care for cervical incompetence, third trimester
Maternal care for oth abnlt of cervix, first trimester
Maternal care for oth abnlt of cervix, second trimester
Maternal care for oth abnlt of cervix, third trimester
Maternal care for incarceration of gravid uterus, first tri
Maternal care for incarceration of gravid uterus, second tri
Maternal care for incarceration of gravid uterus, third tri
Maternal care for prolapse of gravid uterus, first tri
Maternal care for prolapse of gravid uterus, second tri
Maternal care for prolapse of gravid uterus, third tri
Maternal care for retroversion of gravid uterus, first tri
Maternal care for retroversion of gravid uterus, second tri
Maternal care for retroversion of gravid uterus, third tri
Maternal care for oth abnlt of gravid uterus, first tri
Maternal care for oth abnlt of gravid uterus, second tri
Maternal care for oth abnlt of gravid uterus, third tri
Maternal care for abnormality of vagina, first trimester
Maternal care for abnormality of vagina, second trimester
Maternal care for abnormality of vagina, third trimester
Maternal care for abnlt of vulva and perineum, first tri
Maternal care for abnlt of vulva and perineum, second tri
PC v2014A
310
O34.73
O34.81
O34.82
O34.83
O34.91
O34.92
O34.93
O35.0XX0
O35.0XX1
O35.0XX2
O35.0XX3
O35.0XX4
Maternal care for abnlt of vulva and perineum, third tri
Maternal care for oth abnlt of pelvic organs, first tri
Maternal care for oth abnlt of pelvic organs, second tri
Maternal care for oth abnlt of pelvic organs, third tri
Maternal care for abnlt of pelvic organ, unsp, first tri
Maternal care for abnlt of pelvic organ, unsp, second tri
Maternal care for abnlt of pelvic organ, unsp, third tri
Maternal care for (suspected) cnsl malform in fetus, unsp
Maternal care for (suspected) cnsl malform in fetus, fetus 1
Maternal care for (suspected) cnsl malform in fetus, fetus 2
Maternal care for (suspected) cnsl malform in fetus, fetus 3
Maternal care for (suspected) cnsl malform in fetus, fetus 4
O35.0XX5
O35.0XX9
O35.1XX0
O35.1XX1
O35.1XX2
O35.1XX3
O35.1XX4
O35.1XX5
O35.1XX9
O35.2XX0
O35.2XX1
O35.2XX2
O35.2XX3
O35.2XX4
O35.2XX5
O35.2XX9
O35.3XX0
O35.3XX1
O35.3XX2
O35.3XX3
O35.3XX4
O35.3XX5
O35.3XX9
O35.4XX0
O35.4XX1
O35.4XX2
O35.4XX3
O35.4XX4
O35.4XX5
O35.4XX9
O35.5XX0
O35.5XX1
O35.5XX2
O35.5XX3
O35.5XX4
O35.5XX5
O35.5XX9
O35.6XX0
O35.6XX1
O35.6XX2
Maternal care for (suspected) cnsl malform in fetus, fetus 5
Maternal care for (suspected) cnsl malform in fetus, oth
Maternal care for chromosomal abnormality in fetus, unsp
Maternal care for chromosomal abnormality in fetus, fetus 1
Maternal care for chromosomal abnormality in fetus, fetus 2
Maternal care for chromosomal abnormality in fetus, fetus 3
Maternal care for chromosomal abnormality in fetus, fetus 4
Maternal care for chromosomal abnormality in fetus, fetus 5
Maternal care for chromosomal abnormality in fetus, oth
Maternal care for hereditary disease in fetus, unsp
Maternal care for hereditary disease in fetus, fetus 1
Maternal care for hereditary disease in fetus, fetus 2
Maternal care for hereditary disease in fetus, fetus 3
Maternal care for hereditary disease in fetus, fetus 4
Maternal care for hereditary disease in fetus, fetus 5
Maternal care for hereditary disease in fetus, oth
Matern care for damag to fts from viral dis in mother, unsp
Matern care for damag to fts from viral dis in mother, fts1
Matern care for damag to fts from viral dis in mother, fts2
Matern care for damag to fts from viral dis in mother, fts3
Matern care for damag to fts from viral dis in mother, fts4
Matern care for damag to fts from viral dis in mother, fts5
Matern care for damag to fetus from viral dis in mother, oth
Maternal care for damage to fetus from alcohol, unsp
Maternal care for damage to fetus from alcohol, fetus 1
Maternal care for damage to fetus from alcohol, fetus 2
Maternal care for damage to fetus from alcohol, fetus 3
Maternal care for damage to fetus from alcohol, fetus 4
Maternal care for damage to fetus from alcohol, fetus 5
Maternal care for damage to fetus from alcohol, oth
Maternal care for (suspected) damage to fetus by drugs, unsp
Maternal care for damage to fetus by drugs, fetus 1
Maternal care for damage to fetus by drugs, fetus 2
Maternal care for damage to fetus by drugs, fetus 3
Maternal care for damage to fetus by drugs, fetus 4
Maternal care for damage to fetus by drugs, fetus 5
Maternal care for (suspected) damage to fetus by drugs, oth
Maternal care for damage to fetus by radiation, unsp
Maternal care for damage to fetus by radiation, fetus 1
Maternal care for damage to fetus by radiation, fetus 2
PC v2014A
311
O35.6XX3
O35.6XX4
O35.6XX5
O35.6XX9
O35.8XX0
Maternal care for damage to fetus by radiation, fetus 3
Maternal care for damage to fetus by radiation, fetus 4
Maternal care for damage to fetus by radiation, fetus 5
Maternal care for damage to fetus by radiation, oth
Maternal care for oth fetal abnormality and damage, unsp
O35.8XX1
O35.8XX2
O35.8XX3
O35.8XX4
O35.8XX5
O35.8XX9
O35.9XX0
O35.9XX1
O35.9XX2
O35.9XX3
O35.9XX4
O35.9XX5
O35.9XX9
O36.0110
O36.0111
O36.0112
O36.0113
O36.0114
O36.0115
O36.0119
O36.0120
O36.0121
O36.0122
O36.0123
O36.0124
O36.0125
O36.0129
O36.0130
O36.0131
O36.0132
O36.0133
O36.0134
O36.0135
O36.0139
O36.0910
O36.0911
O36.0912
O36.0913
O36.0914
O36.0915
O36.0919
O36.0920
O36.0921
O36.0922
O36.0923
O36.0924
Maternal care for oth fetal abnormality and damage, fetus 1
Maternal care for oth fetal abnormality and damage, fetus 2
Maternal care for oth fetal abnormality and damage, fetus 3
Maternal care for oth fetal abnormality and damage, fetus 4
Maternal care for oth fetal abnormality and damage, fetus 5
Maternal care for oth fetal abnormality and damage, oth
Maternal care for fetal abnormality and damage, unsp, unsp
Maternal care for fetal abnlt and damage, unsp, fetus 1
Maternal care for fetal abnlt and damage, unsp, fetus 2
Maternal care for fetal abnlt and damage, unsp, fetus 3
Maternal care for fetal abnlt and damage, unsp, fetus 4
Maternal care for fetal abnlt and damage, unsp, fetus 5
Maternal care for fetal abnormality and damage, unsp, oth
Maternal care for anti-D antibodies, first trimester, unsp
Maternal care for anti-D antibodies, first tri, fetus 1
Maternal care for anti-D antibodies, first tri, fetus 2
Maternal care for anti-D antibodies, first tri, fetus 3
Maternal care for anti-D antibodies, first tri, fetus 4
Maternal care for anti-D antibodies, first tri, fetus 5
Maternal care for anti-D antibodies, first trimester, oth
Maternal care for anti-D antibodies, second trimester, unsp
Maternal care for anti-D antibodies, second tri, fetus 1
Maternal care for anti-D antibodies, second tri, fetus 2
Maternal care for anti-D antibodies, second tri, fetus 3
Maternal care for anti-D antibodies, second tri, fetus 4
Maternal care for anti-D antibodies, second tri, fetus 5
Maternal care for anti-D antibodies, second trimester, oth
Maternal care for anti-D antibodies, third trimester, unsp
Maternal care for anti-D antibodies, third tri, fetus 1
Maternal care for anti-D antibodies, third tri, fetus 2
Maternal care for anti-D antibodies, third tri, fetus 3
Maternal care for anti-D antibodies, third tri, fetus 4
Maternal care for anti-D antibodies, third tri, fetus 5
Maternal care for anti-D antibodies, third trimester, oth
Maternal care for oth rhesus isoimmun, first trimester, unsp
Maternal care for oth rhesus isoimmun, first tri, fetus 1
Maternal care for oth rhesus isoimmun, first tri, fetus 2
Maternal care for oth rhesus isoimmun, first tri, fetus 3
Maternal care for oth rhesus isoimmun, first tri, fetus 4
Maternal care for oth rhesus isoimmun, first tri, fetus 5
Maternal care for oth rhesus isoimmun, first trimester, oth
Maternal care for oth rhesus isoimmun, second tri, unsp
Maternal care for oth rhesus isoimmun, second tri, fetus 1
Maternal care for oth rhesus isoimmun, second tri, fetus 2
Maternal care for oth rhesus isoimmun, second tri, fetus 3
Maternal care for oth rhesus isoimmun, second tri, fetus 4
O36.0925
Maternal care for oth rhesus isoimmun, second tri, fetus 5
PC v2014A
312
O36.0929
O36.0930
O36.0931
O36.0932
O36.0933
O36.0934
O36.0935
O36.0939
O36.1110
O36.1111
O36.1112
O36.1113
O36.1114
O36.1115
O36.1119
O36.1120
O36.1121
O36.1122
O36.1123
O36.1124
O36.1125
Maternal care for oth rhesus isoimmun, second trimester, oth
Maternal care for oth rhesus isoimmun, third trimester, unsp
Maternal care for oth rhesus isoimmun, third tri, fetus 1
Maternal care for oth rhesus isoimmun, third tri, fetus 2
Maternal care for oth rhesus isoimmun, third tri, fetus 3
Maternal care for oth rhesus isoimmun, third tri, fetus 4
Maternal care for oth rhesus isoimmun, third tri, fetus 5
Maternal care for oth rhesus isoimmun, third trimester, oth
Maternal care for Anti-A sensitization, first tri, unsp
Maternal care for Anti-A sensitization, first tri, fetus 1
Maternal care for Anti-A sensitization, first tri, fetus 2
Maternal care for Anti-A sensitization, first tri, fetus 3
Maternal care for Anti-A sensitization, first tri, fetus 4
Maternal care for Anti-A sensitization, first tri, fetus 5
Maternal care for Anti-A sensitization, first trimester, oth
Maternal care for Anti-A sensitization, second tri, unsp
Maternal care for Anti-A sensitization, second tri, fetus 1
Maternal care for Anti-A sensitization, second tri, fetus 2
Maternal care for Anti-A sensitization, second tri, fetus 3
Maternal care for Anti-A sensitization, second tri, fetus 4
Maternal care for Anti-A sensitization, second tri, fetus 5
O36.1129
O36.1130
O36.1131
O36.1132
O36.1133
O36.1134
O36.1135
O36.1139
O36.1910
O36.1911
O36.1912
O36.1913
O36.1914
O36.1915
O36.1919
O36.1920
O36.1921
O36.1922
O36.1923
O36.1924
O36.1925
O36.1929
O36.1930
Maternal care for Anti-A sensitization, second tri, oth
Maternal care for Anti-A sensitization, third tri, unsp
Maternal care for Anti-A sensitization, third tri, fetus 1
Maternal care for Anti-A sensitization, third tri, fetus 2
Maternal care for Anti-A sensitization, third tri, fetus 3
Maternal care for Anti-A sensitization, third tri, fetus 4
Maternal care for Anti-A sensitization, third tri, fetus 5
Maternal care for Anti-A sensitization, third trimester, oth
Maternal care for oth isoimmunization, first trimester, unsp
Maternal care for oth isoimmun, first trimester, fetus 1
Maternal care for oth isoimmun, first trimester, fetus 2
Maternal care for oth isoimmun, first trimester, fetus 3
Maternal care for oth isoimmun, first trimester, fetus 4
Maternal care for oth isoimmun, first trimester, fetus 5
Maternal care for oth isoimmunization, first trimester, oth
Maternal care for oth isoimmun, second trimester, unsp
Maternal care for oth isoimmun, second trimester, fetus 1
Maternal care for oth isoimmun, second trimester, fetus 2
Maternal care for oth isoimmun, second trimester, fetus 3
Maternal care for oth isoimmun, second trimester, fetus 4
Maternal care for oth isoimmun, second trimester, fetus 5
Maternal care for oth isoimmunization, second trimester, oth
Maternal care for oth isoimmunization, third trimester, unsp
O36.1931
O36.1932
O36.1933
O36.1934
O36.1935
O36.1939
O36.21x0
O36.21x1
Maternal care for oth isoimmun, third trimester, fetus 1
Maternal care for oth isoimmun, third trimester, fetus 2
Maternal care for oth isoimmun, third trimester, fetus 3
Maternal care for oth isoimmun, third trimester, fetus 4
Maternal care for oth isoimmun, third trimester, fetus 5
Maternal care for oth isoimmunization, third trimester, oth
Maternal care for hydrops fetalis, first trimester, unsp
Maternal care for hydrops fetalis, first trimester, fetus 1
PC v2014A
313
O36.21x2
O36.21x3
O36.21x4
O36.21x5
O36.21x9
O36.22x0
O36.22x1
O36.22x2
O36.22x3
O36.22x4
O36.22x5
O36.22x9
O36.23x0
O36.23x1
Maternal care for hydrops fetalis, first trimester, fetus 2
Maternal care for hydrops fetalis, first trimester, fetus 3
Maternal care for hydrops fetalis, first trimester, fetus 4
Maternal care for hydrops fetalis, first trimester, fetus 5
Maternal care for hydrops fetalis, first trimester, oth
Maternal care for hydrops fetalis, second trimester, unsp
Maternal care for hydrops fetalis, second trimester, fetus 1
Maternal care for hydrops fetalis, second trimester, fetus 2
Maternal care for hydrops fetalis, second trimester, fetus 3
Maternal care for hydrops fetalis, second trimester, fetus 4
Maternal care for hydrops fetalis, second trimester, fetus 5
Maternal care for hydrops fetalis, second trimester, oth
Maternal care for hydrops fetalis, third trimester, unsp
Maternal care for hydrops fetalis, third trimester, fetus 1
O36.23x2
O36.23x3
O36.23x4
O36.23x5
O36.23x9
O36.4XX0
O36.4XX1
O36.4XX2
O36.4XX3
O36.4XX4
O36.4XX5
O36.4XX9
O36.5110
O36.5111
O36.5112
O36.5113
O36.5114
O36.5115
O36.5119
O36.5120
O36.5121
O36.5122
O36.5123
O36.5124
Maternal care for hydrops fetalis, third trimester, fetus 2
Maternal care for hydrops fetalis, third trimester, fetus 3
Maternal care for hydrops fetalis, third trimester, fetus 4
Maternal care for hydrops fetalis, third trimester, fetus 5
Maternal care for hydrops fetalis, third trimester, oth
Maternal care for intrauterine death, not applicable or unsp
Maternal care for intrauterine death, fetus 1
Maternal care for intrauterine death, fetus 2
Maternal care for intrauterine death, fetus 3
Maternal care for intrauterine death, fetus 4
Maternal care for intrauterine death, fetus 5
Maternal care for intrauterine death, other fetus
Matern care for known or susp placntl insuff, 1st tri, unsp
Matern care for known or susp placntl insuff, 1st tri, fts1
Matern care for known or susp placntl insuff, 1st tri, fts2
Matern care for known or susp placntl insuff, 1st tri, fts3
Matern care for known or susp placntl insuff, 1st tri, fts4
Matern care for known or susp placntl insuff, 1st tri, fts5
Matern care for known or susp placntl insuff, first tri, oth
Matern care for known or susp placntl insuff, 2nd tri, unsp
Matern care for known or susp placntl insuff, 2nd tri, fts1
Matern care for known or susp placntl insuff, 2nd tri, fts2
Matern care for known or susp placntl insuff, 2nd tri, fts3
Matern care for known or susp placntl insuff, 2nd tri, fts4
O36.5125
O36.5129
O36.5130
O36.5131
O36.5132
O36.5133
O36.5134
O36.5135
O36.5139
O36.5910
O36.5911
O36.5912
O36.5913
O36.5914
Matern care for known or susp placntl insuff, 2nd tri, fts5
Matern care for known or susp placntl insuff, 2nd tri, oth
Matern care for or susp placntl insuff, third tri, unsp
Matern care for or susp placntl insuff, third tri, fts1
Matern care for or susp placntl insuff, third tri, fts2
Matern care for or susp placntl insuff, third tri, fts3
Matern care for or susp placntl insuff, third tri, fts4
Matern care for or susp placntl insuff, third tri, fts5
Matern care for known or susp placntl insuff, third tri, oth
Matern care for oth or susp poor fetl grth, 1st tri, unsp
Matern care for oth or susp poor fetl grth, 1st tri, fts1
Matern care for oth or susp poor fetl grth, 1st tri, fts2
Matern care for oth or susp poor fetl grth, 1st tri, fts3
Matern care for oth or susp poor fetl grth, 1st tri, fts4
PC v2014A
314
O36.5915
O36.5919
O36.5920
O36.5921
O36.5922
O36.5923
O36.5924
Matern care for oth or susp poor fetl grth, 1st tri, fts5
Matern care for oth or susp poor fetl grth, 1st tri, oth
Matern care for oth or susp poor fetl grth, 2nd tri, unsp
Matern care for oth or susp poor fetl grth, 2nd tri, fts1
Matern care for oth or susp poor fetl grth, 2nd tri, fts2
Matern care for oth or susp poor fetl grth, 2nd tri, fts3
Matern care for oth or susp poor fetl grth, 2nd tri, fts4
O36.5925
O36.5929
O36.5930
O36.5931
O36.5932
O36.5933
O36.5934
O36.5935
O36.5939
O36.61X0
O36.61X1
O36.61X2
O36.61X3
O36.61X4
O36.61X5
O36.61X9
O36.62X0
O36.62X1
O36.62X2
O36.62X3
O36.62X4
O36.62X5
O36.62X9
O36.63X0
O36.63X1
O36.63X2
O36.63X3
O36.63X4
O36.63X5
O36.63X9
O36.71X0
O36.71X1
O36.71X2
O36.71X3
O36.71X4
O36.71X5
O36.71X9
O36.72X0
O36.72X1
O36.72X2
O36.72X3
O36.72X4
O36.72X5
O36.72X9
O36.73X0
Matern care for oth or susp poor fetl grth, 2nd tri, fts5
Matern care for oth or susp poor fetl grth, 2nd tri, oth
Matern care for oth or susp poor fetl grth, third tri, unsp
Matern care for oth or susp poor fetl grth, third tri, fts1
Matern care for oth or susp poor fetl grth, third tri, fts2
Matern care for oth or susp poor fetl grth, third tri, fts3
Matern care for oth or susp poor fetl grth, third tri, fts4
Matern care for oth or susp poor fetl grth, third tri, fts5
Matern care for oth or susp poor fetl grth, third tri, oth
Maternal care for excess fetal growth, first trimester, unsp
Maternal care for excess fetal growth, first tri, fetus 1
Maternal care for excess fetal growth, first tri, fetus 2
Maternal care for excess fetal growth, first tri, fetus 3
Maternal care for excess fetal growth, first tri, fetus 4
Maternal care for excess fetal growth, first tri, fetus 5
Maternal care for excess fetal growth, first trimester, oth
Maternal care for excess fetal growth, second tri, unsp
Maternal care for excess fetal growth, second tri, fetus 1
Maternal care for excess fetal growth, second tri, fetus 2
Maternal care for excess fetal growth, second tri, fetus 3
Maternal care for excess fetal growth, second tri, fetus 4
Maternal care for excess fetal growth, second tri, fetus 5
Maternal care for excess fetal growth, second trimester, oth
Maternal care for excess fetal growth, third trimester, unsp
Maternal care for excess fetal growth, third tri, fetus 1
Maternal care for excess fetal growth, third tri, fetus 2
Maternal care for excess fetal growth, third tri, fetus 3
Maternal care for excess fetal growth, third tri, fetus 4
Maternal care for excess fetal growth, third tri, fetus 5
Maternal care for excess fetal growth, third trimester, oth
Maternal care for viable fetus in abd preg, first tri, unsp
Maternal care for viable fetus in abd preg, first tri, fetus 1
Maternal care for viable fetus in abd preg, first tri, fetus 2
Maternal care for viable fetus in abd preg, first tri, fetus 3
Maternal care for viable fetus in abd preg, first tri, fetus 4
Maternal care for viable fetus in abd preg, first tri, fetus 5
Maternal care for viable fetus in abd preg, first tri, oth fetus
Maternal care for viable fetus in abd preg, second tri, unsp
Maternal care for viable fetus in abd preg, second tri, fetus 1
Maternal care for viable fetus in abd preg, second tri, fetus 2
Maternal care for viable fetus in abd preg, second tri, fetus 3
Maternal care for viable fetus in abd preg, second tri, fetus 4
Maternal care for viable fetus in abd preg, second tri, fetus 5
Maternal care for viable fetus in abd preg, second tri, oth fetus
Maternal care for viable fetus in abd preg, third tri, unsp
PC v2014A
315
O36.73X1
O36.73X2
O36.73X3
O36.73X4
O36.73X5
O36.73X9
O36.8120
O36.8121
O36.8122
O36.8123
O36.8124
O36.8125
O36.8129
O36.8130
O36.8131
O36.8132
O36.8133
O36.8134
O36.8135
O36.8139
O36.8910
O36.8911
O36.8912
O36.8913
O36.8914
O36.8915
O36.8919
O36.8920
O36.8921
O36.8922
O36.8923
O36.8924
O36.8925
O36.8929
O36.8930
O36.8931
O36.8932
O36.8933
O36.8934
O36.8935
O36.8939
O36.91X0
O36.91X1
O36.91X2
O36.91X3
Maternal care for viable fetus in abd preg, third tri, fetus 1
Maternal care for viable fetus in abd preg, third tri, fetus 2
Maternal care for viable fetus in abd preg, third tri, fetus 3
Maternal care for viable fetus in abd preg, third tri, fetus 4
Maternal care for viable fetus in abd preg, third tri, fetus 5
Maternal care for viable fetus in abd preg, third tri, oth fetus
Decreased fetal movements, second trimester, unsp
Decreased fetal movements, second trimester, fetus 1
Decreased fetal movements, second trimester, fetus 2
Decreased fetal movements, second trimester, fetus 3
Decreased fetal movements, second trimester, fetus 4
Decreased fetal movements, second trimester, fetus 5
Decreased fetal movements, second trimester, other fetus
Decreased fetal movements, third trimester, unsp
Decreased fetal movements, third trimester, fetus 1
Decreased fetal movements, third trimester, fetus 2
Decreased fetal movements, third trimester, fetus 3
Decreased fetal movements, third trimester, fetus 4
Decreased fetal movements, third trimester, fetus 5
Decreased fetal movements, third trimester, other fetus
Maternal care for other fetal problems, first trimester, unsp
Maternal care for other fetal problems, first trimester, fetus 1
Maternal care for other fetal problems, first trimester, fetus 2
Maternal care for other fetal problems, first trimester, fetus 3
Maternal care for other fetal problems, first trimester, fetus 4
Maternal care for other fetal problems, first trimester, fetus 5
Maternal care for other fetal problems, first trimester, oth fetus
Maternal care for other fetal problems, second trimester, unsp
Maternal care for other fetal problems, second trimester, fetus 1
Maternal care for other fetal problems, second trimester, fetus 2
Maternal care for other fetal problems, second trimester, fetus 3
Maternal care for other fetal problems, second trimester, fetus 4
Maternal care for other fetal problems, second trimester, fetus 5
Maternal care for other fetal problems, second trimester, oth fetus
Maternal care for other fetal problems, third trimester, unsp
Maternal care for other fetal problems, third trimester, fetus 1
Maternal care for other fetal problems, third trimester, fetus 2
Maternal care for other fetal problems, third trimester, fetus 3
Maternal care for other fetal problems, third trimester, fetus 4
Maternal care for other fetal problems, third trimester, fetus 5
Maternal care for other fetal problems, third trimester, oth fetus
Maternal care for fetal problem, unsp, first trimester, unsp
Maternal care for fetal problem, unsp, first tri, fetus 1
Maternal care for fetal problem, unsp, first tri, fetus 2
Maternal care for fetal problem, unsp, first tri, fetus 3
O36.91X4
O36.91X5
O36.91X9
O36.92X0
O36.92X1
O36.92X2
O36.92X3
Maternal care for fetal problem, unsp, first tri, fetus 4
Maternal care for fetal problem, unsp, first tri, fetus 5
Maternal care for fetal problem, unsp, first trimester, oth
Maternal care for fetal problem, unsp, second tri, unsp
Maternal care for fetal problem, unsp, second tri, fetus 1
Maternal care for fetal problem, unsp, second tri, fetus 2
Maternal care for fetal problem, unsp, second tri, fetus 3
PC v2014A
316
O36.92X4
O36.92X5
O36.92X9
O36.93X0
O36.93X1
Maternal care for fetal problem, unsp, second tri, fetus 4
Maternal care for fetal problem, unsp, second tri, fetus 5
Maternal care for fetal problem, unsp, second trimester, oth
Maternal care for fetal problem, unsp, third trimester, unsp
Maternal care for fetal problem, unsp, third tri, fetus 1
O36.93X2
O36.93X3
O36.93X4
O36.93X5
O36.93X9
O40.1XX0
O40.1XX1
O40.1XX2
O40.1XX3
O40.1XX4
O40.1XX5
O40.1XX9
O40.2XX0
O40.2XX1
O40.2XX2
O40.2XX3
O40.2XX4
O40.2XX5
O40.2XX9
O40.3XX0
O40.3XX1
O40.3XX2
O40.3XX3
O40.3XX4
O40.3XX5
O40.3XX9
O41.01X0
O41.01X1
O41.01X2
O41.01X3
O41.01X4
O41.01X5
O41.01X9
Maternal care for fetal problem, unsp, third tri, fetus 2
Maternal care for fetal problem, unsp, third tri, fetus 3
Maternal care for fetal problem, unsp, third tri, fetus 4
Maternal care for fetal problem, unsp, third tri, fetus 5
Maternal care for fetal problem, unsp, third trimester, oth
Polyhydramnios, first trimester, not applicable or unsp
Polyhydramnios, first trimester, fetus 1
Polyhydramnios, first trimester, fetus 2
Polyhydramnios, first trimester, fetus 3
Polyhydramnios, first trimester, fetus 4
Polyhydramnios, first trimester, fetus 5
Polyhydramnios, first trimester, other fetus
Polyhydramnios, second trimester, not applicable or unsp
Polyhydramnios, second trimester, fetus 1
Polyhydramnios, second trimester, fetus 2
Polyhydramnios, second trimester, fetus 3
Polyhydramnios, second trimester, fetus 4
Polyhydramnios, second trimester, fetus 5
Polyhydramnios, second trimester, other fetus
Polyhydramnios, third trimester, not applicable or unsp
Polyhydramnios, third trimester, fetus 1
Polyhydramnios, third trimester, fetus 2
Polyhydramnios, third trimester, fetus 3
Polyhydramnios, third trimester, fetus 4
Polyhydramnios, third trimester, fetus 5
Polyhydramnios, third trimester, other fetus
Oligohydramnios, first trimester, not applicable or unsp
Oligohydramnios, first trimester, fetus 1
Oligohydramnios, first trimester, fetus 2
Oligohydramnios, first trimester, fetus 3
Oligohydramnios, first trimester, fetus 4
Oligohydramnios, first trimester, fetus 5
Oligohydramnios, first trimester, other fetus
O41.02X0
O41.02X1
O41.02X2
O41.02X3
O41.02X4
O41.02X5
O41.02X9
O41.03X0
O41.03X1
O41.03X2
O41.03X3
O41.03X4
O41.03X5
Oligohydramnios, second trimester, not applicable or unsp
Oligohydramnios, second trimester, fetus 1
Oligohydramnios, second trimester, fetus 2
Oligohydramnios, second trimester, fetus 3
Oligohydramnios, second trimester, fetus 4
Oligohydramnios, second trimester, fetus 5
Oligohydramnios, second trimester, other fetus
Oligohydramnios, third trimester, not applicable or unsp
Oligohydramnios, third trimester, fetus 1
Oligohydramnios, third trimester, fetus 2
Oligohydramnios, third trimester, fetus 3
Oligohydramnios, third trimester, fetus 4
Oligohydramnios, third trimester, fetus 5
O41.03X9
Oligohydramnios, third trimester, other fetus
PC v2014A
317
O41.1010
O41.1011
O41.1012
O41.1013
O41.1014
O41.1015
O41.1019
O41.1020
O41.1021
O41.1022
O41.1023
O41.1024
O41.1025
O41.1029
O41.1030
O41.1031
O41.1032
O41.1033
O41.1034
O41.1035
O41.1039
O41.1210
O41.1211
O41.1212
O41.1213
O41.1214
O41.1215
O41.1219
O41.1220
O41.1221
O41.1222
Infct of amniotic sac and membrns, unsp, first tri, unsp
Infct of amniotic sac and membrns, unsp, first tri, fetus 1
Infct of amniotic sac and membrns, unsp, first tri, fetus 2
Infct of amniotic sac and membrns, unsp, first tri, fetus 3
Infct of amniotic sac and membrns, unsp, first tri, fetus 4
Infct of amniotic sac and membrns, unsp, first tri, fetus 5
Infct of amniotic sac and membrns, unsp, first tri, oth
Infct of amniotic sac and membrns, unsp, second tri, unsp
Infct of amniotic sac and membrns, unsp, second tri, fetus 1
Infct of amniotic sac and membrns, unsp, second tri, fetus 2
Infct of amniotic sac and membrns, unsp, second tri, fetus 3
Infct of amniotic sac and membrns, unsp, second tri, fetus 4
Infct of amniotic sac and membrns, unsp, second tri, fetus 5
Infct of amniotic sac and membrns, unsp, second tri, oth
Infct of amniotic sac and membrns, unsp, third tri, unsp
Infct of amniotic sac and membrns, unsp, third tri, fetus 1
Infct of amniotic sac and membrns, unsp, third tri, fetus 2
Infct of amniotic sac and membrns, unsp, third tri, fetus 3
Infct of amniotic sac and membrns, unsp, third tri, fetus 4
Infct of amniotic sac and membrns, unsp, third tri, fetus 5
Infct of amniotic sac and membrns, unsp, third tri, oth
Chorioamnionitis, first trimester, not applicable or unsp
Chorioamnionitis, first trimester, fetus 1
Chorioamnionitis, first trimester, fetus 2
Chorioamnionitis, first trimester, fetus 3
Chorioamnionitis, first trimester, fetus 4
Chorioamnionitis, first trimester, fetus 5
Chorioamnionitis, first trimester, other fetus
Chorioamnionitis, second trimester, not applicable or unsp
Chorioamnionitis, second trimester, fetus 1
Chorioamnionitis, second trimester, fetus 2
O41.1223
O41.1224
O41.1225
O41.1229
O41.1230
O41.1231
O41.1232
O41.1233
O41.1234
O41.1235
O41.1239
O41.1410
O41.1411
O41.1412
Chorioamnionitis, second trimester, fetus 3
Chorioamnionitis, second trimester, fetus 4
Chorioamnionitis, second trimester, fetus 5
Chorioamnionitis, second trimester, other fetus
Chorioamnionitis, third trimester, not applicable or unsp
Chorioamnionitis, third trimester, fetus 1
Chorioamnionitis, third trimester, fetus 2
Chorioamnionitis, third trimester, fetus 3
Chorioamnionitis, third trimester, fetus 4
Chorioamnionitis, third trimester, fetus 5
Chorioamnionitis, third trimester, other fetus
Placentitis, first trimester, not applicable or unspecified
Placentitis, first trimester, fetus 1
Placentitis, first trimester, fetus 2
O41.1413
O41.1414
O41.1415
O41.1419
O41.1420
O41.1421
O41.1422
Placentitis, first trimester, fetus 3
Placentitis, first trimester, fetus 4
Placentitis, first trimester, fetus 5
Placentitis, first trimester, other fetus
Placentitis, second trimester, not applicable or unspecified
Placentitis, second trimester, fetus 1
Placentitis, second trimester, fetus 2
PC v2014A
318
O41.1423
O41.1424
O41.1425
O41.1429
O41.1430
O41.1431
O41.1432
O41.1433
O41.1434
O41.1435
O41.1439
O41.8X10
O41.8X11
O41.8X12
O41.8X13
O41.8X14
O41.8X15
O41.8X19
O41.8X20
O41.8X21
O41.8X22
O41.8X23
O41.8X24
O41.8X25
Placentitis, second trimester, fetus 3
Placentitis, second trimester, fetus 4
Placentitis, second trimester, fetus 5
Placentitis, second trimester, other fetus
Placentitis, third trimester, not applicable or unspecified
Placentitis, third trimester, fetus 1
Placentitis, third trimester, fetus 2
Placentitis, third trimester, fetus 3
Placentitis, third trimester, fetus 4
Placentitis, third trimester, fetus 5
Placentitis, third trimester, other fetus
Oth disrd of amniotic fluid and membrns, first tri, unsp
Oth disrd of amniotic fluid and membrns, first tri, fetus 1
Oth disrd of amniotic fluid and membrns, first tri, fetus 2
Oth disrd of amniotic fluid and membrns, first tri, fetus 3
Oth disrd of amniotic fluid and membrns, first tri, fetus 4
Oth disrd of amniotic fluid and membrns, first tri, fetus 5
Oth disrd of amniotic fluid and membrns, first tri, oth
Oth disrd of amniotic fluid and membrns, second tri, unsp
Oth disrd of amniotic fluid and membrns, second tri, fetus 1
Oth disrd of amniotic fluid and membrns, second tri, fetus 2
Oth disrd of amniotic fluid and membrns, second tri, fetus 3
Oth disrd of amniotic fluid and membrns, second tri, fetus 4
Oth disrd of amniotic fluid and membrns, second tri, fetus 5
O41.8X29
O41.8X30
O41.8X31
O41.8X32
O41.8X33
O41.8X34
O41.8X35
O41.8X39
O41.91X0
O41.91X1
O41.91X2
O41.91X3
O41.91X4
O41.91X5
O41.91X9
O41.92X0
O41.92X1
O41.92X2
O41.92X3
O41.92X4
O41.92X5
O41.92X9
O41.93X0
O41.93X1
O41.93X2
O41.93X3
O41.93X4
O41.93X5
Oth disrd of amniotic fluid and membrns, second tri, oth
Oth disrd of amniotic fluid and membrns, third tri, unsp
Oth disrd of amniotic fluid and membrns, third tri, fetus 1
Oth disrd of amniotic fluid and membrns, third tri, fetus 2
Oth disrd of amniotic fluid and membrns, third tri, fetus 3
Oth disrd of amniotic fluid and membrns, third tri, fetus 4
Oth disrd of amniotic fluid and membrns, third tri, fetus 5
Oth disrd of amniotic fluid and membrns, third tri, oth
Disorder of amnio fluid and membrns, unsp, first tri, unsp
Disord of amnio fluid and membrns, unsp, first tri, fetus 1
Disord of amnio fluid and membrns, unsp, first tri, fetus 2
Disord of amnio fluid and membrns, unsp, first tri, fetus 3
Disord of amnio fluid and membrns, unsp, first tri, fetus 4
Disord of amnio fluid and membrns, unsp, first tri, fetus 5
Disorder of amniotic fluid and membrns, unsp, first tri, oth
Disorder of amnio fluid and membrns, unsp, second tri, unsp
Disord of amnio fluid and membrns, unsp, second tri, fetus 1
Disord of amnio fluid and membrns, unsp, second tri, fetus 2
Disord of amnio fluid and membrns, unsp, second tri, fetus 3
Disord of amnio fluid and membrns, unsp, second tri, fetus 4
Disord of amnio fluid and membrns, unsp, second tri, fetus 5
Disorder of amnio fluid and membrns, unsp, second tri, oth
Disorder of amnio fluid and membrns, unsp, third tri, unsp
Disord of amnio fluid and membrns, unsp, third tri, fetus 1
Disord of amnio fluid and membrns, unsp, third tri, fetus 2
Disord of amnio fluid and membrns, unsp, third tri, fetus 3
Disord of amnio fluid and membrns, unsp, third tri, fetus 4
Disord of amnio fluid and membrns, unsp, third tri, fetus 5
PC v2014A
319
O41.93X9
O42.00
O42.011
O42.012
O42.013
O42.02
O42.10
O42.111
O42.112
O42.113
O42.12
O42.911
O42.912
O42.913
O42.92
O43.011
O43.012
Disorder of amniotic fluid and membrns, unsp, third tri, oth
Prem ROM. Onset labor w/n 24 hr of rupt, unsp weeks gest
Pretrm prem ROM, onset labor w/n 24 hours of rupt, first tri
Pretrm prem ROM, onset labor w/n 24 hours of rupt, 2nd tri
Pretrm prem ROM, onset labor w/n 24 hours of rupt, third tri
Full-term prem ROM, onset labor within 24 hours of rupture
Prem ROM, onset labor > 24 hr fol rupt, unsp weeks of gest
Pretrm prem ROM, onset labor > 24 hours fol rupt, first tri
Pretrm prem ROM, onset labor > 24 hours fol rupt, second tri
Pretrm prem ROM, onset labor > 24 hours fol rupt, third tri
Full-term premature ROM, onset labor > 24 hr fol rupt
Pretrm prem ROM, unsp time betw rupt and onset labr, 1st tri
Pretrm prem ROM, unsp time betw rupt and onset labr, 2nd tri
Pretrm prem ROM, unsp time betw rupt and onst labr, 3rd tri
Full-term prem ROM, unsp time betw rupture and onset labor
Fetomaternal placental transfusion syndrome, first trimester
Fetomaternal placental transfuse syndrome, second trimester
O43.013
O43.101
O43.102
O43.103
O43.111
O43.112
O43.113
O43.191
O43.192
O43.193
O43.811
O43.812
O43.813
O43.891
O43.892
O43.893
O43.91
O43.92
O43.93
O61.0
O61.1
O61.8
O61.9
O64.1XX0
O64.1XX1
O64.1XX2
O64.1XX3
O64.1XX4
O64.1XX5
O64.1XX9
O64.2XX0
O64.2XX1
O64.2XX2
O64.2XX3
O64.2XX4
Fetomaternal placental transfusion syndrome, third trimester
Malformation of placenta, unspecified, first trimester
Malformation of placenta, unspecified, second trimester
Malformation of placenta, unspecified, third trimester
Circumvallate placenta, first trimester
Circumvallate placenta, second trimester
Circumvallate placenta, third trimester
Other malformation of placenta, first trimester
Other malformation of placenta, second trimester
Other malformation of placenta, third trimester
Placental infarction, first trimester
Placental infarction, second trimester
Placental infarction, third trimester
Other placental disorders, first trimester
Other placental disorders, second trimester
Other placental disorders, third trimester
Unspecified placental disorder, first trimester
Unspecified placental disorder, second trimester
Unspecified placental disorder, third trimester
Failed medical induction of labor
Failed instrumental induction of labor
Other failed induction of labor
Failed induction of labor, unspecified
Obstructed labor due to breech presentation, unsp
Obstructed labor due to breech presentation, fetus 1
Obstructed labor due to breech presentation, fetus 2
Obstructed labor due to breech presentation, fetus 3
Obstructed labor due to breech presentation, fetus 4
Obstructed labor due to breech presentation, fetus 5
Obstructed labor due to breech presentation, other fetus
Obstructed labor due to face presentation, unsp
Obstructed labor due to face presentation, fetus 1
Obstructed labor due to face presentation, fetus 2
Obstructed labor due to face presentation, fetus 3
Obstructed labor due to face presentation, fetus 4
PC v2014A
320
O64.2XX5
O64.2XX9
O64.3XX0
O64.3XX1
O64.3XX2
O64.3XX3
O64.3XX4
O64.3XX5
O64.3XX9
O64.4XX0
Obstructed labor due to face presentation, fetus 5
Obstructed labor due to face presentation, other fetus
Obstructed labor due to brow presentation, unsp
Obstructed labor due to brow presentation, fetus 1
Obstructed labor due to brow presentation, fetus 2
Obstructed labor due to brow presentation, fetus 3
Obstructed labor due to brow presentation, fetus 4
Obstructed labor due to brow presentation, fetus 5
Obstructed labor due to brow presentation, other fetus
Obstructed labor due to shoulder presentation, unsp
O64.4XX1
O64.4XX2
O64.4XX3
O64.4XX4
O64.4XX5
O64.4XX9
O64.5XX0
O64.5XX1
O64.5XX2
O64.5XX3
O64.5XX4
O64.5XX5
O64.5XX9
O64.8XX0
O64.8XX1
O64.8XX2
O64.8XX3
O64.8XX4
O64.8XX5
O64.8XX9
O64.9XX0
O64.9XX1
O64.9XX2
O64.9XX3
O64.9XX4
O64.9XX5
O64.9XX9
O65.0
O65.1
O65.2
O65.3
O65.4
O65.8
O65.9
O66.2
O66.6
O68
O75.2
O75.3
O75.5
O75.89
O75.9
Obstructed labor due to shoulder presentation, fetus 1
Obstructed labor due to shoulder presentation, fetus 2
Obstructed labor due to shoulder presentation, fetus 3
Obstructed labor due to shoulder presentation, fetus 4
Obstructed labor due to shoulder presentation, fetus 5
Obstructed labor due to shoulder presentation, other fetus
Obstructed labor due to compound presentation, unsp
Obstructed labor due to compound presentation, fetus 1
Obstructed labor due to compound presentation, fetus 2
Obstructed labor due to compound presentation, fetus 3
Obstructed labor due to compound presentation, fetus 4
Obstructed labor due to compound presentation, fetus 5
Obstructed labor due to compound presentation, other fetus
Obstructed labor due to oth malposition and malpresent, unsp
Obstructed labor due to oth malpos and malpresent, fetus 1
Obstructed labor due to oth malpos and malpresent, fetus 2
Obstructed labor due to oth malpos and malpresent, fetus 3
Obstructed labor due to oth malpos and malpresent, fetus 4
Obstructed labor due to oth malpos and malpresent, fetus 5
Obstructed labor due to oth malposition and malpresent, oth
Obstructed labor due to malpos and malpresent, unsp, unsp
Obstructed labor due to malpos and malpresent, unsp, fetus 1
Obstructed labor due to malpos and malpresent, unsp, fetus 2
Obstructed labor due to malpos and malpresent, unsp, fetus 3
Obstructed labor due to malpos and malpresent, unsp, fetus 4
Obstructed labor due to malpos and malpresent, unsp, fetus 5
Obstructed labor due to malpos and malpresent, unsp, oth
Obstructed labor due to deformed pelvis
Obstructed labor due to generally contracted pelvis
Obstructed labor due to pelvic inlet contraction
Obst labor due to pelvic outlet and mid-cavity contrctn
Obstructed labor due to fetopelvic disproportion, unsp
Obstructed labor due to other maternal pelvic abnormalities
Obstructed labor due to maternal pelvic abnormality, unsp
Obstructed labor due to unusually large fetus
Obstructed labor due to other multiple fetuses
Labor and delivery comp by abnlt of fetal acid-base balance
Pyrexia during labor, not elsewhere classified
Other infection during labor
Delayed delivery after artificial rupture of membranes
Other specified complications of labor and delivery
Complication of labor and delivery, unspecified
PC v2014A
321
O76
O77.0
O77.1
Abnlt in fetal heart rate and rhythm comp labor and delivery
Labor and delivery complicated by meconium in amniotic fluid
Fetal stress in labor or delivery due to drug administration
O77.8
O77.9
O80
Labor and delivery comp by oth evidence of fetal stress
Labor and delivery complicated by fetal stress, unspecified
Encounter for full-term uncomplicated delivery
Table 11.03 Complications Mainly in the Course of Labor and
Delivery
Short Description
ICD-10-CM Code
O64.1XX0
Obstructed labor due to breech presentation, unsp
O64.1XX1
Obstructed labor due to breech presentation, fetus 1
O64.1XX2
Obstructed labor due to breech presentation, fetus 2
O64.1XX3
Obstructed labor due to breech presentation, fetus 3
O64.1XX4
Obstructed labor due to breech presentation, fetus 4
O64.1XX5
Obstructed labor due to breech presentation, fetus 5
O64.1XX9
Obstructed labor due to breech presentation, other fetus
O64.2XX0
Obstructed labor due to face presentation, unsp
O64.2XX1
Obstructed labor due to face presentation, fetus 1
O64.2XX2
Obstructed labor due to face presentation, fetus 2
O64.2XX3
Obstructed labor due to face presentation, fetus 3
O64.2XX4
Obstructed labor due to face presentation, fetus 4
O64.2XX5
Obstructed labor due to face presentation, fetus 5
O64.2XX9
Obstructed labor due to face presentation, other fetus
O64.3XX0
Obstructed labor due to brow presentation, unsp
O64.3XX1
Obstructed labor due to brow presentation, fetus 1
O64.3XX2
Obstructed labor due to brow presentation, fetus 2
O64.3XX3
Obstructed labor due to brow presentation, fetus 3
O64.3XX4
Obstructed labor due to brow presentation, fetus 4
O64.3XX5
Obstructed labor due to brow presentation, fetus 5
O64.3XX9
Obstructed labor due to brow presentation, other fetus
O64.4XX0
Obstructed labor due to shoulder presentation, unsp
O64.4XX1
Obstructed labor due to shoulder presentation, fetus 1
O64.4XX2
Obstructed labor due to shoulder presentation, fetus 2
O64.4XX3
Obstructed labor due to shoulder presentation, fetus 3
O64.4XX4
Obstructed labor due to shoulder presentation, fetus 4
O64.4XX5
Obstructed labor due to shoulder presentation, fetus 5
O64.4XX9
Obstructed labor due to shoulder presentation, other fetus
O64.5XX0
Obstructed labor due to compound presentation, unsp
O64.5XX1
Obstructed labor due to compound presentation, fetus 1
O64.5XX2
Obstructed labor due to compound presentation, fetus 2
O64.5XX3
Obstructed labor due to compound presentation, fetus 3
O64.5XX4
Obstructed labor due to compound presentation, fetus 4
O64.5XX5
Obstructed labor due to compound presentation, fetus 5
O64.5XX9
Obstructed labor due to compound presentation, other fetus
O64.8XX0
O64.8XX1
O64.8XX2
O64.8XX3
PC v2014A
Obstructed labor due to oth malposition and malpresent, unsp
Obstructed labor due to oth malpos and malpresent, fetus 1
Obstructed labor due to oth malpos and malpresent, fetus 2
Obstructed labor due to oth malpos and malpresent, fetus 3
322
O64.8XX4
O64.8XX5
O64.8XX9
O64.9XX0
O64.9XX1
O64.9XX2
O64.9XX3
O64.9XX4
O64.9XX5
O64.9XX9
O65.0
O65.1
O65.2
O65.3
O65.4
O65.5
O65.8
O65.9
O64.0XX0
O64.0XX1
O64.0XX2
O64.0XX3
O64.0XX4
O64.0XX5
O64.0XX9
O66.0
O66.1
O66.40
Obstructed labor due to oth malpos and malpresent, fetus 4
Obstructed labor due to oth malpos and malpresent, fetus 5
Obstructed labor due to oth malposition and malpresent, oth
Obstructed labor due to malpos and malpresent, unsp, unsp
Obstructed labor due to malpos and malpresent, unsp, fetus 1
Obstructed labor due to malpos and malpresent, unsp, fetus 2
Obstructed labor due to malpos and malpresent, unsp, fetus 3
Obstructed labor due to malpos and malpresent, unsp, fetus 4
Obstructed labor due to malpos and malpresent, unsp, fetus 5
Obstructed labor due to malpos and malpresent, unsp, oth
Obstructed labor due to deformed pelvis
Obstructed labor due to generally contracted pelvis
Obstructed labor due to pelvic inlet contraction
Obst labor due to pelvic outlet and mid-cavity contrctn
Obstructed labor due to fetopelvic disproportion, unsp
Obstructed labor due to abnlt of maternal pelvic organs
Obstructed labor due to other maternal pelvic abnormalities
Obstructed labor due to maternal pelvic abnormality, unsp
Obstructed labor due to incmpl rotation of fetal head, unsp
Obst labor due to incmpl rotation of fetal head, fetus 1
Obst labor due to incmpl rotation of fetal head, fetus 2
Obst labor due to incmpl rotation of fetal head, fetus 3
Obst labor due to incmpl rotation of fetal head, fetus 4
Obst labor due to incmpl rotation of fetal head, fetus 5
Obstructed labor due to incmpl rotation of fetal head, oth
Obstructed labor due to shoulder dystocia
Obstructed labor due to locked twins
Failed trial of labor, unspecified
O66.41
O66.5
O66.2
O66.3
O66.6
O66.8
O66.9
O62.0
O62.1
O62.2
O62.3
O62.4
O62.8
O62.9
Failed attempt vaginal birth after previous cesarean del
Attempted application of vacuum extractor and forceps
Obstructed labor due to unusually large fetus
Obstructed labor due to other abnormalities of fetus
Obstructed labor due to other multiple fetuses
Other specified obstructed labor
Obstructed labor, unspecified
Primary inadequate contractions
Secondary uterine inertia
Other uterine inertia
Precipitate labor
Hypertonic, incoordinate, and prolonged uterine contractions
Other abnormalities of forces of labor
Abnormality of forces of labor, unspecified
O63.0
O63.9
O63.1
O63.2
O69.0XX0
O69.0XX1
O69.0XX2
O69.0XX3
O69.0XX4
O69.0XX5
Prolonged first stage (of labor)
Long labor, unspecified
Prolonged second stage (of labor)
Delayed delivery of second twin, triplet, etc.
Labor and delivery complicated by prolapse of cord, unsp
Labor and delivery complicated by prolapse of cord, fetus 1
Labor and delivery complicated by prolapse of cord, fetus 2
Labor and delivery complicated by prolapse of cord, fetus 3
Labor and delivery complicated by prolapse of cord, fetus 4
Labor and delivery complicated by prolapse of cord, fetus 5
PC v2014A
323
O69.0XX9
O69.1XX0
O69.1XX1
O69.1XX2
O69.1XX3
O69.1XX4
O69.1XX5
O69.1XX9
O69.2XX0
Labor and delivery complicated by prolapse of cord, oth
Labor and delivery comp by cord around neck, w comprsn, unsp
Labor and del comp by cord around neck, w comprsn, fetus 1
Labor and del comp by cord around neck, w comprsn, fetus 2
Labor and del comp by cord around neck, w comprsn, fetus 3
Labor and del comp by cord around neck, w comprsn, fetus 4
Labor and del comp by cord around neck, w comprsn, fetus 5
Labor and delivery comp by cord around neck, w comprsn, oth
Labor and del comp by oth cord entangle, w comprsn, unsp
O69.2XX1
O69.2XX2
O69.2XX3
O69.2XX4
O69.2XX5
O69.2XX9
O69.81X0
O69.81X1
O69.81X2
O69.81X3
O69.81X4
O69.81X5
O69.81X9
O69.82X0
O69.82X1
O69.82X2
O69.82X3
O69.82X4
O69.82X5
O69.82X9
O69.89X0
O69.89X1
O69.89X2
O69.89X3
O69.89X4
O69.89X5
Labor and del comp by oth cord entangle, w comprsn, fetus 1
Labor and del comp by oth cord entangle, w comprsn, fetus 2
Labor and del comp by oth cord entangle, w comprsn, fetus 3
Labor and del comp by oth cord entangle, w comprsn, fetus 4
Labor and del comp by oth cord entangle, w comprsn, fetus 5
Labor and delivery comp by oth cord entangle, w comprsn, oth
Labor and del comp by cord around neck, w/o comprsn, unsp
Labor and del comp by cord around neck, w/o comprsn, fetus 1
Labor and del comp by cord around neck, w/o comprsn, fetus 2
Labor and del comp by cord around neck, w/o comprsn, fetus 3
Labor and del comp by cord around neck, w/o comprsn, fetus 4
Labor and del comp by cord around neck, w/o comprsn, fetus 5
Labor and del comp by cord around neck, w/o comprsn, oth
Labor and del comp by oth cord entangle, w/o comprsn, unsp
Labor and del comp by oth cord entangle, w/o comprsn, fts1
Labor and del comp by oth cord entangle, w/o comprsn, fts2
Labor and del comp by oth cord entangle, w/o comprsn, fts3
Labor and del comp by oth cord entangle, w/o comprsn, fts4
Labor and del comp by oth cord entangle, w/o comprsn, fts5
Labor and del comp by oth cord entangle, w/o comprsn, oth
Labor and delivery complicated by oth cord comp, unsp
Labor and delivery complicated by oth cord comp, fetus 1
Labor and delivery complicated by oth cord comp, fetus 2
Labor and delivery complicated by oth cord comp, fetus 3
Labor and delivery complicated by oth cord comp, fetus 4
Labor and delivery complicated by oth cord comp, fetus 5
O69.89X9
O69.3XX0
O69.3XX1
O69.3XX2
O69.3XX3
O69.3XX4
O69.3XX5
O69.3XX9
O69.4XX0
O69.4XX1
O69.4XX2
O69.4XX3
O69.4XX4
O69.4XX5
O69.4XX9
O69.5XX0
Labor and delivery complicated by oth cord comp, oth
Labor and delivery complicated by short cord, unsp
Labor and delivery complicated by short cord, fetus 1
Labor and delivery complicated by short cord, fetus 2
Labor and delivery complicated by short cord, fetus 3
Labor and delivery complicated by short cord, fetus 4
Labor and delivery complicated by short cord, fetus 5
Labor and delivery complicated by short cord, other fetus
Labor and delivery complicated by vasa previa, unsp
Labor and delivery complicated by vasa previa, fetus 1
Labor and delivery complicated by vasa previa, fetus 2
Labor and delivery complicated by vasa previa, fetus 3
Labor and delivery complicated by vasa previa, fetus 4
Labor and delivery complicated by vasa previa, fetus 5
Labor and delivery complicated by vasa previa, other fetus
Labor and delivery comp by vascular lesion of cord, unsp
PC v2014A
324
O69.5XX1
O69.5XX2
O69.5XX3
O69.5XX4
O69.5XX5
O69.5XX9
O43.121
O43.122
O43.123
O69.89X0
O69.89X1
O69.89X2
O69.89X3
O69.89X4
O69.89X5
O69.89X9
O69.9XX0
O69.9XX1
O69.9XX2
O69.9XX3
O69.9XX4
O69.9XX5
O69.9XX9
O70.0
O70.1
Labor and delivery comp by vascular lesion of cord, fetus 1
Labor and delivery comp by vascular lesion of cord, fetus 2
Labor and delivery comp by vascular lesion of cord, fetus 3
Labor and delivery comp by vascular lesion of cord, fetus 4
Labor and delivery comp by vascular lesion of cord, fetus 5
Labor and delivery comp by vascular lesion of cord, oth
Velamentous insertion of umbilical cord, first trimester
Velamentous insertion of umbilical cord, second trimester
Velamentous insertion of umbilical cord, third trimester
Labor and delivery complicated by oth cord comp, unsp
Labor and delivery complicated by oth cord comp, fetus 1
Labor and delivery complicated by oth cord comp, fetus 2
Labor and delivery complicated by oth cord comp, fetus 3
Labor and delivery complicated by oth cord comp, fetus 4
Labor and delivery complicated by oth cord comp, fetus 5
Labor and delivery complicated by oth cord comp, oth
Labor and delivery complicated by cord comp, unsp, unsp
Labor and delivery complicated by cord comp, unsp, fetus 1
Labor and delivery complicated by cord comp, unsp, fetus 2
Labor and delivery complicated by cord comp, unsp, fetus 3
Labor and delivery complicated by cord comp, unsp, fetus 4
Labor and delivery complicated by cord comp, unsp, fetus 5
Labor and delivery complicated by cord comp, unsp, oth
First degree perineal laceration during delivery
Second degree perineal laceration during delivery
O70.2
O70.3
O70.9
O90.2
O71.89
O71.9
O71.02
O71.03
O71.1
O71.2
O71.3
O71.4
O71.5
O71.6
O71.7
O71.7
O71.81
O71.89
O71.81
O71.89
O71.9
O71.9
O72.0
O72.1
O72.2
O72.3
O43.211
Third degree perineal laceration during delivery
Fourth degree perineal laceration during delivery
Perineal laceration during delivery, unspecified
Obstetric hematoma of pelvis
Other specified trauma to perineum and vulva
Obstetric trauma, unspecified
Rupture of uterus before onset of labor, second trimester
Rupture of uterus before onset of labor, third trimester
Rupture of uterus during labor
Postpartum inversion of uterus
Obstetric laceration of cervix
Obstetric high vaginal laceration alone
Other obstetric injury to pelvic organs
Obstetric damage to pelvic joints and ligaments
Obstetric hematoma of pelvis
Obstetric hematoma of pelvis
Laceration of uterus, not elsewhere classified
Other specified obstetric trauma
Laceration of uterus, not elsewhere classified
Other specified obstetric trauma
Obstetric trauma, unspecified
Obstetric trauma, unspecified
Third-stage hemorrhage
Other immediate postpartum hemorrhage
Delayed and secondary postpartum hemorrhage
Postpartum coagulation defects
Placenta accreta, first trimester
PC v2014A
325
O43.212
O43.213
O43.221
O43.222
O43.223
O43.231
O43.232
O43.233
O73.0
O73.1
O74.0
O74.1
O74.0
O74.1
O89.09
O74.2
O74.2
O74.3
O74.3
O74.4
O74.5
Placenta accreta, second trimester
Placenta accreta, third trimester
Placenta increta, first trimester
Placenta increta, second trimester
Placenta increta, third trimester
Placenta percreta, first trimester
Placenta percreta, second trimester
Placenta percreta, third trimester
Retained placenta without hemorrhage
Retained portions of placenta and membranes, w/o hemorrhage
Aspirat pneumonitis due to anesth during labor and delivery
Oth pulmonary comp of anesthesia during labor and delivery
Aspirat pneumonitis due to anesth during labor and delivery
Oth pulmonary comp of anesthesia during labor and delivery
Oth pulmonary comp of anesthesia during the puerperium
Cardiac comp of anesthesia during labor and delivery
Cardiac comp of anesthesia during labor and delivery
Cnsl complications of anesthesia during labor and delivery
Cnsl complications of anesthesia during labor and delivery
Toxic reaction to local anesthesia during labor and delivery
Spinal and epidur anesthesia-induced hdache dur labr and del
O74.6
O74.7
O74.8
O74.4
O74.5
O74.6
O74.7
O74.8
O89.8
O74.9
O74.9
O89.9
O75.0
O75.0
O75.1
O75.1
O26.51
O26.52
O26.53
O26.51
O26.52
O26.53
O90.4
O75.4
O75.4
O66.5
O64.1XX0
O82
O75.81
O75.89
O75.81
Oth comp of spinal and epidural anesth during labor and del
Failed or difficult intubation for anesth dur labor and del
Other complications of anesthesia during labor and delivery
Toxic reaction to local anesthesia during labor and delivery
Spinal and epidur anesthesia-induced hdache dur labr and del
Oth comp of spinal and epidural anesth during labor and del
Failed or difficult intubation for anesth dur labor and del
Other complications of anesthesia during labor and delivery
Other complications of anesthesia during the puerperium
Complication of anesthesia during labor and delivery, unsp
Complication of anesthesia during labor and delivery, unsp
Complication of anesthesia during the puerperium, unsp
Maternal distress during labor and delivery
Maternal distress during labor and delivery
Shock during or following labor and delivery
Shock during or following labor and delivery
Maternal hypotension syndrome, first trimester
Maternal hypotension syndrome, second trimester
Maternal hypotension syndrome, third trimester
Maternal hypotension syndrome, first trimester
Maternal hypotension syndrome, second trimester
Maternal hypotension syndrome, third trimester
Postpartum acute kidney failure
Other complications of obstetric surgery and procedures
Other complications of obstetric surgery and procedures
Attempted application of vacuum extractor and forceps
Obstructed labor due to breech presentation, unsp
Encounter for cesarean delivery without indication
Maternal exhaustion complicating labor and delivery
Other specified complications of labor and delivery
Maternal exhaustion complicating labor and delivery
PC v2014A
326
O75.89
O75.9
O75.9
Other specified complications of labor and delivery
Complication of labor and delivery, unspecified
Complication of labor and delivery, unspecified
Table 11.04 Complication of the Puerperium
ICD-10-CM Code
Short Description
O22.01
Varicose veins of lower extremity in pregnancy, first trimester
O22.02
Varicose veins of lower extremity in pregnancy, second trimester
O22.03
Varicose veins of lower extremity in pregnancy, third trimester
O22.11
Genital varices in pregnancy, first trimester
O22.12
Genital varices in pregnancy, third trimester
O22.13
Genital varices in pregnancy, third trimester
O22.22
Superficial thrombophlebitis in pregnancy, second trimester
O22.23
Superficial thrombophlebitis in pregnancy, third trimester
O22.31
Deep phlebothrombosis in pregnancy, first trimester
O22.32
Deep phlebothrombosis in pregnancy, second trimester
O22.33
Deep phlebothrombosis in pregnancy, third trimester
O22.41
Hemorrhoids in pregnancy, first trimester
O22.42
Hemorrhoids in pregnancy, second trimester
O22.43
Hemorrhoids in pregnancy, third trimester
O22.51
Cerebral venous thrombosis in pregnancy, first trimester
O22.52
Cerebral venous thrombosis in pregnancy, second trimester
O22.53
Cerebral venous thrombosis in pregnancy, third trimester
O22.8X1
Other venous complications in pregnancy, first trimester
O22.8X2
Other venous complications in pregnancy, second trimester
O22.8X3
Other venous complications in pregnancy, third trimester
O22.91
Venous complication in pregnancy, unspecified, first trimester
O22.92
Venous complication in pregnancy, unspecified, second trimester
O22.93
Venous complication in pregnancy, unspecified, third trimester
O85
Puerperal sepsis
O86.0
Infection of obstetric surgical wound
O86.12
Endometritis following delivery
O86.4
Pyrexia of unknown origin following delivery
O86.81
Puerperal septic thrombophlebitis
O86.89
Other specified puerperal infections
O87.0
Superficial thrombophlebitis in the puerperium
O87.1
Deep phlebothrombosis in the puerperium
O87.2
Hemorrhoids in the puerperium
O87.3
Cerebral venous thrombosis in the puerperium
O87.4
Varicose veins of lower extremity in the puerperium
O87.8
Other venous complications in the puerperium
O87.9
Venous complication in the puerperium, unspecified
O88.011
Air embolism in pregnancy, first trimester
O88.012
Air embolism in pregnancy, second trimester
O88.013
Air embolism in pregnancy, third trimester
O88.02
Air embolism in childbirth
O88.02
Air embolism in childbirth
O88.03
Air embolism in the puerperium
O88.111
Amniotic fluid embolism in pregnancy, third trimester
O88.12
Amniotic fluid embolism in childbirth
O88.13
Amniotic fluid embolism in the puerperium
PC v2014A
327
O88.211
O88.212
O88.213
O88.22
O88.23
O88.311
O88.312
Thromboembolism in pregnancy, first trimester
Thromboembolism in pregnancy, second trimester
Thromboembolism in pregnancy, third trimester
Thromboembolism in childbirth
Thromboembolism in the puerperium
Pyemic and septic embolism in pregnancy, first trimester
Pyemic and septic embolism in pregnancy, second trimester
O88.313
O88.32
O88.33
O88.811
O88.812
O88.813
O88.82
O88.83
O90.0
O90.1
O90.2
O90.89
O90.9
O91.011
O91.012
O91.013
O91.02
O91.111
O91.112
O91.113
O91.12
O91.211
O91.212
O91.213
O91.22
O91.23
O92.011
O92.012
O92.013
O92.03
O92.111
O92.112
O92.113
O92.13
O92.20
Pyemic and septic embolism in pregnancy, third trimester
Pyemic and septic embolism in childbirth
Pyemic and septic embolism in the puerperium
Other embolism in pregnancy, first trimester
Other embolism in pregnancy, second trimester
Other embolism in childbirth
Other embolism in childbirth
Other embolism in the puerperium
Disruption of cesarean delivery wound
Disruption of perineal obstetric wound
Hematoma of obstetric wound
Other complications of the puerperium, not elsewhere classified
Complication of the puerperium, unspecified
Infection of nipple associated with pregnancy, first trimester
Infection of nipple associated with pregnancy, second trimester
Infection of nipple associated with pregnancy, third trimester
Infection of nipple associated with the puerperium
Abscess of breast associated with pregnancy, first trimester
Abscess of breast associated with pregnancy, second trimester
Abscess of breast associated with pregnancy, third trimester
Abscess of breast associated with the puerperium
Nonpurulent mastitis associated with pregnancy, first trimester
Nonpurulent mastitis associated with pregnancy, second trimester
Nonpurulent mastitis associated with pregnancy, third trimester
Nonpurulent mastitis associated with the puerperium
Nonpurulent mastitis associated with lactation
Retracted nipple associated with pregnancy, first trimester
Retracted nipple associated with pregnancy, second trimester
Retracted nipple associated with pregnancy, third trimester
Retracted nipple associated with lactation
Cracked nipple associated with pregnancy, first trimester
Cracked nipple associated with pregnancy, second trimester
Cracked nipple associated with pregnancy, third trimester
Cracked nipple associated with lactation
Unspecified disorder of breast associated with pregnancy and the puerperium
O92.29
O92.3
O92.5
O92.6
O92.70
O92.79
O99.411
O99.412
O99.413
O99.42
Other disorders of breast associated with pregnancy and the puerperium
Agalactia
Suppressed lactation
Galactorrhea
Unspecified disorders of lactation
Other disorders of lactation
Diseases of the circulatory system complicating pregnancy, first trimester
Diseases of the circulatory system complicating pregnancy, second trimester
Diseases of the circulatory system complicating pregnancy, third trimester
Diseases of the circulatory system complicating childbirth
PC v2014A
328
Table 11.05 Medical Induction of Labor
ICD-10-PCS
Code
0U7C7ZZ
10900ZC
10903ZC
10904ZC
10907ZC
10908ZC
3E053VJ
3E0DXGC
Code Description
Dilation of Cervix, Via Natural or Artificial Opening
Drainage of Amniotic Fluid, Therapeutic from Products of Conception, Open Approach
Drainage of Amniotic Fluid, Therapeutic from Products of Conception, Percutaneous Approach
Drainage of Amniotic Fluid, Therapeutic from Products of Conception, Percutaneous Endoscopic
Approach
Drainage of Amniotic Fluid, Therapeutic from Products of Conception, Via Natural or Artificial
Opening
Drainage of Amniotic Fluid, Therapeutic from Products of Conception, Via Natural or Artificial
Opening Endoscopic
Introduction of Other Hormone into Peripheral Artery, Percutaneous Approach
Introduction of Other Therapeutic Substance into Mouth and Pharynx, External Approach
Table 11.06.1 Planned Cesarean Section in Labor
ICD-10Code Description
PCS Code
O75.82
Onset (spontaneous) of labor after 37 completed weeks of gestation but before 39 completed weeks
gestation, with delivery by (planned) cesarean section
Table 11.06 Cesarean Section
Code Description
ICD-10-PCS Code
10D00Z0
Extraction of Products of Conception, Classical, Open Approach
10D00Z1
Extraction of Products of Conception, Low Cervical, Open Approach
10D00Z2
Extraction of Products of Conception, Extraperitoneal, Open Approach
10D00Z0
Extraction of Products of Conception, Classical, Open Approach
10D00Z0
Extraction of Products of Conception, Classical, Open Approach
10D00Z1
Extraction of Products of Conception, Low Cervical, Open Approach
10D00Z2
Extraction of Products of Conception, Extraperitoneal, Open Approach
Table 11.07 Conditions Possibly Justifying Elective Delivery Prior to
39 Weeks Gestation
ICD-10-CM
Code Description
Code
B20
Human immunodeficiency virus [HIV] disease
O09.291 Supervision of pregnancy with other poor reproductive or obstetric history, first trimester
O09.292 Supervision of pregnancy with other poor reproductive or obstetric history, second trimester
O09.293 Supervision of pregnancy with other poor reproductive or obstetric history, third trimester
O09.299 Supervision of pregnancy with other poor reproductive or obstetric history, unspecified trimester
O10.011 Pre-existing essential hypertension complicating pregnancy, first trimester
O10.012 Pre-existing essential hypertension complicating pregnancy, second trimester
O10.013 Pre-existing essential hypertension complicating pregnancy, third trimester
O10.02
O10.111
PC v2014A
Pre-existing essential hypertension complicating childbirth
Pre-existing hypertensive heart disease complicating pregnancy, first trimester
329
O10.112
O10.113
O10.12
O10.211
O10.212
O10.212
O10.213
O10.22
O10.311
O10.312
O10.313
O10.32
O10.411
O10.412
O10.413
O10.42
O10.911
O10.912
O10.913
O10.92
O11.1
O11.1
O11.2
O11.2
O11.3
O11.3
O12.11
O12.12
O12.13
O12.21
O12.22
O12.23
O13.1
O13.1
O13.2
O13.2
O13.3
O13.3
O14.02
Pre-existing hypertensive heart disease complicating pregnancy, second trimester
Pre-existing hypertensive heart disease complicating pregnancy, third trimester
Pre-existing hypertensive heart disease complicating childbirth
Pre-existing hypertensive chronic kidney disease complicating pregnancy, first trimester
Pre-existing hypertensive chronic kidney disease complicating pregnancy, second trimester
Pre-existing hypertensive chronic kidney disease complicating pregnancy, second trimester
Pre-existing hypertensive chronic kidney disease complicating pregnancy, third trimester
Pre-existing hypertensive chronic kidney disease complicating childbirth
Pre-existing hypertensive heart and chronic kidney disease complicating pregnancy, first trimester
Pre-existing hypertensive heart and chronic kidney disease complicating pregnancy, second trimester
Pre-existing hypertensive heart and chronic kidney disease complicating pregnancy, third trimester
Pre-existing hypertensive heart and chronic kidney disease complicating childbirth
Pre-existing secondary hypertension complicating pregnancy, first trimester
Pre-existing secondary hypertension complicating pregnancy, second trimester
Pre-existing secondary hypertension complicating pregnancy, third trimester
Pre-existing secondary hypertension complicating childbirth
Unspecified pre-existing hypertension complicating pregnancy, first trimester
Unspecified pre-existing hypertension complicating pregnancy, second trimester
Unspecified pre-existing hypertension complicating pregnancy, third trimester
Unspecified pre-existing hypertension complicating childbirth
Pre-existing hypertension with pre-eclampsia, first trimester
Pre-existing hypertension with pre-eclampsia, first trimester
Pre-existing hypertension with pre-eclampsia, second trimester
Pre-existing hypertension with pre-eclampsia, second trimester
Pre-existing hypertension with pre-eclampsia, third trimester
Pre-existing hypertension with pre-eclampsia, third trimester
Gestational proteinuria, first trimester
Gestational proteinuria, second trimester
Gestational proteinuria, third trimester
Gestational edema with proteinuria, first trimester
Gestational edema with proteinuria, second trimester
Gestational edema with proteinuria, third trimester
Gestational [pregnancy-induced] hypertension without significant proteinuria, first trimester
Gestational [pregnancy-induced] hypertension without significant proteinuria, first trimester
Gestational [pregnancy-induced] hypertension without significant proteinuria, second trimester
Gestational [pregnancy-induced] hypertension without significant proteinuria, second trimester
Gestational [pregnancy-induced] hypertension without significant proteinuria, third trimester
Gestational [pregnancy-induced] hypertension without significant proteinuria, third trimester
Mild to moderate pre-eclampsia, second trimester
O14.02
O14.03
O14.03
O14.12
O14.12
O14.13
O14.13
O14.22
O14.22
O14.23
O14.23
O14.92
O14.93
O15.02
Mild to moderate pre-eclampsia, second trimester
Mild to moderate pre-eclampsia, third trimester
Mild to moderate pre-eclampsia, third trimester
Severe pre-eclampsia, second trimester
Severe pre-eclampsia, second trimester
Severe pre-eclampsia, third trimester
Severe pre-eclampsia, third trimester
HELLP syndrome (HELLP), second trimester
HELLP syndrome (HELLP), second trimester
HELLP syndrome (HELLP), third trimester
HELLP syndrome (HELLP), third trimester
Unspecified pre-eclampsia, second trimester
Unspecified pre-eclampsia, third trimester
Eclampsia in pregnancy, second trimester
PC v2014A
330
O15.03
O15.1
O15.2
O15.2
O16.1
O16.2
O16.3
O2.662
O24.011
O24.012
O24.013
O24.02
O24.111
O24.112
O24.113
O24.12
O24.311
O24.312
O24.313
O24.32
O24.410
O24.414
O24.419
O24.420
O24.424
O24.429
O24.811
O24.812
O24.813
O24.82
O24.911
O24.912
O24.913
O24.92
O26.611
O26.612
O26.613
Eclampsia in pregnancy, third trimester
Eclampsia in labor
Eclampsia in the puerperium
Eclampsia in the puerperium
Unspecified maternal hypertension, first trimester
Unspecified maternal hypertension, second trimester
Unspecified maternal hypertension, third trimester
Liver and biliary tract disorders in childbirth
Pre-existing diabetes mellitus, type 1, in pregnancy, first trimester
Pre-existing diabetes mellitus, type 1, in pregnancy, second trimester
Pre-existing diabetes mellitus, type 1, in pregnancy, third trimester
Pre-existing diabetes mellitus, type 1, in childbirth
Pre-existing diabetes mellitus, type 2, in pregnancy, first trimester
Pre-existing diabetes mellitus, type 2, in pregnancy, second trimester
Pre-existing diabetes mellitus, type 2, in pregnancy, third trimester
Pre-existing diabetes mellitus, type 2, in childbirth
Unspecified pre-existing diabetes mellitus in pregnancy, first trimester
Unspecified pre-existing diabetes mellitus in pregnancy, second trimester
Unspecified pre-existing diabetes mellitus in pregnancy, third trimester
Unspecified pre-existing diabetes mellitus in childbirth
Gestational diabetes mellitus in pregnancy, diet controlled
Gestational diabetes mellitus in pregnancy, insulin controlled
Gestational diabetes mellitus in pregnancy, unspecified control
Gestational diabetes mellitus in childbirth, diet controlled
Gestational diabetes mellitus in childbirth, insulin controlled
Gestational diabetes mellitus in childbirth, unspecified control
Other pre-existing diabetes mellitus in pregnancy, first trimester
Other pre-existing diabetes mellitus in pregnancy, second trimester
Other pre-existing diabetes mellitus in pregnancy, third trimester
Other pre-existing diabetes mellitus in childbirth
Unspecified diabetes mellitus in pregnancy, first trimester
Unspecified diabetes mellitus in pregnancy, second trimester
Unspecified diabetes mellitus in pregnancy, third trimester
Unspecified diabetes mellitus in childbirth
Liver and biliary tract disorders in pregnancy, first trimester
Liver and biliary tract disorders in pregnancy, second trimester
Liver and biliary tract disorders in pregnancy, third trimester
O26.831
O26.831
O26.832
O26.832
O26.833
O26.833
O30.001
Pregnancy related renal disease, first trimester
Pregnancy related renal disease, first trimester
Pregnancy related renal disease, second trimester
Pregnancy related renal disease, second trimester
Pregnancy related renal disease, third trimester
Pregnancy related renal disease, third trimester
Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, first
trimester
Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, second
trimester
Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, third
trimester
Twin pregnancy, monochorionic/monoamniotic, first trimester
Twin pregnancy, monochorionic/monoamniotic, second trimester
Twin pregnancy, monochorionic/monoamniotic, third trimester
O30.002
O30.003
O30.011
O30.012
O30.013
PC v2014A
331
O30.031
O30.032
O30.033
O30.041
O30.042
O30.043
O30.091
O30.092
O30.093
O30.101
O30.102
O30.103
O30.111
O30.112
O30.113
O30.121
O30.122
O30.123
O30.191
O30.192
O30.193
O30.201
O30.202
O30.203
O30.211
O30.212
O30.213
O30.221
O30.222
O30.223
O30.291
Twin pregnancy, monochorionic/diamniotic, first trimester
Twin pregnancy, monochorionic/diamniotic, second trimester
Twin pregnancy, monochorionic/diamniotic, third trimester
Twin pregnancy, dichorionic/diamniotic, first trimester
Twin pregnancy, dichorionic/diamniotic, second trimester
Twin pregnancy, dichorionic/diamniotic, third trimester
Twin pregnancy, unable to determine number of placenta and number of amniotic sacs, first trimester
Twin pregnancy, unable to determine number of placenta and number of amniotic sacs, second
trimester
Twin pregnancy, unable to determine number of placenta and number of amniotic sacs, third trimester
Triplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, first
trimester
Triplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, second
trimester
Triplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, third
trimester
Triplet pregnancy with two or more monochorionic fetuses, first trimester
Triplet pregnancy with two or more monochorionic fetuses, second trimester
Triplet pregnancy with two or more monochorionic fetuses, third trimester
Triplet pregnancy with two or more monoamniotic fetuses, first trimester
Triplet pregnancy with two or more monoamniotic fetuses, second trimester
Triplet pregnancy with two or more monoamniotic fetuses, third trimester
Triplet pregnancy, unable to determine number of placenta and number of amniotic sacs, first trimester
Triplet pregnancy, unable to determine number of placenta and number of amniotic sacs, second
trimester
Triplet pregnancy, unable to determine number of placenta and number of amniotic sacs, third trimester
Quadruplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, first
trimester
Quadruplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs,
second trimester
Quadruplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, third
trimester
Quadruplet pregnancy with two or more monochorionic fetuses, first trimester
Quadruplet pregnancy with two or more monochorionic fetuses, second trimester
Quadruplet pregnancy with two or more monochorionic fetuses, third trimester
O30.811
O30.812
O30.813
Quadruplet pregnancy with two or more monoamniotic fetuses, first trimester
Quadruplet pregnancy with two or more monoamniotic fetuses, second trimester
Quadruplet pregnancy with two or more monoamniotic fetuses, third trimester
Quadruplet pregnancy, unable to determine number of placenta and number of amniotic sacs, first
trimester
Quadruplet pregnancy, unable to determine number of placenta and number of amniotic sacs, second
trimester
Quadruplet pregnancy, unable to determine number of placenta and number of amniotic sacs, third
trimester
Other specified multiple gestation, unspecified number of placenta and unspecified number of amniotic
sacs, first trimester
Other specified multiple gestation, unspecified number of placenta and unspecified number of amniotic
sacs, second trimester
Other specified multiple gestation, unspecified number of placenta and unspecified number of amniotic
sacs, third trimester
Other specified multiple gestation with two or more monochorionic fetuses, first trimester
Other specified multiple gestation with two or more monochorionic fetuses, second trimester
Other specified multiple gestation with two or more monochorionic fetuses, third trimester
PC v2014A
332
O30.292
O30.293
O30.801
O30.802
O30.803
O30.821
O30.822
O30.823
O30.891
O30.892
O30.893
O30.91
O30.92
O30.93
O31.11X0
O31.11X0
O31.11X0
O31.11X0
O31.11X1
O31.11X1
O31.11X2
O31.11X2
O31.11X3
O31.11X4
O31.11X5
O31.11X9
O31.12X0
O31.12X0
O31.12X1
O31.12X1
O31.12X2
O31.12X2
O31.12X3
O31.12X4
O31.12X5
O31.12X9
O31.13X0
O31.13X0
O31.13X1
O31.13X1
O31.13X2
O31.13X2
O31.13X3
O31.13X4
O31.13X5
O31.13X9
O31.21X0
PC v2014A
Other specified multiple gestation with two or more monoamniotic fetuses, first trimester
Other specified multiple gestation with two or more monoamniotic fetuses, second trimester
Other specified multiple gestation with two or more monoamniotic fetuses, third trimester
Other specified multiple gestation, unable to determine number of placenta and number of amniotic
sacs, first trimester
Other specified multiple gestation, unable to determine number of placenta and number of amniotic
sacs, second trimester
Other specified multiple gestation, unable to determine number of placenta and number of amniotic
sacs, third trimester
Multiple gestation, unspecified, first trimester
Multiple gestation, unspecified, second trimester
Multiple gestation, unspecified, third trimester
Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, not applicable or
unspecified
Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, not applicable or
unspecified
Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, not applicable or
unspecified
Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, not applicable or
unspecified
Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, fetus 1
Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, fetus 1
Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, fetus 2
Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, fetus 2
Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, fetus 3
Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, fetus 4
Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, fetus 5
Continuing pregnancy after spontaneous abortion of one fetus or more, first trimester, other fetus
Continuing pregnancy after spontaneous abortion of one fetus or more, second trimester, not
applicable or unspecified
Continuing pregnancy after spontaneous abortion of one fetus or more, second trimester, not
applicable or unspecified
Continuing pregnancy after spontaneous abortion of one fetus or more, second trimester, fetus 1
Continuing pregnancy after spontaneous abortion of one fetus or more, second trimester, fetus 1
Continuing pregnancy after spontaneous abortion of one fetus or more, second trimester, fetus 2
Continuing pregnancy after spontaneous abortion of one fetus or more, second trimester, fetus 2
Continuing pregnancy after spontaneous abortion of one fetus or more, second trimester, fetus 3
Continuing pregnancy after spontaneous abortion of one fetus or more, second trimester, fetus 4
Continuing pregnancy after spontaneous abortion of one fetus or more, second trimester, fetus 5
Continuing pregnancy after spontaneous abortion of one fetus or more, second trimester, other fetus
Continuing pregnancy after spontaneous abortion of one fetus or more, third trimester, not applicable
or unspecified
Continuing pregnancy after spontaneous abortion of one fetus or more, third trimester, not applicable
or unspecified
Continuing pregnancy after spontaneous abortion of one fetus or more, third trimester, fetus 1
Continuing pregnancy after spontaneous abortion of one fetus or more, third trimester, fetus 1
Continuing pregnancy after spontaneous abortion of one fetus or more, third trimester, fetus 2
Continuing pregnancy after spontaneous abortion of one fetus or more, third trimester, fetus 2
Continuing pregnancy after spontaneous abortion of one fetus or more, third trimester, fetus 3
Continuing pregnancy after spontaneous abortion of one fetus or more, third trimester, fetus 4
Continuing pregnancy after spontaneous abortion of one fetus or more, third trimester, fetus 5
Continuing pregnancy after spontaneous abortion of one fetus or more, third trimester, other fetus
Continuing pregnancy after intrauterine death of one fetus or more, first trimester, not applicable or
unspecified
333
O31.21X0 Continuing pregnancy after intrauterine death of one fetus or more, first trimester, not applicable or
unspecified
O31.21X1 Continuing pregnancy after intrauterine death of one fetus or more, first trimester, fetus 1
O31.21X1 Continuing pregnancy after intrauterine death of one fetus or more, first trimester, fetus 1
O31.21X2
O31.21X2
O31.21X3
O31.21X4
O31.21X5
O31.21X9
O31.22X0
O31.22X0
O31.22X1
O31.22X1
O31.22X2
O31.22X2
O31.22X3
O31.22X4
O31.22X5
O31.22X9
O31.23X0
O31.23X0
O31.23X1
O31.23X1
O31.23X2
O31.23X2
O31.23X3
O31.23X4
O31.23X5
O31.23X9
O31.31X0
O31.31X1
O31.31X2
O31.31X3
O31.31X4
O31.31X5
O31.31X9
O31.32X0
O31.32X1
O31.32X2
O31.32X3
O31.32X4
O31.32X5
O31.32X9
O31.33X0
PC v2014A
Continuing pregnancy after intrauterine death of one fetus or more, first trimester, fetus 2
Continuing pregnancy after intrauterine death of one fetus or more, first trimester, fetus 2
Continuing pregnancy after intrauterine death of one fetus or more, first trimester, fetus 3
Continuing pregnancy after intrauterine death of one fetus or more, first trimester, fetus 4
Continuing pregnancy after intrauterine death of one fetus or more, first trimester, fetus 5
Continuing pregnancy after intrauterine death of one fetus or more, first trimester, other fetus
Continuing pregnancy after intrauterine death of one fetus or more, second trimester, not applicable or
unspecified
Continuing pregnancy after intrauterine death of one fetus or more, second trimester, not applicable or
unspecified
Continuing pregnancy after intrauterine death of one fetus or more, second trimester, fetus 1
Continuing pregnancy after intrauterine death of one fetus or more, second trimester, fetus 1
Continuing pregnancy after intrauterine death of one fetus or more, second trimester, fetus 2
Continuing pregnancy after intrauterine death of one fetus or more, second trimester, fetus 2
Continuing pregnancy after intrauterine death of one fetus or more, second trimester, fetus 3
Continuing pregnancy after intrauterine death of one fetus or more, second trimester, fetus 4
Continuing pregnancy after intrauterine death of one fetus or more, second trimester, fetus 5
Continuing pregnancy after intrauterine death of one fetus or more, second trimester, other fetus
Continuing pregnancy after intrauterine death of one fetus or more, third trimester, not applicable or
unspecified
Continuing pregnancy after intrauterine death of one fetus or more, third trimester, not applicable or
unspecified
Continuing pregnancy after intrauterine death of one fetus or more, third trimester, fetus 1
Continuing pregnancy after intrauterine death of one fetus or more, third trimester, fetus 1
Continuing pregnancy after intrauterine death of one fetus or more, third trimester, fetus 2
Continuing pregnancy after intrauterine death of one fetus or more, third trimester, fetus 2
Continuing pregnancy after intrauterine death of one fetus or more, third trimester, fetus 3
Continuing pregnancy after intrauterine death of one fetus or more, third trimester, fetus 4
Continuing pregnancy after intrauterine death of one fetus or more, third trimester, fetus 5
Continuing pregnancy after intrauterine death of one fetus or more, third trimester, other fetus
Continuing pregnancy after elective fetal reduction of one fetus or more, first trimester, not applicable or
unspecified
Continuing pregnancy after elective fetal reduction of one fetus or more, first trimester, fetus 1
Continuing pregnancy after elective fetal reduction of one fetus or more, first trimester, fetus 2
Continuing pregnancy after elective fetal reduction of one fetus or more, first trimester, fetus 3
Continuing pregnancy after elective fetal reduction of one fetus or more, first trimester, fetus 4
Continuing pregnancy after elective fetal reduction of one fetus or more, first trimester, fetus 5
Continuing pregnancy after elective fetal reduction of one fetus or more, first trimester, other fetus
Continuing pregnancy after elective fetal reduction of one fetus or more, second trimester, not
applicable or unspecified
Continuing pregnancy after elective fetal reduction of one fetus or more, second trimester, fetus 1
Continuing pregnancy after elective fetal reduction of one fetus or more, second trimester, fetus 2
Continuing pregnancy after elective fetal reduction of one fetus or more, second trimester, fetus 3
Continuing pregnancy after elective fetal reduction of one fetus or more, second trimester, fetus 4
Continuing pregnancy after elective fetal reduction of one fetus or more, second trimester, fetus 5
Continuing pregnancy after elective fetal reduction of one fetus or more, second trimester, other fetus
Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester, not applicable
or unspecified
334
O31.33X1
O31.33X2
O31.33X3
O31.33X4
O31.33X5
O31.33X9
O31.8X10
O31.8X11
O31.8X12
O31.8X13
O31.8X14
O31.8X15
O31.8X19
O31.8X20
O31.8X21
O31.8X22
Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester, fetus 1
Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester, fetus 2
Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester, fetus 3
Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester, fetus 4
Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester, fetus 5
Continuing pregnancy after elective fetal reduction of one fetus or more, third trimester, other fetus
Other complications specific to multiple gestation, first trimester, not applicable or unspecified
Other complications specific to multiple gestation, first trimester, fetus 1
Other complications specific to multiple gestation, first trimester, fetus 2
Other complications specific to multiple gestation, first trimester, fetus 3
Other complications specific to multiple gestation, first trimester, fetus 4
Other complications specific to multiple gestation, first trimester, fetus 5
Other complications specific to multiple gestation, first trimester, other fetus
Other complications specific to multiple gestation, second trimester, not applicable or unspecified
Other complications specific to multiple gestation, second trimester, fetus 1
Other complications specific to multiple gestation, second trimester, fetus 2
O31.8X23
O31.8X24
O31.8X25
O31.8X29
O31.8X30
O31.8X31
O31.8X32
O31.8X33
O31.8X34
O31.8X35
O31.8X39
O32.0XX0
O32.0XX1
O32.0XX2
O32.0XX3
O32.0XX4
O32.0XX5
O32.0XX9
O32.9XX0
O32.9XX1
O32.9XX2
O32.9XX3
O32.9XX4
O32.9XX5
O32.9XX9
O35.0XX0
Other complications specific to multiple gestation, second trimester, fetus 3
Other complications specific to multiple gestation, second trimester, fetus 4
Other complications specific to multiple gestation, second trimester, fetus 5
Other complications specific to multiple gestation, second trimester, other fetus
Other complications specific to multiple gestation, third trimester, not applicable or unspecified
Other complications specific to multiple gestation, third trimester, fetus 1
Other complications specific to multiple gestation, third trimester, fetus 2
Other complications specific to multiple gestation, third trimester, fetus 3
Other complications specific to multiple gestation, third trimester, fetus 4
Other complications specific to multiple gestation, third trimester, fetus 5
Other complications specific to multiple gestation, third trimester, other fetus
Maternal care for unstable lie, not applicable or unspecified
Maternal care for unstable lie, fetus 1
Maternal care for unstable lie, fetus 2
Maternal care for unstable lie, fetus 3
Maternal care for unstable lie, fetus 4
Maternal care for unstable lie, fetus 5
Maternal care for unstable lie, other fetus
Maternal care for malpresentation of fetus, unspecified, not applicable or unspecified
Maternal care for malpresentation of fetus, unspecified, fetus 1
Maternal care for malpresentation of fetus, unspecified, fetus 2
Maternal care for malpresentation of fetus, unspecified, fetus 3
Maternal care for malpresentation of fetus, unspecified, fetus 4
Maternal care for malpresentation of fetus, unspecified, fetus 5
Maternal care for malpresentation of fetus, unspecified, other fetus
Maternal care for (suspected) central nervous system malformation in fetus, not applicable or
unspecified
Maternal care for (suspected) central nervous system malformation in fetus, fetus 1
Maternal care for (suspected) central nervous system malformation in fetus, fetus 2
Maternal care for (suspected) central nervous system malformation in fetus, fetus 3
Maternal care for (suspected) central nervous system malformation in fetus, fetus 4
Maternal care for (suspected) central nervous system malformation in fetus, fetus 5
Maternal care for (suspected) central nervous system malformation in fetus, other fetus
Maternal care for (suspected) chromosomal abnormality in fetus, not applicable or unspecified
Maternal care for (suspected) chromosomal abnormality in fetus, fetus 1
Maternal care for (suspected) chromosomal abnormality in fetus, fetus 2
O35.0XX1
O35.0XX2
O35.0XX3
O35.0XX4
O35.0XX5
O35.0XX9
O35.1XX0
O35.1XX1
O35.1XX2
PC v2014A
335
O35.1XX3
O35.1XX4
O35.1XX5
O35.1XX9
O35.3XX0
O35.3XX1
O35.3XX2
O35.3XX3
O35.3XX4
O35.3XX5
O35.3XX9
O35.4XX0
O35.4XX1
Maternal care for (suspected) chromosomal abnormality in fetus, fetus 3
Maternal care for (suspected) chromosomal abnormality in fetus, fetus 4
Maternal care for (suspected) chromosomal abnormality in fetus, fetus 5
Maternal care for (suspected) chromosomal abnormality in fetus, other fetus
Maternal care for (suspected) damage to fetus from viral disease in mother, not applicable or
unspecified
Maternal care for (suspected) damage to fetus from viral disease in mother, fetus 1
Maternal care for (suspected) damage to fetus from viral disease in mother, fetus 2
Maternal care for (suspected) damage to fetus from viral disease in mother, fetus 3
Maternal care for (suspected) damage to fetus from viral disease in mother, fetus 4
Maternal care for (suspected) damage to fetus from viral disease in mother, fetus 5
Maternal care for (suspected) damage to fetus from viral disease in mother, other fetus
Maternal care for (suspected) damage to fetus from alcohol, not applicable or unspecified
Maternal care for (suspected) damage to fetus from alcohol, fetus 1
O35.4XX2
O35.4XX3
O35.4XX4
O35.4XX5
O35.4XX9
O35.5XX0
O35.5XX1
O35.5XX2
O35.5XX3
O35.5XX4
O35.5XX5
O35.5XX9
O35.6XX0
O35.6XX1
O35.6XX2
O35.6XX3
O35.6XX4
O35.6XX5
O35.6XX9
O35.8XX0
O35.8XX1
O35.8XX2
O35.8XX3
O35.8XX4
O35.8XX5
O35.8XX9
O36.0110
O36.0111
O36.0112
O36.0113
O36.0114
O36.0115
O36.0119
O36.0120
O36.0121
O36.0122
O36.0123
O36.0124
Maternal care for (suspected) damage to fetus from alcohol, fetus 2
Maternal care for (suspected) damage to fetus from alcohol, fetus 3
Maternal care for (suspected) damage to fetus from alcohol, fetus 4
Maternal care for (suspected) damage to fetus from alcohol, fetus 5
Maternal care for (suspected) damage to fetus from alcohol, other fetus
Maternal care for (suspected) damage to fetus by drugs, not applicable or unspecified
Maternal care for (suspected) damage to fetus by drugs, fetus 1
Maternal care for (suspected) damage to fetus by drugs, fetus 2
Maternal care for (suspected) damage to fetus by drugs, fetus 3
Maternal care for (suspected) damage to fetus by drugs, fetus 4
Maternal care for (suspected) damage to fetus by drugs, fetus 5
Maternal care for (suspected) damage to fetus by drugs, other fetus
Maternal care for (suspected) damage to fetus by radiation, not applicable or unspecified
Maternal care for (suspected) damage to fetus by radiation, fetus 1
Maternal care for (suspected) damage to fetus by radiation, fetus 2
Maternal care for (suspected) damage to fetus by radiation, fetus 3
Maternal care for (suspected) damage to fetus by radiation, fetus 4
Maternal care for (suspected) damage to fetus by radiation, fetus 5
Maternal care for (suspected) damage to fetus by radiation, other fetus
Maternal care for other (suspected) fetal abnormality and damage, not applicable or unspecified
Maternal care for other (suspected) fetal abnormality and damage, fetus 1
Maternal care for other (suspected) fetal abnormality and damage, fetus 2
Maternal care for other (suspected) fetal abnormality and damage, fetus 3
Maternal care for other (suspected) fetal abnormality and damage, fetus 4
Maternal care for other (suspected) fetal abnormality and damage, fetus 5
Maternal care for other (suspected) fetal abnormality and damage, other fetus
Maternal care for anti-D [Rh] antibodies, first trimester, not applicable or unspecified
Maternal care for anti-D [Rh] antibodies, first trimester, fetus 1
Maternal care for anti-D [Rh] antibodies, first trimester, fetus 2
Maternal care for anti-D [Rh] antibodies, first trimester, fetus 3
Maternal care for anti-D [Rh] antibodies, first trimester, fetus 4
Maternal care for anti-D [Rh] antibodies, first trimester, fetus 5
Maternal care for anti-D [Rh] antibodies, first trimester, other fetus
Maternal care for anti-D [Rh] antibodies, second trimester, not applicable or unspecified
Maternal care for anti-D [Rh] antibodies, second trimester, fetus 1
Maternal care for anti-D [Rh] antibodies, second trimester, fetus 2
Maternal care for anti-D [Rh] antibodies, second trimester, fetus 3
Maternal care for anti-D [Rh] antibodies, second trimester, fetus 4
PC v2014A
336
O36.0125
O36.0129
O36.0130
O36.0131
O36.0132
O36.0133
O36.0134
O36.0135
O36.0139
O36.0910
O36.0911
Maternal care for anti-D [Rh] antibodies, second trimester, fetus 5
Maternal care for anti-D [Rh] antibodies, second trimester, other fetus
Maternal care for anti-D [Rh] antibodies, third trimester, not applicable or unspecified
Maternal care for anti-D [Rh] antibodies, third trimester, fetus 1
Maternal care for anti-D [Rh] antibodies, third trimester, fetus 2
Maternal care for anti-D [Rh] antibodies, third trimester, fetus 3
Maternal care for anti-D [Rh] antibodies, third trimester, fetus 4
Maternal care for anti-D [Rh] antibodies, third trimester, fetus 5
Maternal care for anti-D [Rh] antibodies, third trimester, other fetus
Maternal care for other rhesus isoimmunization, first trimester, not applicable or unspecified
Maternal care for other rhesus isoimmunization, first trimester, fetus 1
O36.0912
O36.0913
O36.0914
O36.0915
O36.0919
O36.0920
O36.0921
O36.0922
O36.0923
O36.0924
O36.0925
O36.0929
O36.0930
O36.0931
O36.0932
O36.0933
O36.0934
O36.0935
O36.0939
O36.1110
O36.1111
O36.1112
O36.1113
O36.1114
O36.1115
O36.1119
O36.1120
O36.1121
O36.1122
O36.1123
O36.1124
O36.1125
O36.1129
O36.1130
O36.1131
O36.1132
O36.1133
O36.1134
O36.1139
O36.1910
O36.1911
O36.1912
Maternal care for other rhesus isoimmunization, first trimester, fetus 2
Maternal care for other rhesus isoimmunization, first trimester, fetus 3
Maternal care for other rhesus isoimmunization, first trimester, fetus 4
Maternal care for other rhesus isoimmunization, first trimester, fetus 5
Maternal care for other rhesus isoimmunization, first trimester, other fetus
Maternal care for other rhesus isoimmunization, second trimester, not applicable or unspecified
Maternal care for other rhesus isoimmunization, second trimester, fetus 1
Maternal care for other rhesus isoimmunization, second trimester, fetus 2
Maternal care for other rhesus isoimmunization, second trimester, fetus 3
Maternal care for other rhesus isoimmunization, second trimester, fetus 4
Maternal care for other rhesus isoimmunization, second trimester, fetus 5
Maternal care for other rhesus isoimmunization, second trimester, other fetus
Maternal care for other rhesus isoimmunization, third trimester, not applicable or unspecified
Maternal care for other rhesus isoimmunization, third trimester, fetus 1
Maternal care for other rhesus isoimmunization, third trimester, fetus 2
Maternal care for other rhesus isoimmunization, third trimester, fetus 3
Maternal care for other rhesus isoimmunization, third trimester, fetus 4
Maternal care for other rhesus isoimmunization, third trimester, fetus 5
Maternal care for other rhesus isoimmunization, third trimester, other fetus
Maternal care for Anti-A sensitization, first trimester, not applicable or unspecified
Maternal care for Anti-A sensitization, first trimester, fetus 1
Maternal care for Anti-A sensitization, first trimester, fetus 2
Maternal care for Anti-A sensitization, first trimester, fetus 3
Maternal care for Anti-A sensitization, first trimester, fetus 4
Maternal care for Anti-A sensitization, first trimester, fetus 5
Maternal care for Anti-A sensitization, first trimester, other fetus
Maternal care for Anti-A sensitization, second trimester, not applicable or unspecified
Maternal care for Anti-A sensitization, second trimester, fetus 1
Maternal care for Anti-A sensitization, second trimester, fetus 2
Maternal care for Anti-A sensitization, second trimester, fetus 3
Maternal care for Anti-A sensitization, second trimester, fetus 4
Maternal care for Anti-A sensitization, second trimester, fetus 5
Maternal care for Anti-A sensitization, second trimester, other fetus
Maternal care for Anti-A sensitization, third trimester, not applicable or unspecified
Maternal care for Anti-A sensitization, third trimester, fetus 2
Maternal care for Anti-A sensitization, third trimester, fetus 3
Maternal care for Anti-A sensitization, third trimester, fetus 4
Maternal care for Anti-A sensitization, third trimester, fetus 5
Maternal care for Anti-A sensitization, third trimester, other fetus
Maternal care for other isoimmunization, first trimester, not applicable or unspecified
Maternal care for other isoimmunization, first trimester, fetus 1
Maternal care for other isoimmunization, first trimester, fetus 2
PC v2014A
337
O36.1913
O36.1914
O36.1915
O36.1919
O36.1920
O36.1921
O36.1922
Maternal care for other isoimmunization, first trimester, fetus 3
Maternal care for other isoimmunization, first trimester, fetus 4
Maternal care for other isoimmunization, first trimester, fetus 5
Maternal care for other isoimmunization, first trimester, other fetus
Maternal care for other isoimmunization, second trimester, not applicable or unspecified
Maternal care for other isoimmunization, second trimester, fetus 1
Maternal care for other isoimmunization, second trimester, fetus 2
O36.1923
O36.1924
O36.1925
O36.1929
O36.1930
O36.1931
O36.1932
O36.1933
O36.1934
O36.1935
O36.1939
O36.1940
O36.1941
O36.1942
O36.1943
O36.1944
O36.1945
O36.4XX9
O36.5110
Maternal care for other isoimmunization, second trimester, fetus 3
Maternal care for other isoimmunization, second trimester, fetus 4
Maternal care for other isoimmunization, second trimester, fetus 5
Maternal care for other isoimmunization, second trimester, other fetus
Maternal care for other isoimmunization, third trimester, not applicable or unspecified
Maternal care for other isoimmunization, third trimester, fetus 1
Maternal care for other isoimmunization, third trimester, fetus 2
Maternal care for other isoimmunization, third trimester, fetus 3
Maternal care for other isoimmunization, third trimester, fetus 4
Maternal care for other isoimmunization, third trimester, fetus 5
Maternal care for other isoimmunization, third trimester, other fetus
Maternal care for intrauterine death, not applicable or unspecified
Maternal care for intrauterine death, fetus 1
Maternal care for intrauterine death, fetus 2
Maternal care for intrauterine death, fetus 3
Maternal care for intrauterine death, fetus 4
Maternal care for intrauterine death, fetus 5
Maternal care for intrauterine death, other fetus
Maternal care for known or suspected placental insufficiency, first trimester, not applicable or
unspecified
Maternal care for known or suspected placental insufficiency, first trimester, fetus 1
Maternal care for known or suspected placental insufficiency, first trimester, fetus 2
Maternal care for known or suspected placental insufficiency, first trimester, fetus 3
Maternal care for known or suspected placental insufficiency, first trimester, fetus 4
Maternal care for known or suspected placental insufficiency, first trimester, fetus 5
Maternal care for known or suspected placental insufficiency, first trimester, other fetus
Maternal care for known or suspected placental insufficiency, second trimester, not applicable or
unspecified
Maternal care for known or suspected placental insufficiency, second trimester, fetus 1
Maternal care for known or suspected placental insufficiency, second trimester, fetus 2
Maternal care for known or suspected placental insufficiency, second trimester, fetus 3
Maternal care for known or suspected placental insufficiency, second trimester, fetus 4
Maternal care for known or suspected placental insufficiency, second trimester, fetus 5
Maternal care for known or suspected placental insufficiency, second trimester, other fetus
Maternal care for known or suspected placental insufficiency, third trimester, not applicable or
unspecified
Maternal care for known or suspected placental insufficiency, third trimester, fetus 1
Maternal care for known or suspected placental insufficiency, third trimester, fetus 2
Maternal care for known or suspected placental insufficiency, third trimester, fetus 3
Maternal care for known or suspected placental insufficiency, third trimester, fetus 4
Maternal care for known or suspected placental insufficiency, third trimester, fetus 5
Maternal care for known or suspected placental insufficiency, third trimester, other fetus
Maternal care for other known or suspected poor fetal growth, first trimester, not applicable or
unspecified
Maternal care for other known or suspected poor fetal growth, first trimester, fetus 1
Maternal care for other known or suspected poor fetal growth, first trimester, fetus 2
O36.5111
O36.5112
O36.5113
O36.5114
O36.5115
O36.5119
O36.5120
O36.5121
O36.5122
O36.5123
O36.5124
O36.5125
O36.5129
O36.5130
O36.5131
O36.5132
O36.5133
O36.5134
O36.5135
O36.5139
O36.5910
O36.5911
O36.5912
PC v2014A
338
O36.5913
O36.5914
O36.5915
O36.5919
O36.5920
Maternal care for other known or suspected poor fetal growth, first trimester, fetus 3
Maternal care for other known or suspected poor fetal growth, first trimester, fetus 4
Maternal care for other known or suspected poor fetal growth, first trimester, fetus 5
Maternal care for other known or suspected poor fetal growth, first trimester, other fetus
Maternal care for other known or suspected poor fetal growth, second trimester, not applicable or
unspecified
O36.5921
O36.5922
O36.5923
O36.5924
O36.5925
O36.5929
O36.5930
Maternal care for other known or suspected poor fetal growth, second trimester, fetus 1
Maternal care for other known or suspected poor fetal growth, second trimester, fetus 2
Maternal care for other known or suspected poor fetal growth, second trimester, fetus 3
Maternal care for other known or suspected poor fetal growth, second trimester, fetus 4
Maternal care for other known or suspected poor fetal growth, second trimester, fetus 5
Maternal care for other known or suspected poor fetal growth, second trimester, other fetus
Maternal care for other known or suspected poor fetal growth, third trimester, not applicable or
unspecified
Maternal care for other known or suspected poor fetal growth, third trimester, fetus 1
Maternal care for other known or suspected poor fetal growth, third trimester, fetus 2
Maternal care for other known or suspected poor fetal growth, third trimester, fetus 3
Maternal care for other known or suspected poor fetal growth, third trimester, fetus 4
Maternal care for other known or suspected poor fetal growth, third trimester, fetus 5
Maternal care for other known or suspected poor fetal growth, third trimester, other fetus
Polyhydramnios, first trimester, not applicable or unspecified
Polyhydramnios, first trimester, fetus 1
Polyhydramnios, first trimester, fetus 2
Polyhydramnios, first trimester, fetus 3
Polyhydramnios, first trimester, fetus 4
Polyhydramnios, first trimester, fetus 5
Polyhydramnios, first trimester, other fetus
Polyhydramnios, second trimester, not applicable or unspecified
Polyhydramnios, second trimester, fetus 1
Polyhydramnios, second trimester, fetus 2
Polyhydramnios, second trimester, fetus 3
Polyhydramnios, second trimester, fetus 4
Polyhydramnios, second trimester, fetus 5
Polyhydramnios, second trimester, other fetus
Polyhydramnios, third trimester, not applicable or unspecified
Polyhydramnios, third trimester, fetus 1
Polyhydramnios, third trimester, fetus 2
Polyhydramnios, third trimester, fetus 3
Polyhydramnios, third trimester, fetus 4
Polyhydramnios, third trimester, fetus 5
Polyhydramnios, third trimester, other fetus
Oligohydramnios, first trimester, not applicable or unspecified
Oligohydramnios, first trimester, fetus 1
Oligohydramnios, first trimester, fetus 2
Oligohydramnios, first trimester, fetus 3
Oligohydramnios, first trimester, fetus 4
Oligohydramnios, first trimester, fetus 5
Oligohydramnios, first trimester, other fetus
Oligohydramnios, second trimester, not applicable or unspecified
Oligohydramnios, second trimester, fetus 1
Oligohydramnios, second trimester, fetus 2
Oligohydramnios, second trimester, fetus 3
O36.5931
O36.5932
O36.5933
O36.5934
O36.5935
O36.5939
O40.1XX0
O40.1XX1
O40.1XX2
O40.1XX3
O40.1XX4
O40.1XX5
O40.1XX9
O40.2XX0
O40.2XX1
O40.2XX2
O40.2XX3
O40.2XX4
O40.2XX5
O40.2XX9
O40.3XX0
O40.3XX1
O40.3XX2
O40.3XX3
O40.3XX4
O40.3XX5
O40.3XX9
O41.01X0
O41.01X1
O41.01X2
O41.01X3
O41.01X4
O41.01X5
O41.01X9
O41.02X0
O41.02X1
O41.02X2
O41.02X3
PC v2014A
339
O41.02X4
O41.02X5
O41.02X9
O41.03X0
O41.03X1
O41.03X2
Oligohydramnios, second trimester, fetus 4
Oligohydramnios, second trimester, fetus 5
Oligohydramnios, second trimester, other fetus
Oligohydramnios, third trimester, not applicable or unspecified
Oligohydramnios, third trimester, fetus 1
Oligohydramnios, third trimester, fetus 2
O41.03X3
O41.03X4
O41.03X5
O41.03X9
O41.1010
O41.1011
O41.1012
O41.1013
O41.1014
O41.1015
O41.1019
O41.1020
O41.1021
O41.1022
O41.1023
O41.1024
O41.1025
O41.1029
O41.1030
O41.1031
O41.1032
O41.1033
O41.1034
O41.1035
O41.1039
O41.1210
O41.1211
O41.1212
O41.1213
O41.1214
O41.1215
O41.1219
O41.1220
O41.1221
O41.1222
O41.1223
O41.1224
O41.1225
O41.1229
O41.1230
O41.1231
O41.1232
O41.1233
O41.1234
O41.1235
O41.1239
O41.1410
Oligohydramnios, third trimester, fetus 3
Oligohydramnios, third trimester, fetus 4
Oligohydramnios, third trimester, fetus 5
Oligohydramnios, third trimester, other fetus
Infection of amniotic sac and membranes, unspecified, first trimester, not applicable or unspecified
Infection of amniotic sac and membranes, unspecified, first trimester, fetus 1
Infection of amniotic sac and membranes, unspecified, first trimester, fetus 2
Infection of amniotic sac and membranes, unspecified, first trimester, fetus 3
Infection of amniotic sac and membranes, unspecified, first trimester, fetus 4
Infection of amniotic sac and membranes, unspecified, first trimester, fetus 5
Infection of amniotic sac and membranes, unspecified, first trimester, other fetus
Infection of amniotic sac and membranes, unspecified, second trimester, not applicable or unspecified
Infection of amniotic sac and membranes, unspecified, second trimester, fetus 1
Infection of amniotic sac and membranes, unspecified, second trimester, fetus 2
Infection of amniotic sac and membranes, unspecified, second trimester, fetus 3
Infection of amniotic sac and membranes, unspecified, second trimester, fetus 4
Infection of amniotic sac and membranes, unspecified, second trimester, fetus 5
Infection of amniotic sac and membranes, unspecified, second trimester, other fetus
Infection of amniotic sac and membranes, unspecified, third trimester, not applicable or unspecified
Infection of amniotic sac and membranes, unspecified, third trimester, fetus 1
Infection of amniotic sac and membranes, unspecified, third trimester, fetus 2
Infection of amniotic sac and membranes, unspecified, third trimester, fetus 3
Infection of amniotic sac and membranes, unspecified, third trimester, fetus 4
Infection of amniotic sac and membranes, unspecified, third trimester, fetus 5
Infection of amniotic sac and membranes, unspecified, third trimester, other fetus
Chorioamnionitis, first trimester, not applicable or unspecified
Chorioamnionitis, first trimester, fetus 1
Chorioamnionitis, first trimester, fetus 2
Chorioamnionitis, first trimester, fetus 3
Chorioamnionitis, first trimester, fetus 4
Chorioamnionitis, first trimester, fetus 5
Chorioamnionitis, first trimester, other fetus
Chorioamnionitis, second trimester, not applicable or unspecified
Chorioamnionitis, second trimester, fetus 1
Chorioamnionitis, second trimester, fetus 2
Chorioamnionitis, second trimester, fetus 3
Chorioamnionitis, second trimester, fetus 4
Chorioamnionitis, second trimester, fetus 5
Chorioamnionitis, second trimester, other fetus
Chorioamnionitis, third trimester, not applicable or unspecified
Chorioamnionitis, third trimester, fetus 1
Chorioamnionitis, third trimester, fetus 2
Chorioamnionitis, third trimester, fetus 3
Chorioamnionitis, third trimester, fetus 4
Chorioamnionitis, third trimester, fetus 5
Chorioamnionitis, third trimester, other fetus
Placentitis, first trimester, not applicable or unspecified
PC v2014A
340
O41.1411 Placentitis, first trimester, fetus 1
O41.1412 Placentitis, first trimester, fetus 2
O41.1413 Placentitis, first trimester, fetus 3
O41.1414
O41.1415
O41.1419
O41.1420
O41.1421
O41.1422
O41.1423
O41.1424
O41.1425
O41.1429
O41.1430
O41.1431
O41.1432
O41.1433
O41.1434
O41.1435
O41.1439
O42.011
O42.012
O42.013
O42.02
O42.111
O43.011
O43.012
O43.013
O43.021
O43.022
O43.023
O44.01
O44.02
O44.03
O44.11
O44.12
O44.13
O45.001
Placentitis, first trimester, fetus 4
Placentitis, first trimester, fetus 5
Placentitis, first trimester, other fetus
Placentitis, second trimester, not applicable or unspecified
Placentitis, second trimester, fetus 1
Placentitis, second trimester, fetus 2
Placentitis, second trimester, fetus 3
Placentitis, second trimester, fetus 4
Placentitis, second trimester, fetus 5
Placentitis, second trimester, other fetus
Placentitis, third trimester, not applicable or unspecified
Placentitis, third trimester, fetus 1
Placentitis, third trimester, fetus 2
Placentitis, third trimester, fetus 3
Placentitis, third trimester, fetus 4
Placentitis, third trimester, fetus 5
Placentitis, third trimester, other fetus
Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, first trimester
Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, second trimester
Preterm premature rupture of membranes, onset of labor within 24 hours of rupture, third trimester
Full-term premature rupture of membranes, onset of labor within 24 hours of rupture
Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture, first
trimester
Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture, second
trimester
Preterm premature rupture of membranes, onset of labor more than 24 hours following rupture, third
trimester
Full-term premature rupture of membranes, onset of labor more than 24 hours following rupture
Preterm premature rupture of membranes, unspecified as to length of time between rupture and onset
of labor, first trimester
Preterm premature rupture of membranes, unspecified as to length of time between rupture and onset
of labor, second trimester
Preterm premature rupture of membranes, unspecified as to length of time between rupture and onset
of labor, third trimester
Full-term premature rupture of membranes, unspecified as to length of time between rupture and onset
of labor
Fetomaternal placental transfusion syndrome, first trimester
Fetomaternal placental transfusion syndrome, second trimester
Fetomaternal placental transfusion syndrome, third trimester
Fetus-to-fetus placental transfusion syndrome, first trimester
Fetus-to-fetus placental transfusion syndrome, second trimester
Fetus-to-fetus placental transfusion syndrome, third trimester
Placenta previa specified as without hemorrhage, first trimester
Placenta previa specified as without hemorrhage, second trimester
Placenta previa specified as without hemorrhage, third trimester
Placenta previa with hemorrhage, first trimester
Placenta previa with hemorrhage, second trimester
Placenta previa with hemorrhage, third trimester
Premature separation of placenta with coagulation defect, unspecified, first trimester
PC v2014A
341
O42.112
O42.113
O42.12
O42.911
O42.912
O42.913
O42.92
O45.002
O45.003
O45.011
O45.012
O45.013
O45.021
O45.022
O45.023
O45.091
O45.092
O45.093
O45.8X1
O45.8X2
O45.8X3
O45.91
O45.92
O45.93
O46.001
O46.002
O46.003
O46.011
O46.012
O46.013
O46.021
O46.022
O46.023
O46.091
O46.092
O46.093
O46.8X1
O46.8X2
O46.8X3
O46.91
O46.92
O46.93
O48.0
O66.6
O67.0
O67.8
O67.9
O68
O69.4XX0
O69.4XX1
O69.4XX2
O69.4XX3
O69.4XX4
O69.4XX9
O76
O99.111
Premature separation of placenta with coagulation defect, unspecified, second trimester
Premature separation of placenta with coagulation defect, unspecified, third trimester
Premature separation of placenta with afibrinogenemia, first trimester
Premature separation of placenta with afibrinogenemia, second trimester
Premature separation of placenta with afibrinogenemia, third trimester
Premature separation of placenta with disseminated intravascular coagulation, first trimester
Premature separation of placenta with disseminated intravascular coagulation, second trimester
Premature separation of placenta with disseminated intravascular coagulation, third trimester
Premature separation of placenta with other coagulation defect, first trimester
Premature separation of placenta with other coagulation defect, second trimester
Premature separation of placenta with other coagulation defect, third trimester
Other premature separation of placenta, first trimester
Other premature separation of placenta, second trimester
Other premature separation of placenta, third trimester
Premature separation of placenta, unspecified, first trimester
Premature separation of placenta, unspecified, second trimester
Premature separation of placenta, unspecified, third trimester
Antepartum hemorrhage with coagulation defect, unspecified, first trimester
Antepartum hemorrhage with coagulation defect, unspecified, second trimester
Antepartum hemorrhage with coagulation defect, unspecified, third trimester
Antepartum hemorrhage with afibrinogenemia, first trimester
Antepartum hemorrhage with afibrinogenemia, second trimester
Antepartum hemorrhage with afibrinogenemia, third trimester
Antepartum hemorrhage with disseminated intravascular coagulation, first trimester
Antepartum hemorrhage with disseminated intravascular coagulation, second trimester
Antepartum hemorrhage with disseminated intravascular coagulation, third trimester
Antepartum hemorrhage with other coagulation defect, first trimester
Antepartum hemorrhage with other coagulation defect, second trimester
Antepartum hemorrhage with other coagulation defect, third trimester
Other antepartum hemorrhage, first trimester
Other antepartum hemorrhage, second trimester
Other antepartum hemorrhage, third trimester
Antepartum hemorrhage, unspecified, first trimester
Antepartum hemorrhage, unspecified, second trimester
Antepartum hemorrhage, unspecified, third trimester
Post-term pregnancy
Obstructed labor due to other multiple fetuses
Intrapartum hemorrhage with coagulation defect
Other intrapartum hemorrhage
Intrapartum hemorrhage, unspecified
Labor and delivery complicated by abnormality of fetal acid-base balance
Labor and delivery complicated by vasa previa, not applicable or unspecified
Labor and delivery complicated by vasa previa, fetus 1
Labor and delivery complicated by vasa previa, fetus 2
Labor and delivery complicated by vasa previa, fetus 3
Labor and delivery complicated by vasa previa, fetus 4
Labor and delivery complicated by vasa previa, other fetus
Abnormality in fetal heart rate and rhythm complicating labor and delivery
Other diseases of the blood and blood-forming organs and certain disorders involving the immune
mechanism complicating pregnancy, first trimester
O99.112
Other diseases of the blood and blood-forming organs and certain disorders involving the immune
mechanism complicating pregnancy, second trimester
Other diseases of the blood and blood-forming organs and certain disorders involving the immune
O99.113
PC v2014A
342
O99.12
O99.810
O99.814
O99.815
Z21
Z37.1
mechanism complicating pregnancy, third trimester
Other diseases of the blood and blood-forming organs and certain disorders involving the immune
mechanism complicating childbirth
Abnormal glucose complicating pregnancy
Abnormal glucose complicating childbirth
Abnormal glucose complicating the puerperium
Asymptomatic human immunodeficiency virus [HIV] infection status
Single stillbirth
Table 11.08 Outcome of Delivery
ICD-10-CM CodeCode Description
Z37.0
Single Live Birth
Table 11.09.1 Fetal Demise
ICD-10-CM Code
Code Description
O36.4XX0
Maternal care for intrauterine death, not applicable or unspecified
O36.4XX1
Maternal care for intrauterine death, fetus 1
O36.4XX2
Maternal care for intrauterine death, fetus 2
O36.4XX3
Maternal care for intrauterine death, fetus 3
Table 11.09 Contraindications to Vaginal Delivery
Short Description
ICD-10-CM Code
O30.001
Twin preg, unsp num plcnta & amnio sacs, first trimester
O30.002
Twin preg, unsp num plcnta & amnio sacs, second trimester
O30.003
Twin preg, unsp num plcnta & amnio sacs, third trimester
O30.011
Twin pregnancy, monochorionic/monoamniotic, first trimester
O30.012
Twin pregnancy, monochorionic/monoamniotic, second trimester
O30.013
Twin pregnancy, monochorionic/monoamniotic, third trimester
O30.031
Twin pregnancy, monochorionic/diamniotic, first trimester
O30.032
Twin pregnancy, monochorionic/diamniotic, second trimester
O30.033
Twin pregnancy, monochorionic/diamniotic, third trimester
O30.041
Twin pregnancy, dichorionic/diamniotic, first trimester
O30.042
Twin pregnancy, dichorionic/diamniotic, second trimester
O30.043
Twin pregnancy, dichorionic/diamniotic, third trimester
O30.091
Twin preg, unable to dtrm num plcnta & amnio sacs, first tri
O30.092
Twin preg, unable to dtrm num plcnta & amnio sacs, 2nd tri
O30.093
Twin preg, unable to dtrm num plcnta & amnio sacs, third tri
O30.101
Triplet preg, unsp num plcnta & amnio sacs, first trimester
O30.102
Triplet preg, unsp num plcnta & amnio sacs, second trimester
O30.103
Triplet preg, unsp num plcnta & amnio sacs, third trimester
O30.111
O30.112
O30.113
O30.121
O30.122
O30.123
Triplet preg w two or more monochorionic fetuses, first tri
Triplet preg w two or more monochorionic fetuses, second tri
Triplet preg w two or more monochorionic fetuses, third tri
Triplet preg w two or more monoamnio fetuses, first tri
Triplet preg w two or more monoamnio fetuses, second tri
Triplet preg w two or more monoamnio fetuses, third tri
O30.191
Trp preg, unable to dtrm num plcnta & amnio sacs, first tri
PC v2014A
343
O30.192
O30.193
O30.201
O30.202
O30.203
O30.211
O30.212
O30.213
O30.221
O30.222
O30.223
O30.291
O30.292
O30.293
O30.801
O30.802
O30.803
O30.811
O30.812
O30.813
O30.821
O30.822
O30.823
O30.891
O30.892
O30.893
O30.91
O30.92
O30.93
O31.11X0
O31.11X1
O31.11X2
O31.11X3
O31.11X4
O31.11X5
O31.11X9
O31.12X0
O31.12X1
O31.12X2
O31.12X3
O31.12X4
O31.12X5
O31.12X9
O31.13X0
Trp preg, unable to dtrm num plcnta & amnio sacs, second tri
Trp preg, unable to dtrm num plcnta & amnio sacs, third tri
Quad preg, unsp num plcnta & amnio sacs, first trimester
Quad preg, unsp num plcnta & amnio sacs, second trimester
Quad preg, unsp num plcnta & amnio sacs, third trimester
Quad preg w two or more monochorionic fetuses, first tri
Quad preg w two or more monochorionic fetuses, second tri
Quad preg w two or more monochorionic fetuses, third tri
Quad preg w two or more monoamnio fetuses, first trimester
Quad preg w two or more monoamnio fetuses, second trimester
Quad preg w two or more monoamnio fetuses, third trimester
Quad preg, unable to dtrm num plcnta & amnio sacs, first tri
Quad preg, unable to dtrm num plcnta & amnio sacs, 2nd tri
Quad preg, unable to dtrm num plcnta & amnio sacs, third tri
Oth multiple gest, unsp num plcnta & amnio sacs, first tri
Oth multiple gest, unsp num plcnta & amnio sacs, second tr
Oth multiple gest, unsp num plcnta & amnio sacs, third tri
Oth mult gest w two or more monochorionic fetuses, first tr
Oth mult gest w two or more monochorionic fetuses, 2nd tri
Oth mult gest w two or more monochorionic fetuses, third tri
Oth multiple gest w two or more monoamnio fetuses, first tri
Oth mult gest w two or more monoamnio fetuses, second tri
Oth multiple gest w two or more monoamnio fetuses, third tri
Oth mult gest, unab to dtrm num plcnta & amnio sacs, 1st tri
Oth mult gest, unab to dtrm num plcnta & amnio sacs, 1st tri
Oth mult gest, unab to dtrm num plcnta & amnio sacs, 3rd tri
Multiple gestation, unspecified, first trimester
Multiple gestation, unspecified, second trimester
Multiple gestation, unspecified, third trimester
Cont preg aft spon abort of one fts or more, unsp tri, unsp
Cont preg aft spon abort of one fts or more, unsp tri, fts1
Cont preg aft spon abort of one fts or more, unsp tri, fts2
Cont preg aft spon abort of one fts or more, unsp tri, fts3
Cont preg aft spon abort of one fts or more, unsp tri, fts4
Cont preg aft spon abort of one fts or more, unsp tri, fts5
Cont preg aft spon abort of one fetus or more, unsp tri, oth
Cont preg aft spon abort of one fetus or more, 2nd tri, unsp
Cont preg aft spon abort of one fetus or more, 2nd tri, fts1
Cont preg aft spon abort of one fetus or more, 2nd tri, fts2
Cont preg aft spon abort of one fetus or more, 2nd tri, fts3
Cont preg aft spon abort of one fetus or more, 2nd tri, fts4
Cont preg aft spon abort of one fetus or more, 2nd tri, fts5
Cont preg aft spon abort of one fetus or more, 2nd tri, oth
Cont preg aft spon abort of one fts or more, third tri, unsp
O31.13X1
O31.13X2
O31.13X3
O31.13X4
O31.13X5
O31.13X9
O31.21X0
O31.21X1
Cont preg aft spon abort of one fts or more, third tri, fts1
Cont preg aft spon abort of one fts or more, third tri, fts2
Cont preg aft spon abort of one fts or more, third tri, fts3
Cont preg aft spon abort of one fts or more, third tri, fts4
Cont preg aft spon abort of one fts or more, third tri, fts5
Cont preg aft spon abort of one fts or more, third tri, oth
Cont preg aft uterin dth of one fts or more, first tri, unsp
Cont preg aft uterin dth of one fts or more, first tri, fts1
PC v2014A
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O31.21X2
O31.21X3
O31.21X4
O31.21X5
O31.21X9
O31.22X0
O31.22X1
O31.22X2
O31.22X3
O31.22X4
O31.22X5
O31.22X9
O31.23X0
O31.23X1
O31.23X2
O31.23X3
O31.23X4
O31.23X5
Cont preg aft uterin dth of one fts or more, first tri, fts2
Cont preg aft uterin dth of one fts or more, first tri, fts3
Cont preg aft uterin dth of one fts or more, first tri, fts4
Cont preg aft uterin dth of one fts or more, first tri, fts5
Cont preg aft uterin dth of one fts or more, first tri, oth
Cont preg aft uterin dth of one fetus or more, 2nd tri, unsp
Cont preg aft uterin dth of one fetus or more, 2nd tri, fts1
Cont preg aft uterin dth of one fetus or more, 2nd tri, fts2
Cont preg aft uterin dth of one fetus or more, 2nd tri, fts3
Cont preg aft uterin dth of one fetus or more, 2nd tri, fts4
Cont preg aft uterin dth of one fetus or more, 2nd tri, fts5
Cont preg aft uterin dth of one fetus or more, 2nd tri, oth
Cont preg aft uterin dth of one fts or more, third tri, unsp
Cont preg aft uterin dth of one fts or more, third tri, fts1
Cont preg aft uterin dth of one fts or more, third tri, fts2
Cont preg aft uterin dth of one fts or more, third tri, fts3
Cont preg aft uterin dth of one fts or more, third tri, fts4
Cont preg aft uterin dth of one fts or more, third tri, fts5
O31.23X9
O31.8X10
O31.8X11
O31.8X12
O31.8X13
O31.8X14
O31.8X15
O31.8X19
O31.8X20
O31.8X21
O31.8X22
O31.8X23
O31.8X24
O31.8X25
O31.8X29
O31.8X30
O31.8X31
O31.8X32
O31.8X33
O31.8X34
O31.8X35
O31.8X39
O32.1XX0
O32.1XX1
O32.1XX2
O32.1XX3
O32.1XX4
O32.1XX5
O32.1XX9
O32.2XX0
O32.2XX1
O32.2XX2
O32.2XX3
O32.2XX4
Cont preg aft uterin dth of one fts or more, third tri, oth
Oth comp specific to multiple gest, first trimester, unsp
Oth comp specific to multiple gest, first trimester, fetus 1
Oth comp specific to multiple gest, first trimester, fetus 2
Oth comp specific to multiple gest, first trimester, fetus 3
Oth comp specific to multiple gest, first trimester, fetus 4
Oth comp specific to multiple gest, first trimester, fetus 5
Oth comp specific to multiple gest, first trimester, oth
Oth comp specific to multiple gest, second trimester, unsp
Oth comp specific to multiple gest, second tri, fetus 1
Oth comp specific to multiple gest, second tri, fetus 2
Oth comp specific to multiple gest, second tri, fetus 3
Oth comp specific to multiple gest, second tri, fetus 4
Oth comp specific to multiple gest, second tri, fetus 5
Oth comp specific to multiple gest, second trimester, oth
Oth comp specific to multiple gest, third trimester, unsp
Oth comp specific to multiple gest, third trimester, fetus 1
Oth comp specific to multiple gest, third trimester, fetus 2
Oth comp specific to multiple gest, third trimester, fetus 3
Oth comp specific to multiple gest, third trimester, fetus 4
Oth comp specific to multiple gest, third trimester, fetus 5
Oth comp specific to multiple gest, third trimester, oth
Maternal care for breech presentation, unsp
Maternal care for breech presentation, fetus 1
Maternal care for breech presentation, fetus 2
Maternal care for breech presentation, fetus 3
Maternal care for breech presentation, fetus 4
Maternal care for breech presentation, fetus 5
Maternal care for breech presentation, other fetus
Maternal care for transverse and oblique lie, unsp
Maternal care for transverse and oblique lie, fetus 1
Maternal care for transverse and oblique lie, fetus 2
Maternal care for transverse and oblique lie, fetus 3
Maternal care for transverse and oblique lie, fetus 4
PC v2014A
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O32.2XX5
O32.2XX9
O32.3XX0
O32.3XX1
O32.3XX2
O32.3XX3
O32.3XX4
O32.3XX5
O32.3XX9
O32.6XX0
O32.6XX1
Maternal care for transverse and oblique lie, fetus 5
Maternal care for transverse and oblique lie, other fetus
Maternal care for face, brow and chin presentation, unsp
Maternal care for face, brow and chin presentation, fetus 1
Maternal care for face, brow and chin presentation, fetus 2
Maternal care for face, brow and chin presentation, fetus 3
Maternal care for face, brow and chin presentation, fetus 4
Maternal care for face, brow and chin presentation, fetus 5
Maternal care for face, brow and chin presentation, other fetus
Maternal care for compound presentation, unsp
Maternal care for compound presentation, fetus 1
O32.6XX2
O32.6XX3
O32.6XX4
O32.6XX5
O32.6XX9
O32.8XX0
O32.8XX1
O32.8XX2
O32.8XX3
O32.8XX4
O32.8XX5
O32.8XX9
O32.9XX0
O32.9XX1
O32.9XX2
O32.9XX3
O32.9XX4
O32.9XX5
O32.9XX9
O34.21
O36.4XX0
O36.4XX1
O36.4XX2
O36.4XX3
O36.4XX4
O36.4XX5
O36.4XX9
O60.12X0
O60.12X1
O60.12X2
O60.12X3
O60.12X4
O60.12X5
O60.12X9
O60.13X0
O60.13X1
O60.13X2
O60.13X3
O60.13X4
O60.13X5
O60.13X9
Maternal care for compound presentation, fetus 2
Maternal care for compound presentation, fetus 3
Maternal care for compound presentation, fetus 4
Maternal care for compound presentation, fetus 5
Maternal care for compound presentation, other fetus
Maternal care for oth malpresentation of fetus, unsp
Maternal care for other malpresentation of fetus, fetus 1
Maternal care for other malpresentation of fetus, fetus 2
Maternal care for other malpresentation of fetus, fetus 3
Maternal care for other malpresentation of fetus, fetus 4
Maternal care for other malpresentation of fetus, fetus 5
Maternal care for other malpresentation of fetus, other fetus
Maternal care for malpresentation of fetus, unsp, unsp
Maternal care for malpresentation of fetus, unsp, fetus 1
Maternal care for malpresentation of fetus, unsp, fetus 2
Maternal care for malpresentation of fetus, unsp, fetus 3
Maternal care for malpresentation of fetus, unsp, fetus 4
Maternal care for malpresentation of fetus, unsp, fetus 5
Maternal care for malpresentation of fetus, unsp, oth fetus
Maternal care for scar from previous cesarean delivery
Maternal care for intrauterine death, not applicable or unsp
Maternal care for intrauterine death, fetus 1
Maternal care for intrauterine death, fetus 2
Maternal care for intrauterine death, fetus 3
Maternal care for intrauterine death, fetus 4
Maternal care for intrauterine death, fetus 5
Maternal care for intrauterine death, other fetus
Preterm labor second tri w preterm delivery second tri, unsp
Preterm labor second tri w preterm del second tri, fetus 1
Preterm labor second tri w preterm del second tri, fetus 2
Preterm labor second tri w preterm del second tri, fetus 3
Preterm labor second tri w preterm del second tri, fetus 4
Preterm labor second tri w preterm del second tri, fetus 5
Preterm labor second tri w preterm delivery second tri, oth
Preterm labor second tri w preterm delivery third tri, unsp
Preterm labor second tri w preterm del third tri, fetus 1
Preterm labor second tri w preterm del third tri, fetus 2
Preterm labor second tri w preterm del third tri, fetus 3
Preterm labor second tri w preterm del third tri, fetus 4
Preterm labor second tri w preterm del third tri, fetus 5
Preterm labor second tri w preterm delivery third tri, oth
PC v2014A
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O60.14X0
O60.14X1
O60.14X2
O60.14X3
Preterm labor third tri w preterm delivery third tri, unsp
Preterm labor third tri w preterm del third tri, fetus 1
Preterm labor third tri w preterm del third tri, fetus 2
Preterm labor third tri w preterm del third tri, fetus 3
O60.14X4
O60.14X5
O60.14X9
O60.22X0
O60.22X1
O60.22X2
O60.22X3
O60.22X4
O60.22X5
O60.22X9
O60.23X0
O60.23X1
O60.23X2
O60.23X3
O60.23X4
O60.23X5
O60.23X9
O63.2
O64.1XX0
O64.1XX1
O64.1XX2
O64.1XX3
O64.1XX4
O64.1XX5
O64.1XX9
O64.2XX0
O64.2XX1
O64.2XX2
O64.2XX3
O64.2XX4
O64.2XX5
O64.2XX9
O64.3XX0
O64.3XX1
O64.3XX2
O64.3XX3
O64.3XX4
O64.3XX5
O64.3XX9
O64.4XX0
O64.4XX1
O64.4XX2
O64.4XX3
O64.4XX4
O64.4XX5
O64.4XX9
Preterm labor third tri w preterm del third tri, fetus 4
Preterm labor third tri w preterm del third tri, fetus 5
Preterm labor third tri w preterm delivery third tri, oth
Term delivery w preterm labor, second trimester, unsp
Term delivery with preterm labor, second trimester, fetus 1
Term delivery with preterm labor, second trimester, fetus 2
Term delivery with preterm labor, second trimester, fetus 3
Term delivery with preterm labor, second trimester, fetus 4
Term delivery with preterm labor, second trimester, fetus 5
Term delivery w preterm labor, second trimester, oth fetus
Term delivery w preterm labor, third trimester, unsp
Term delivery with preterm labor, third trimester, fetus 1
Term delivery with preterm labor, third trimester, fetus 2
Term delivery with preterm labor, third trimester, fetus 3
Term delivery with preterm labor, third trimester, fetus 4
Term delivery with preterm labor, third trimester, fetus 5
Term delivery with preterm labor, third trimester, oth fetus
Delayed delivery of second twin, triplet, etc.
Obstructed labor due to breech presentation, unsp
Obstructed labor due to breech presentation, fetus 1
Obstructed labor due to breech presentation, fetus 2
Obstructed labor due to breech presentation, fetus 3
Obstructed labor due to breech presentation, fetus 4
Obstructed labor due to breech presentation, fetus 5
Obstructed labor due to breech presentation, other fetus
Obstructed labor due to face presentation, unsp
Obstructed labor due to face presentation, fetus 1
Obstructed labor due to face presentation, fetus 2
Obstructed labor due to face presentation, fetus 3
Obstructed labor due to face presentation, fetus 4
Obstructed labor due to face presentation, fetus 5
Obstructed labor due to face presentation, other fetus
Obstructed labor due to brow presentation, unsp
Obstructed labor due to brow presentation, fetus 1
Obstructed labor due to brow presentation, fetus 2
Obstructed labor due to brow presentation, fetus 3
Obstructed labor due to brow presentation, fetus 4
Obstructed labor due to brow presentation, fetus 5
Obstructed labor due to brow presentation, other fetus
Obstructed labor due to shoulder presentation, unsp
Obstructed labor due to shoulder presentation, fetus 1
Obstructed labor due to shoulder presentation, fetus 2
Obstructed labor due to shoulder presentation, fetus 3
Obstructed labor due to shoulder presentation, fetus 4
Obstructed labor due to shoulder presentation, fetus 5
Obstructed labor due to shoulder presentation, other fetus
O64.5XX0
O64.5XX1
Obstructed labor due to compound presentation, unsp
Obstructed labor due to compound presentation, fetus 1
PC v2014A
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O64.5XX2
O64.5XX3
O64.5XX4
O64.5XX5
O64.5XX9
O64.8XX0
O64.8XX1
O64.8XX2
O64.8XX3
O64.8XX4
O64.8XX5
O64.8XX9
O66.1
O66.6
P01.5
Z37.1
Obstructed labor due to compound presentation, fetus 2
Obstructed labor due to compound presentation, fetus 3
Obstructed labor due to compound presentation, fetus 4
Obstructed labor due to compound presentation, fetus 5
Obstructed labor due to compound presentation, other fetus
Obstructed labor due to oth malposition and malpresent, unsp
Obstructed labor due to oth malpos and malpresent, fetus 1
Obstructed labor due to oth malpos and malpresent, fetus 2
Obstructed labor due to oth malpos and malpresent, fetus 3
Obstructed labor due to oth malpos and malpresent, fetus 4
Obstructed labor due to oth malpos and malpresent, fetus 5
Obstructed labor due to oth malposition and malpresent, oth
Obstructed labor due to locked twins
Obstructed labor due to other multiple fetuses
Newborn (suspected to be) affected by multiple pregnancy
Single stillbirth
Z37.2
Z37.3
Z37.4
Z37.50
Z37.51
Z37.52
Z37.53
Z37.54
Z37.59
Z37.60
Z37.61
Z37.62
Z37.63
Z37.64
Z37.69
Z37.7
Twins, both liveborn
Twins, one liveborn and one stillborn
Twins, both stillborn
Multiple births, unspecified, all liveborn
Triplets, all liveborn
Quadruplets, all liveborn
Quintuplets, all liveborn
Sextuplets, all liveborn
Other multiple births, all liveborn
Multiple births, unspecified, some liveborn
Triplets, some liveborn
Quadruplets, some liveborn
Quintuplets, some liveborn
Sextuplets, some liveborn
Other multiple births, some liveborn
Other multiple births, all stillborn
Table 11.10.1 Sepsis
ICD-10-CM Code
Code Description
A40.0
Sepsis due to streptococcus, group A
A40.1
Sepsis due to streptococcus, group B
A40.3
Sepsis due to Streptococcus pneumoniae
A40.8
Other streptococcal sepsis
A40.9
Streptococcal sepsis, unspecified
A41.2
Sepsis due to unspecified staphylococcus
A41.01
Sepsis due to Methicillin susceptible Staphylococcus aureus
A41.02
Sepsis due to Methicillin resistant Staphylococcus aureus
A41.1
Sepsis due to other specified staphylococcus
A40.3
Sepsis due to Streptococcus pneumoniae
A41.4
Sepsis due to anaerobes
A41.50
Gram-negative sepsis, unspecified
A41.3
Sepsis due to Hemophilus influenzae
A41.51
Sepsis due to Escherichia coli [E. coli]
A41.52
Sepsis due to Pseudomonas
A41.53
Sepsis due to Serratia
PC v2014A
348
A41.59
A41.81
A41.89
A42.7
B37.7
R65.21
R78.81
Other Gram-negative sepsis
Sepsis due to Enterococcus
Other specified sepsis
Actinomycotic sepsis
Candidal sepsis
Severe sepsis with septic shock
Bacteremia
A02.1
Salmonella sepsis
A22.7
A26.7
A32.7
A40.0
A40..1
A40.3
A40.8
A40.9
A41.01
A41.02
A41.1
A41.2
A41.3
A41.4
A41.50
A41.51
A41.52
A41.53
A41.59
A41.81
A41.89
A41.9
A42.7
A54.86
B37.7
R65.20
R65.21
T81.12XA
Anthrax sepsis
Erysipelothrix sepsis
Listerial sepsis
Sepsis due to streptococcus, group A
Sepsis due to streptococcus, group B
Sepsis due to Streptococcus pneumoniae
Other streptococcal sepsis
Streptococcal sepsis, unspecified
Sepsis due to Methicillin susceptible Staphylococcus aureus
Sepsis due to Methicillin resistant Staphylococcus aureus
Sepsis due to other specified staphylococcus
Sepsis due to unspecified staphylococcus
Sepsis due to Hemophilus influenzae
Sepsis due to anaerobes
Gram-negative sepsis, unspecified
Sepsis due to Escherichia coli [E. coli]
Sepsis due to Pseudomonas
Sepsis due to Serratia
Other Gram-negative sepsis
Sepsis due to Enterococcus
Other specified sepsis
Sepsis, unspecified organism
Actinomycotic sepsis
Gonococcal sepsis
Candidal sepsis
Severe sepsis without septic shock
Severe sepsis with septic shock
Postprocedural septic shock, initial encounter
Table 11.10.2 Septicemias or Bacteremias
ICD-10-CM
Code
A40.0
A40.1
A40.3
A40.8
A40.9
A41.2
A41.01
A41.02
A41.1
A40.3
PC v2014A
Code Description
Sepsis due to streptococcus, group A
Sepsis due to streptococcus, group B
Sepsis due to Streptococcus pneumoniae
Other streptococcal sepsis
Streptococcal sepsis, unspecified
Sepsis due to unspecified staphylococcus
Sepsis due to Methicillin susceptible Staphylococcus aureus
Sepsis due to Methicillin resistant Staphylococcus aureus
Sepsis due to other specified staphylococcus
Sepsis due to Streptococcus pneumoniae
349
A41.4
A41.50
A41.3
A41.51
A41.52
A41.53
A41.59
A41.81
A41.89
A42.7
B95.2
B95.8
A49.01
B95.61
B95.7
B96.1
B96.21
B96.22
B96.23
B96.20
B96.29
B96.5
B37.7
R65.21
R57.1
R57.8
R78.81
A021
A227
A267
A327
A40.0
A40.1
A40.3
A40.8
A40.9
A41.01
A41.02
A41.1
A41.2
A41.3
A41.4
A41.50
A41.51
A41.52
A41.53
A41.59
A41.81
A41.89
PC v2014A
Sepsis due to anaerobes
Gram-negative sepsis, unspecified
Sepsis due to Hemophilus influenzae
Sepsis due to Escherichia coli [E. coli]
Sepsis due to Pseudomonas
Sepsis due to Serratia
Other Gram-negative sepsis
Sepsis due to Enterococcus
Other specified sepsis
Actinomycotic sepsis
Enterococcus as the cause of diseases classified elsewhere
Unspecified staphylococcus as the cause of diseases classified elsewhere
Methicillin susceptible Staphylococcus aureus infection, unspecified site
Methicillin susceptible Staphylococcus aureus infection as the cause of diseases classified
elsewhere
Other staphylococcus as the cause of diseases classified elsewhere
Klebsiella pneumoniae [K. pneumoniae] as the cause of diseases classified elsewhere
Shiga toxin-producing Escherichia coli [E. coli] (STEC) O157 as the cause of diseases classified
elsewhere
Other specified Shiga toxin-producing Escherichia coli [E. coli] (STEC) as the cause of diseases
classified elsewhere
Unspecified Shiga toxin-producing Escherichia coli [E. coli] (STEC) as the cause of diseases
classified elsewhere
Unspecified Escherichia coli [E. coli] as the cause of diseases classified elsewhere
Other Escherichia coli [E. coli] as the cause of diseases classified elsewhere
Pseudomonas (aeruginosa) (mallei) (pseudomallei) as the cause of diseases classified elsewhere
Candidal sepsis
Severe sepsis with septic shock
Hypovolemic shock
Other shock
Bacteremia
Salmonella sepsis
Anthrax sepsis
Erysipelothrix sepsis
Listerial sepsis
Sepsis due to streptococcus, group A
Sepsis due to streptococcus, group B
Sepsis due to Streptococcus pneumoniae
Other streptococcal sepsis
Streptococcal sepsis, unspecified
Sepsis due to Methicillin susceptible Staphylococcus aureus
Sepsis due to Methicillin resistant Staphylococcus aureus
Sepsis due to other specified staphylococcus
Sepsis due to unspecified staphylococcus
Sepsis due to Hemophilus influenzae
Sepsis due to anaerobes
Gram-negative sepsis, unspecified
Sepsis due to Escherichia coli [E. coli]
Sepsis due to Pseudomonas
Sepsis due to Serratia
Other Gram-negative sepsis
Sepsis due to Enterococcus
Other specified sepsis
350
A41.9
A42.7
A54.86
B37.7
R65.20
R65.21
T81.10XA
Sepsis, unspecified organism
Actinomycotic sepsis
Gonococcal sepsis
Candidal sepsis
Severe sepsis without septic shock
Severe sepsis with septic shock
Postprocedural shock unspecified, initial encounter
Table 11.10.3 Liveborn Newborn
ICD-10-CM Code
Code Description
Z38.00
Single liveborn infant, delivered vaginally
Z38.2
Single liveborn infant, unspecified as to place of birth
Z38.01
Single liveborn infant, delivered by cesarean
Z38.1
Single liveborn infant, born outside hospital
Z38.5
Twin liveborn infant, unspecified as to place of birth
Z38.31
Twin liveborn infant, delivered by cesarean
Z38.4
Twin liveborn infant, born outside hospital
Z38.30
Twin liveborn infant, delivered vaginally
Z38.61
Triplet liveborn infant, delivered vaginally
Z38.63
Quadruplet liveborn infant, delivered vaginally
Z38.65
Quintuplet liveborn infant, delivered vaginally
Z38.68
Other multiple liveborn infant, delivered vaginally
Z38.8
Other multiple liveborn infant, unspecified as to place of birth
Z38.62
Triplet liveborn infant, delivered by cesarean
Z38.64
Quadruplet liveborn infant, delivered by cesarean
Z38.66
Quintuplet liveborn infant, delivered by cesarean
Z38.69
Other multiple liveborn infant, delivered by cesarean
Z38.7
Other multiple liveborn infant, born outside hospital
Table 11.10 Newborn Septicemia or Bacteremia
Code Description
ICD-10-CM Code
P36.0
Sepsis of newborn due to streptococcus, group B
P36.10
Sepsis of newborn due to unspecified streptococci
P36.19
Sepsis of newborn due to other streptococci
P36.2
P36.30
P36.39
P36.4
P36.5
P36.8
P36.9
R78.81
Sepsis of newborn due to Staphylococcus aureus
Sepsis of newborn due to unspecified staphylococci
Sepsis of newborn due to other staphylococci
Sepsis of newborn due to Escherichia coli
Sepsis of newborn due to anaerobes
Other bacterial sepsis of newborn
Bacterial sepsis of newborn, unspecified
Bacteremia
Table 11.12 Birth Weight 500 – 749 grams
Code Description
ICD-10-CM Code
P05.02
Newborn light for gestational age, 500-749 grams
P05.12
Newborn small for gestational age, 500-749 grams
P07.02
Extremely low birth weight newborn, 500-749 grams
PC v2014A
351
Table 11.13.1 Birth Weight 500-999 Grams
ICD-10-CM Code
Code Description
P07.02
Extremely low birth weight newborn, 500-749 grams
P07.03
Extremely low birth weight newborn, 750-999 grams
Table 11.13 Birth Weight 750 -999 grams
ICD-10-CM Code
Code Description
P05.03
Newborn light for gestational age, 750-999 grams
P05.13
Newborn small for gestational age, 750-999 grams
P07.03
Extremely low birth weight newborn, 750-999 grams
Table 11.14 Birth Weight 1000–1499 Grams
Code Description
ICD-10-CM Code
P05.04
Newborn light for gestational age, 1000-1249 grams
P05.05
Newborn light for gestational age, 1250-1499 grams
P05.14
Newborn small for gestational age, 1000-1249 grams
P05.15
Newborn small for gestational age, 1250-1499 grams
P07.14
Other low birth weight newborn, 1000-1249 grams
P07.15
Other low birth weight newborn, 1250-1499 grams
Table 11.15 Birth Weight 1500–1999 Grams
ICD-10-CM Code
P05.06
P05.07
P05.16
P05.17
P07.16
P07.17
Code Description
Newborn light for gestational age, 1500-1749 grams
Newborn light for gestational age, 1750-1999 grams
Newborn small for gestational age, 1500-1749 grams
Newborn small for gestational age, 1750-1999 grams
Other low birth weight newborn, 1500-1749 grams
Other low birth weight newborn, 1750-1999 grams
Table 11.16.1 Birth Weight 2000-2500 Grams
Code Description
ICD-10-CM Code
P07.18
Other low birth weight newborn, 2000-2499 grams
Table 11.16 Birth Weight 2000-2499 Grams
ICD-10-CM Code
Code Description
P05.08
Newborn light for gestational age, 2000-2499 grams
P05.18
Newborn small for gestational age, 2000-2499 grams
P07.18
Other low birth weight newborn, 2000-2499 grams
Table 11.17 Birth Weight 2500 Grams and Over
ICD-10-CM Code
PC v2014A
Code Description
352
N/A
No corresponding codes in ICD-10-CM
Table 11.18 Major Surgery
Download table (67,000+ rows) Major Surgery Code Table
Table 11.19 Mechanical Ventilation
ICD-10-PCS Code
Code Description
5A1935Z
Respiratory Ventilation, Less than 24 Consecutive Hours
5A1945Z
Respiratory Ventilation, 24-96 Consecutive Hours
5A1955Z
Respiratory Ventilation, Greater than 96 Consecutive Hours
Table 11.20.1 Single Liveborn Newborn
ICD-10-CM Code
Code Description
Z38.00
Single liveborn infant, delivered vaginally
Z38.2
Single liveborn infant, unspecified as to place of birth
Z38.01
Single liveborn infant, delivered by cesarean
Table 11.20 Birth Weight Less Than 500 Grams
ICD-10-CM Code
Code Description
P05.01
Newborn light for gestational age, less than 500 grams
P05.11
Newborn small for gestational age, less than 500 grams
P07.01
Extremely low birth weight newborn, less than 500 grams
Table 11.21 Galactosemia
ICD-10-CM CodeCode Description
E74.21
Galactosemia
Table 11.22 Parenteral Infusion
Code Description
ICD-10-PCS Code
3E0336Z
Introduction of Nutritional Substance into Peripheral Vein, Percutaneous Approach
3E0436Z
Introduction of Nutritional Substance into Central Vein, Percutaneous Approach
3E0536Z
Introduction of Nutritional Substance into Peripheral Artery, Percutaneous Approach
3E0636Z
Introduction of Nutritional Substance into Central Artery, Percutaneous Approach
Table 11.23 Premature Newborns
ICD-10-CM Code
Code Description
P07.20
Extreme immaturity of newborn, unspecified weeks of gestation
P07.30
Preterm newborn, unspecified weeks of gestation
P07.21
Extreme immaturity of newborn, gestational age less than 23 completed weeks
P07.22
Extreme immaturity of newborn, gestational age 23 completed weeks
P07.23
Extreme immaturity of newborn, gestational age 24 completed weeks
P07.24
Extreme immaturity of newborn, gestational age 25 completed weeks
PC v2014A
353
P07.25
P07.26
P07.31
P07.32
P07.33
P07.34
P07.35
P07.36
P07.37
P07.38
P07.39
PC v2014A
Extreme immaturity of newborn, gestational age 26 completed weeks
Extreme immaturity of newborn, gestational age 27 completed weeks
Preterm newborn, gestational age 28 completed weeks
Preterm newborn, gestational age 29 completed weeks
Preterm newborn, gestational age 30 completed weeks
Preterm newborn, gestational age 31 completed weeks
Preterm newborn, gestational age 32 completed weeks
Preterm newborn, gestational age 33 completed weeks
Preterm newborn, gestational age 34 completed weeks
Preterm newborn, gestational age 35 completed weeks
Preterm newborn, gestational age 36 completed weeks
354
Appendix P Continued
ICD-9-CM to ICD-10-CM Crosswalk of Code Tables
Table 10.01 Mental Disorders
ICD-9Code Description
CM
Code
290.0 Senile dementia, uncomplicated
ICD-10Code Description
CM
Code
F03.90 Unspecified dementia without behavioral
disturbance
290.10 Presenile dementia, uncomplicated
F03.90 Unspecified dementia without behavioral
disturbance
290.11 Presenile dementia with delirium
F03.90 Unspecified dementia without behavioral
disturbance
290.12 Presenile dementia with delusional features
F03.90 Unspecified dementia without behavioral
disturbance
290.12 Presenile dementia with delusional features
F05
Delirium due to known physiological condition
290.13 Presenile dementia with depressive features
F03.90 Unspecified dementia without behavioral
disturbance
290.20 Senile dementia with delusional features
F03.90 Unspecified dementia without behavioral
disturbance
290.20 Senile dementia with delusional features
F05
Delirium due to known physiological condition
290.21 Senile dementia with depressive features
F03.90 Unspecified dementia without behavioral
disturbance
290.3 Senile dementia with delirium
F03.90 Unspecified dementia without behavioral
disturbance
290.3 Senile dementia with delirium
F05
Delirium due to known physiological condition
290.40 Vascular dementia, uncomplicated
F01.50 Vascular dementia without behavioral
disturbance
290.41 Vascular dementia, with delirium
F01.51 Vascular dementia with behavioral disturbance
290.42 Vascular dementia, with delusions
F01.51 Vascular dementia with behavioral disturbance
290.43 Vascular dementia, with depressed mood
F01.51 Vascular dementia with behavioral disturbance
290.8 Other specified senile psychotic conditions
F03.90 Unspecified dementia without behavioral
disturbance
290.9 Unspecified senile psychotic condition
F03.90 Unspecified dementia without behavioral
disturbance
293.0 Delirium due to conditions classified elsewhere F05
Delirium due to known physiological condition
293.1 Subacute delirium
F06.2 Delirium due to known physiological condition
293.81 Psychotic disorder with delusions in conditions F06.0 Psychotic disorder with delusions due to known
classified elsewhere
physiological condition
293.82 Psychotic disorder with hallucinations in
F06.30 Psychotic disorder with hallucinations due to
conditions classified elsewhere
known physiological condition
293.83 Mood disorder in conditions classified elsewhereF06.31 Mood disorder due to known physiological
condition, unspecified
293.83 Mood disorder in conditions classified elsewhereF06.32 Mood disorder due to known physiological
condition with depressive features
293.83 Mood disorder in conditions classified elsewhereF06.33 Mood disorder due to known physiological
PC v2014A
355
condition with major depressive-like episode
293.83 Mood disorder in conditions classified elsewhereF06.34 Mood disorder due to known physiological
condition with manic features
293.83 Mood disorder in conditions classified elsewhereF06.4 Mood disorder due to known physiological
condition with mixed features
293.84 Anxiety disorder in conditions classified
F06.1 Anxiety disorder due to known physiological
elsewhere
condition
293.89 Other specified transient mental disorders due to F53
Catatonic disorder due to known physiological
conditions classified elsewhere, other
condition
293.89 Other specified transient mental disorders due to F06.8 Puerperal psychosis
conditions classified elsewhere, other
293.9 Unspecified transient mental disorder in
F04
Other specified mental disorders due to known
conditions classified elsewhere
physiological condition
294.0 Amnestic disorder in conditions classified
F0280 Amnestic disorder due to known physiological
elsewhere
condition
294.10 Dementia in conditions classified elsewhere
F0281 Dementia in other diseases classified elsewhere
without behavioral disturbance
without behavioral disturbance
294.11 Dementia in conditions classified elsewhere with F03.90 Dementia in other diseases classified elsewhere
behavioral disturbance
with behavioral disturbance
294.20 Dementia, unspecified, without behavioral
F03.91 Unspecified dementia without behavioral
disturbance
disturbance
294.21 Dementia, unspecified, with behavioral
F06.1 Unspecified dementia with behavioral
disturbance
disturbance
294.8 Other persistent mental disorders due to
F06.8 Catatonic disorder due to known physiological
conditions classified elsewhere
condition
294.8 Other persistent mental disorders due to
F06.8 Other specified mental disorders due to known
conditions classified elsewhere
physiological condition
294.9 Unspecified persistent mental disorders due to F20.89 Other specified mental disorders due to known
conditions classified elsewhere
physiological condition
295.00 Simple type schizophrenia, unspecified
F20.89 Other schizophrenia
295.01 Simple type schizophrenia, subchronic
F20.89 Other schizophrenia
295.02 Simple type schizophrenia, chronic
F20.89 Other schizophrenia
295.03 Simple type schizophrenia, subchronic with acuteF20.89 Other schizophrenia
exacerbation
295.04 Simple type schizophrenia, chronic with acute
F20.89 Other schizophrenia
exacerbation
295.05 Simple type schizophrenia, in remission
F20.1 Other schizophrenia
295.10 Disorganized type schizophrenia, unspecified
F20.1 Disorganized schizophrenia
295.11 Disorganized type schizophrenia, subchronic
F20.1 Disorganized schizophrenia
295.12 Disorganized type schizophrenia, chronic
295.13 Disorganized type schizophrenia, subchronic
with acute exacerbation
295.14 Disorganized type schizophrenia, chronic with
acute exacerbation
295.15 Disorganized type schizophrenia, in remission
295.20 Catatonic type schizophrenia, unspecified
295.21 Catatonic type schizophrenia, subchronic
295.22 Catatonic type schizophrenia, chronic
295.23 Catatonic type schizophrenia, subchronic with
acute exacerbation
295.24 Catatonic type schizophrenia, chronic with acute
exacerbation
295.25 Catatonic type schizophrenia, in remission
295.30 Paranoid type schizophrenia, unspecified
PC v2014A
F20.1
F20.1
Disorganized schizophrenia
Disorganized schizophrenia
F20.1
Disorganized schizophrenia
F20.2
F20.2
F20.2
F20.2
F20.2
Disorganized schizophrenia
Catatonic schizophrenia
Catatonic schizophrenia
Catatonic schizophrenia
Catatonic schizophrenia
F20.2
Catatonic schizophrenia
F20.0
F20.0
Catatonic schizophrenia
Paranoid schizophrenia
356
295.31 Paranoid type schizophrenia, subchronic
295.32 Paranoid type schizophrenia, chronic
295.33 Paranoid type schizophrenia, subchronic with
acute exacerbation
295.34 Paranoid type schizophrenia, chronic with acute
exacerbation
295.35 Paranoid type schizophrenia, in remission
295.40 Schizophreniform disorder, unspecified
295.41 Schizophreniform disorder, subchronic
295.42 Schizophreniform disorder, chronic
295.43 Schizophreniform disorder, subchronic with
acute exacerbation
295.44 Schizophreniform disorder, chronic with acute
exacerbation
295.45 Schizophreniform disorder, in remission
295.50 Latent schizophrenia, unspecified
295.51 Latent schizophrenia, subchronic
295.52 Latent schizophrenia, chronic
295.53 Latent schizophrenia, subchronic with acute
exacerbation
295.54 Latent schizophrenia, chronic with acute
exacerbation
295.55 Latent schizophrenia, in remission
295.60 Schizophrenic disorders, residual type,
unspecified
295.61 Schizophrenic disorders, residual type,
subchronic
295.62 Schizophrenic disorders, residual type, chronic
295.63 Schizophrenic disorders, residual type,
subchronic with acute exacerbation
295.64 Schizophrenic disorders, residual type, chronic
with acute exacerbation
295.65 Schizophrenic disorders, residual type, in
remission
295.70 Schizoaffective disorder, unspecified
295.70 Schizoaffective disorder, unspecified
295.70 Schizoaffective disorder, unspecified
295.70 Schizoaffective disorder, unspecified
295.71 Schizoaffective disorder, subchronic
295.72 Schizoaffective disorder, chronic
295.73 Schizoaffective disorder, subchronic with acute
exacerbation
295.74 Schizoaffective disorder, chronic with acute
exacerbation
295.75 Schizoaffective disorder, in remission
295.80 Other specified types of schizophrenia,
unspecified
295.81 Other specified types of schizophrenia,
subchronic
295.82 Other specified types of schizophrenia, chronic
295.83 Other specified types of schizophrenia,
subchronic with acute exacerbation
295.84 Other specified types of schizophrenia, chronic
with acute exacerbation
PC v2014A
F20.0
F20.0
F20.0
Paranoid schizophrenia
Paranoid schizophrenia
Paranoid schizophrenia
F20.0
Paranoid schizophrenia
F20.81
F20.81
F20.81
F20.81
F20.81
Paranoid schizophrenia
Schizophreniform disorder
Schizophreniform disorder
Schizophreniform disorder
Schizophreniform disorder
F20.81 Schizophreniform disorder
F20.89
F20.89
F20.89
F20.89
F20.89
Schizophreniform disorder
Other schizophrenia
Other schizophrenia
Other schizophrenia
Other schizophrenia
F20.89 Other schizophrenia
F20.5
F20.5
Other schizophrenia
Residual schizophrenia
F20.5
Residual schizophrenia
F20.5
F20.5
Residual schizophrenia
Residual schizophrenia
F20.5
Residual schizophrenia
F25.0
Residual schizophrenia
F25.1
F25.8
F25.9
F25.9
F25.9
F25.9
F25.9
Schizoaffective disorder, bipolar type
Schizoaffective disorder, depressive type
Other schizoaffective disorders
Schizoaffective disorder, unspecified
Schizoaffective disorder, unspecified
Schizoaffective disorder, unspecified
Schizoaffective disorder, unspecified
F25.9
Schizoaffective disorder, unspecified
F20.89 Schizoaffective disorder, unspecified
F20.89 Other schizophrenia
F20.89 Other schizophrenia
F20.89 Other schizophrenia
F20.89 Other schizophrenia
F20.89 Other schizophrenia
357
295.85 Other specified types of schizophrenia, in
F20.3
remission
295.90 Unspecified schizophrenia, unspecified
F20.9
295.90 Unspecified schizophrenia, unspecified
F20.9
295.91 Unspecified schizophrenia, subchronic
F20.9
295.92 Unspecified schizophrenia, chronic
F20.9
295.93 Unspecified schizophrenia, subchronic with
F20.9
acute exacerbation
295.94 Unspecified schizophrenia, chronic with acute
F20.9
exacerbation
295.95 Unspecified schizophrenia, in remission
F30.10
296.00 Bipolar I disorder, single manic episode,
F30.9
unspecified
296.00 Bipolar I disorder, single manic episode,
F30.11
unspecified
296.01 Bipolar I disorder, single manic episode, mild
F30.12
296.02 Bipolar I disorder, single manic episode,
F30.13
moderate
296.03 Bipolar I disorder, single manic episode, severe, F30.2
without mention of psychotic behavior
296.04 Bipolar I disorder, single manic episode, severe, F30.3
specified as with psychotic behavior
296.05 Bipolar I disorder, single manic episode, in
F30.4
partial or unspecified remission
296.06 Bipolar I disorder, single manic episode, in full F30.10
remission
296.10 Manic affective disorder, recurrent episode,
F30.11
unspecified
296.11 Manic affective disorder, recurrent episode, mild F30.12
296.12 Manic affective disorder, recurrent episode,
F30.13
moderate
296.13 Manic affective disorder, recurrent episode,
F30.2
severe, without mention of psychotic behavior
296.14 Manic affective disorder, recurrent episode,
F30.3
severe, specified as with psychotic behavior
296.15 Manic affective disorder, recurrent episode, in F30.4
partial or unspecified remission
296.16 Manic affective disorder, recurrent episode, in fullF32.9
remission
296.20 Major depressive affective disorder, single
F32.0
episode, unspecified
296.21 Major depressive affective disorder, single
F32.1
episode, mild
296.22 Major depressive affective disorder, single
F32.2
episode, moderate
296.23 Major depressive affective disorder, single
F32.3
episode, severe, without mention of psychotic
behavior
296.24 Major depressive affective disorder, single
F32.4
episode, severe, specified as with psychotic
behavior
296.25 Major depressive affective disorder, single
F32.5
episode, in partial or unspecified remission
296.26 Major depressive affective disorder, single
F33.40
PC v2014A
Other schizophrenia
Undifferentiated schizophrenia
Schizophrenia, unspecified
Schizophrenia, unspecified
Schizophrenia, unspecified
Schizophrenia, unspecified
Schizophrenia, unspecified
Schizophrenia, unspecified
Manic episode without psychotic symptoms,
unspecified
Manic episode, unspecified
Manic episode without psychotic symptoms, mild
Manic episode without psychotic symptoms,
moderate
Manic episode, severe, without psychotic
symptoms
Manic episode, severe with psychotic symptoms
Manic episode in partial remission
Manic episode in full remission
Manic episode without psychotic symptoms,
unspecified
Manic episode without psychotic symptoms, mild
Manic episode without psychotic symptoms,
moderate
Manic episode, severe, without psychotic
symptoms
Manic episode, severe with psychotic symptoms
Manic episode in partial remission
Manic episode in full remission
Major depressive disorder, single episode,
unspecified
Major depressive disorder, single episode, mild
Major depressive disorder, single episode,
moderate
Major depressive disorder, single episode,
severe without psychotic features
Major depressive disorder, single episode,
severe with psychotic features
Major depressive disorder, single episode, in
partial remission
Major depressive disorder, single episode, in full
358
episode, in full remission
296.30 Major depressive affective disorder, recurrent
episode, unspecified
296.30 Major depressive affective disorder, recurrent
episode, unspecified
296.31 Major depressive affective disorder, recurrent
episode, mild
296.32 Major depressive affective disorder, recurrent
episode, moderate
296.33 Major depressive affective disorder, recurrent
episode, severe, without mention of psychotic
behavior
296.34 Major depressive affective disorder, recurrent
episode, severe, specified as with psychotic
behavior
296.35 Major depressive affective disorder, recurrent
episode, in partial or unspecified remission
296.36 Major depressive affective disorder, recurrent
episode, in full remission
296.40 Bipolar I disorder, most recent episode (or
current) manic, unspecified
296.40 Bipolar I disorder, most recent episode (or
current) manic, unspecified
296.40 Bipolar I disorder, most recent episode (or
current) manic, unspecified
296.41 Bipolar I disorder, most recent episode (or
current) manic, mild
296.42 Bipolar I disorder, most recent episode (or
current) manic, moderate
296.43 Bipolar I disorder, most recent episode (or
current) manic, severe, without mention of
psychotic behavior
296.44 Bipolar I disorder, most recent episode (or
current) manic, severe, specified as with
psychotic behavior
296.45 Bipolar I disorder, most recent episode (or
current) manic, in partial or unspecified
remission
296.46 Bipolar I disorder, most recent episode (or
current) manic, in full remission
296.50 Bipolar I disorder, most recent episode (or
current) depressed, unspecified
296.51 Bipolar I disorder, most recent episode (or
current) depressed, mild
296.52 Bipolar I disorder, most recent episode (or
current) depressed, moderate
296.53 Bipolar I disorder, most recent episode (or
current) depressed, severe, without mention of
psychotic behavior
296.54 Bipolar I disorder, most recent episode (or
current) depressed, severe, specified as with
psychotic behavior
296.55 Bipolar I disorder, most recent episode (or
current) depressed, in partial or unspecified
PC v2014A
F33.0
remission
Major depressive disorder, recurrent, in
remission, unspecified
Major depressive disorder, recurrent, unspecified
F33.1
Major depressive disorder, recurrent, mild
F33.2
Major depressive disorder, recurrent, moderate
F33.3
Major depressive disorder, recurrent severe
without psychotic features
F33.9
F33.41 Major depressive disorder, recurrent, severe with
psychotic symptoms
F33.42 Major depressive disorder, recurrent, in partial
remission
F31.0 Major depressive disorder, recurrent, in full
remission
F31.10 Bipolar disorder, current episode hypomanic
F31.89 Bipolar disorder, current episode manic without
psychotic features, unspecified
F31.11 Other bipolar disorder
F31.12 Bipolar disorder, current episode manic without
psychotic features, mild
F31.13 Bipolar disorder, current episode manic without
psychotic features, moderate
F31.2 Bipolar disorder, current episode manic without
psychotic features, severe
F31.73 Bipolar disorder, current episode manic severe
with psychotic features
F31.74 Bipolar disorder, in partial remission, most
recent episode manic
F31.30 Bipolar disorder, in full remission, most recent
episode manic
F31.31 Bipolar disorder, current episode depressed,
mild or moderate severity, unspecified
F31.32 Bipolar disorder, current episode depressed,
mild
F31.4 Bipolar disorder, current episode depressed,
moderate
F31.5 Bipolar disorder, current episode depressed,
severe, without psychotic features
F31.75 Bipolar disorder, current episode depressed,
severe, with psychotic features
F31.76 Bipolar disorder, in partial remission, most
recent episode depressed
359
remission
296.56 Bipolar I disorder, most recent episode (or
current) depressed, in full remission
296.60 Bipolar I disorder, most recent episode (or
current) mixed, unspecified
296.61 Bipolar I disorder, most recent episode (or
current) mixed, mild
296.62 Bipolar I disorder, most recent episode (or
current) mixed, moderate
296.63 Bipolar I disorder, most recent episode (or
current) mixed, severe, without mention of
psychotic behavior
296.64 Bipolar I disorder, most recent episode (or
current) mixed, severe, specified as with
psychotic behavior
296.65 Bipolar I disorder, most recent episode (or
current) mixed, in partial or unspecified
remission
296.66 Bipolar I disorder, most recent episode (or
current) mixed, in full remission
296.7 Bipolar I disorder, most recent episode (or
current) unspecified
296.7 Bipolar I disorder, most recent episode (or
current) unspecified
296.7 Bipolar I disorder, most recent episode (or
current) unspecified
296.80 Bipolar disorder, unspecified
296.81 Atypical manic disorder
296.82 Atypical depressive disorder
296.89 Other bipolar disorders
296.90 Unspecified episodic mood disorder
296.99 Other specified episodic mood disorder
296.99 Other specified episodic mood disorder
296.99 Other specified episodic mood disorder
297.0 Paranoid state, simple
297.1 Delusional disorder
297.2 Paraphrenia
297.3 Shared psychotic disorder
297.8 Other specified paranoid states
297.9 Unspecified paranoid state
298.0 Depressive type psychosis
298.0 Depressive type psychosis
298.1 Excitative type psychosis
298.2
298.3
298.4
298.8
298.9
Reactive confusion
Acute paranoid reaction
Psychogenic paranoid psychosis
Other and unspecified reactive psychosis
Unspecified psychosis
298.9 Unspecified psychosis
PC v2014A
F31.60 Bipolar disorder, in full remission, most recent
episode depressed
F31.61 Bipolar disorder, current episode mixed,
unspecified
F31.62 Bipolar disorder, current episode mixed, mild
F31.63 Bipolar disorder, current episode mixed,
moderate
F31.64 Bipolar disorder, current episode mixed, severe,
without psychotic features
F31.77 Bipolar disorder, current episode mixed, severe,
with psychotic features
F31.78 Bipolar disorder, in partial remission, most
recent episode mixed
F31.70 Bipolar disorder, in full remission, most recent
episode mixed
F31.71 Bipolar disorder, currently in remission, most
recent episode unspecified
F31.72 Bipolar disorder, in partial remission, most
recent episode hypomanic
F31.9 Bipolar disorder, in full remission, most recent
episode hypomanic
F30.8 Bipolar disorder, unspecified
F32.8 Other manic episodes
F31.81 Other depressive episodes
F39
Bipolar II disorder
F33.8 Unspecified mood [affective] disorder
F34.8 Other recurrent depressive disorders
F349
Other persistent mood [affective] disorders
F22
Persistent mood [affective] disorder, unspecified
F22
Delusional disorders
F22
Delusional disorders
F24
Delusional disorders
F22
Shared psychotic disorder
F23
Delusional disorders
F32.3 Brief psychotic disorder
F33.3 Major depressive disorder, single episode,
severe with psychotic features
F28
Major depressive disorder, recurrent, severe with
psychotic symptoms
F44.89 Other psychotic disorder not due to a substance
or known physiological condition
F23
Other dissociative and conversion disorders
F23
Brief psychotic disorder
F23
Brief psychotic disorder
F28
Brief psychotic disorder
F29
Other psychotic disorder not due to a substance
or known physiological condition
F84.0 Unspecified psychosis not due to a substance or
known physiological condition
360
299.00 Autistic disorder, current or active state
299.01 Autistic disorder, residual state
299.10 Childhood disintegrative disorder, current or
active state
299.11 Childhood disintegrative disorder, residual state
299.80 Other specified pervasive developmental
disorders, current or active state
299.80 Other specified pervasive developmental
disorders, current or active state
299.81 Other specified pervasive developmental
disorders, residual state
299.81 Other specified pervasive developmental
disorders, residual state
299.90 Unspecified pervasive developmental disorder,
current or active state
299.91 Unspecified pervasive developmental disorder,
residual state
300.00 Anxiety state, unspecified
300.01 Panic disorder without agoraphobia
300.02 Generalized anxiety disorder
300.09 Other anxiety states
300.09 Other anxiety states
300.10 Hysteria, unspecified
300.11 Conversion disorder
300.11 Conversion disorder
300.11 Conversion disorder
300.11 Conversion disorder
300.12 Dissociative amnesia
300.13 Dissociative fugue
300.14 Dissociative identity disorder
300.15 Dissociative disorder or reaction, unspecified
300.16 Factitious disorder with predominantly
psychological signs and symptoms
300.16 Factitious disorder with predominantly
psychological signs and symptoms
300.16 Factitious disorder with predominantly
psychological signs and symptoms
300.19 Other and unspecified factitious illness
300.19 Other and unspecified factitious illness
300.20 Phobia, unspecified
300.21 Agoraphobia with panic disorder
300.22 Agoraphobia without mention of panic attacks
300.22 Agoraphobia without mention of panic attacks
300.23 Social phobia
300.23 Social phobia
300.29 Other isolated or specific phobias
PC v2014A
F84.0
F84.3
F84.3
Autistic disorder
Autistic disorder
Other childhood disintegrative disorder
F84.5
F84.8
Other childhood disintegrative disorder
Asperger's syndrome
F84.5
Other pervasive developmental disorders
F84.8
Asperger's syndrome
F84.9
Other pervasive developmental disorders
F84.9
Pervasive developmental disorder, unspecified
F41.9
Pervasive developmental disorder, unspecified
F41.0
F41.1
Anxiety disorder, unspecified
Panic disorder [episodic paroxysmal anxiety]
without agoraphobia
F41.3 Generalized anxiety disorder
F41.8 Other mixed anxiety disorders
F44.9 Other specified anxiety disorders
F44.4 Dissociative and conversion disorder,
unspecified
F44.5 Conversion disorder with motor symptom or
deficit
F44.6 Conversion disorder with seizures or convulsions
F44.7 Conversion disorder with sensory symptom or
deficit
F44.0 Conversion disorder with mixed symptom
presentation
F44.1 Dissociative amnesia
F44.81 Dissociative fugue
F44.9 Dissociative identity disorder
F44.89 Dissociative and conversion disorder,
unspecified
F68.11 Other dissociative and conversion disorders
F68.13 Factitious disorder with predominantly
psychological signs and symptoms
F44.2 Factitious disorder with combined psychological
and physical signs and symptoms
F68.8 Dissociative stupor
F40.9 Other specified disorders of adult personality and
behavior
F40.01 Phobic anxiety disorder, unspecified
F40.00 Agoraphobia with panic disorder
F40.02 Agoraphobia, unspecified
F40.10 Agoraphobia without panic disorder
F40.11 Social phobia, unspecified
F40.210 Social phobia, generalized
F40.218 Arachnophobia
361
300.29 Other isolated or specific phobias
300.29 Other isolated or specific phobias
300.29 Other isolated or specific phobias
300.29 Other isolated or specific phobias
300.29 Other isolated or specific phobias
300.29 Other isolated or specific phobias
300.29 Other isolated or specific phobias
300.29 Other isolated or specific phobias
300.29 Other isolated or specific phobias
300.29 Other isolated or specific phobias
F40.220 Other animal type phobia
F40.228 Fear of thunderstorms
F40.230 Other natural environment type phobia
F40.231 Fear of blood
F40.232 Fear of injections and transfusions
F40.233 Fear of other medical care
F40.240 Fear of injury
F40.241 Claustrophobia
F40.242 Acrophobia
F40.243 Fear of bridges
300.29 Other isolated or specific phobias
300.29 Other isolated or specific phobias
300.29 Other isolated or specific phobias
300.29 Other isolated or specific phobias
300.29 Other isolated or specific phobias
300.29 Other isolated or specific phobias
300.3 Obsessive-compulsive disorders
300.4 Dysthymic disorder
300.5 Neurasthenia
300.6 Depersonalization disorder
300.7 Hypochondriasis
300.7 Hypochondriasis
300.7 Hypochondriasis
300.7 Hypochondriasis
300.81 Somatization disorder
300.82 Undifferentiated somatoform disorder
300.82 Undifferentiated somatoform disorder
300.89 Other somatoform disorders
300.89 Other somatoform disorders
300.9 Unspecified nonpsychotic mental disorder
300.9 Unspecified nonpsychotic mental disorder
300.9 Unspecified nonpsychotic mental disorder
300.9 Unspecified nonpsychotic mental disorder
300.9 Unspecified nonpsychotic mental disorder
301.0 Paranoid personality disorder
301.10 Affective personality disorder, unspecified
301.11 Chronic hypomanic personality disorder
301.12 Chronic depressive personality disorder
301.13 Cyclothymic disorder
301.20 Schizoid personality disorder, unspecified
301.21 Introverted personality
301.22 Schizotypal personality disorder
301.3 Explosive personality disorder
301.4 Obsessive-compulsive personality disorder
301.50 Histrionic personality disorder, unspecified
301.51 Chronic factitious illness with physical symptoms
301.51 Chronic factitious illness with physical symptoms
F40.248 Fear of flying
F40.290 Other situational type phobia
F40.291 Androphobia
F40.298 Gynephobia
F40.8 Other specified phobia
F42
Other phobic anxiety disorders
F34.1 Obsessive-compulsive disorder
F48.8 Dysthymic disorder
F48.1 Other specified nonpsychotic mental disorders
F45.20 Depersonalization-derealization syndrome
F45.21 Hypochondriacal disorder, unspecified
F45.22 Hypochondriasis
F45.29 Body dysmorphic disorder
F45.0 Other hypochondriacal disorders
F45.1 Somatization disorder
F45.9 Undifferentiated somatoform disorder
F45.8 Somatoform disorder, unspecified
F48.8 Other somatoform disorders
F48.9 Other specified nonpsychotic mental disorders
F99
Nonpsychotic mental disorder, unspecified
R45.2 Mental disorder, not otherwise specified
R45.5 Unhappiness
R45.6 Hostility
F60.0 Violent behavior
F34.0 Paranoid personality disorder
F60.89 Cyclothymic disorder
F34.1 Other specific personality disorders
F34.0 Dysthymic disorder
F60.1 Cyclothymic disorder
F60.1 Schizoid personality disorder
F21
Schizoid personality disorder
F60.3 Schizotypal disorder
F60.5 Borderline personality disorder
F60.4 Obsessive-compulsive personality disorder
F68.10 Histrionic personality disorder
F68.12 Factitious disorder, unspecified
F68.13 Factitious disorder with predominantly physical
signs and symptoms
301.51 Chronic factitious illness with physical symptoms F60.4 Factitious disorder with combined psychological
and physical signs and symptoms
301.59 Other histrionic personality disorder
F60.7 Histrionic personality disorder
301.6 Dependent personality disorder
F60.2 Dependent personality disorder
301.7 Antisocial personality disorder
F60.81 Antisocial personality disorder
PC v2014A
362
301.81 Narcissistic personality disorder
301.82 Avoidant personality disorder
301.83 Borderline personality disorder
301.84 Passive-aggressive personality
301.89 Other personality disorders
301.9 Unspecified personality disorder
301.9 Unspecified personality disorder
F60.6
F60.3
F60.89
F60.89
F60.9
F69
F66
Narcissistic personality disorder
Avoidant personality disorder
Borderline personality disorder
Other specific personality disorders
Other specific personality disorders
Personality disorder, unspecified
Unspecified disorder of adult personality and
behavior
302.0 Ego-dystonic sexual orientation
F65.89 Other sexual disorders
302.1 Zoophilia
F65.4 Other paraphilias
302.2 Pedophilia
F65.1 Pedophilia
302.3 Transvestic fetishism
F65.2 Transvestic fetishism
302.4 Exhibitionism
F64.1 Exhibitionism
302.50 Trans-sexualism with unspecified sexual history Z87.890 Gender identity disorder in adolescence and
adulthood
302.50 Trans-sexualism with unspecified sexual history F64.1 Personal history of sex reassignment
302.51 Trans-sexualism with asexual history
F64.1 Gender identity disorder in adolescence and
adulthood
302.52 Trans-sexualism with homosexual history
F64.1 Gender identity disorder in adolescence and
adulthood
302.53 Trans-sexualism with heterosexual history
F64.2 Gender identity disorder in adolescence and
adulthood
302.6 Gender identity disorder in children
F64.8 Gender identity disorder of childhood
302.6 Gender identity disorder in children
F64.9 Other gender identity disorders
302.6 Gender identity disorder in children
F52.9 Gender identity disorder, unspecified
302.70 Psychosexual dysfunction, unspecified
R37
Unspecified sexual dysfunction not due to a
substance or known physiological condition
302.70 Psychosexual dysfunction, unspecified
F52.0 Sexual dysfunction, unspecified
302.71 Hypoactive sexual desire disorder
F52.21 Hypoactive sexual desire disorder
302.72 Psychosexual dysfunction with inhibited sexual F52.22 Male erectile disorder
excitement
302.72 Psychosexual dysfunction with inhibited sexual F52.8 Female sexual arousal disorder
excitement
302.72 Psychosexual dysfunction with inhibited sexual F52.31 Other sexual dysfunction not due to a substance
excitement
or known physiological condition
302.73 Female orgasmic disorder
F52.32 Female orgasmic disorder
302.74 Male orgasmic disorder
F52.4 Male orgasmic disorder
302.75 Premature ejaculation
F52.6 Premature ejaculation
302.76 Dyspareunia, psychogenic
F52.1 Dyspareunia not due to a substance or known
physiological condition
302.79 Psychosexual dysfunction with other specified
F52.8 Sexual aversion disorder
psychosexual dysfunctions
302.79 Psychosexual dysfunction with other specified
F65.0 Other sexual dysfunction not due to a substance
psychosexual dysfunctions
or known physiological condition
302.81 Fetishism
F65.3 Fetishism
302.82 Voyeurism
F65.51 Voyeurism
302.83 Sexual masochism
F65.50
302.84 Sexual sadism
F65.52
302.84 Sexual sadism
F64.1
302.85 Gender identity disorder in adolescents or adults F65.81
302.89 Other specified psychosexual disorders
302.89 Other specified psychosexual disorders
PC v2014A
Sexual masochism
Sadomasochism, unspecified
Sexual sadism
Gender identity disorder in adolescence and
adulthood
F65.89 Frotteurism
F66
Other paraphilias
363
302.89 Other specified psychosexual disorders
302.9 Unspecified psychosexual disorder
306.0 Musculoskeletal malfunction arising from mental
factors
306.1 Respiratory malfunction arising from mental
factors
306.2 Cardiovascular malfunction arising from mental
factors
306.3 Skin disorder arising from mental factors
306.4 Gastrointestinal malfunction arising from mental
factors
306.50 Psychogenic genitourinary malfunction,
unspecified
306.51 Psychogenic vaginismus
F65.9
F45.8
F45.8
Other sexual disorders
Paraphilia, unspecified
Other somatoform disorders
F45.8
Other somatoform disorders
F45.8
Other somatoform disorders
F45.8
F45.8
Other somatoform disorders
Other somatoform disorders
F52.5
Other somatoform disorders
F45.8
Vaginismus not due to a substance or known
physiological condition
Other somatoform disorders
Other somatoform disorders
Other somatoform disorders
306.52 Psychogenic dysmenorrhea
F45.8
306.53 Psychogenic dysuria
F45.8
306.59 Other genitourinary malfunction arising from
F45.8
mental factors
306.6 Endocrine disorder arising from mental factors F45.8
306.7 Disorder of organs of special sense arising from F45.8
mental factors
306.8 Other specified psychophysiological malfunction F59
306.8 Other specified psychophysiological malfunction F45.9
Other somatoform disorders
Other somatoform disorders
Other somatoform disorders
Unspecified behavioral syndromes associated
with physiological disturbances and physical
factors
Somatoform disorder, unspecified
Adult onset fluency disorder
Anorexia nervosa, unspecified
Anorexia nervosa, restricting type
Anorexia nervosa, binge eating/purging type
Other tic disorders
Tic disorder, unspecified
Transient tic disorder
Chronic motor or vocal tic disorder
Tourette's disorder
Stereotyped movement disorders
Sleep disorder not due to a substance or known
physiological condition, unspecified
Adjustment insomnia
306.9 Unspecified psychophysiological malfunction
307.0 Adult onset fluency disorder
307.1 Anorexia nervosa
307.1 Anorexia nervosa
307.1 Anorexia nervosa
307.20 Tic disorder, unspecified
307.20 Tic disorder, unspecified
307.21 Transient tic disorder
307.22 Chronic motor or vocal tic disorder
307.23 Tourette's disorder
307.3 Stereotypic movement disorder
307.40 Nonorganic sleep disorder, unspecified
F98.5
F50.00
F50.01
F50.02
F95.8
F95.9
F95.0
F95.1
F95.2
F98.4
F51.9
F51.02
307.41 Transient disorder of initiating or maintaining
sleep
F51.09
307.41 Transient disorder of initiating or maintaining
sleep
307.42 Persistent disorder of initiating or maintaining
sleep
307.42 Persistent disorder of initiating or maintaining
sleep
307.42 Persistent disorder of initiating or maintaining
sleep
307.44 Persistent disorder of initiating or maintaining
wakefulness
307.44 Persistent disorder of initiating or maintaining
wakefulness
F51.01 Other insomnia not due to a substance or known
physiological condition
F51.03 Primary insomnia
PC v2014A
F51.09 Paradoxical insomnia
F51.11 Other insomnia not due to a substance or known
physiological condition
F51.12 Primary hypersomnia
F51.8
Insufficient sleep syndrome
364
307.45 Circadian rhythm sleep disorder of nonorganic
origin
307.46 Sleep arousal disorder
307.46 Sleep arousal disorder
307.47 Other dysfunctions of sleep stages or arousal
from sleep
307.48 Repetitive intrusions of sleep
F51.3
F51.4
F51.5
F51.8
Other sleep disorders not due to a substance or
known physiological condition
Sleepwalking [somnambulism]
Sleep terrors [night terrors]
Nightmare disorder
Other sleep disorders not due to a substance or
known physiological condition
307.49 Other specific disorders of sleep of nonorganic F50.9 Other sleep disorders not due to a substance or
origin
known physiological condition
307.50 Eating disorder, unspecified
F50.2 Eating disorder, unspecified
307.51 Bulimia nervosa
F98.3 Bulimia nervosa
307.52 Pica
F98.21 Pica of infancy and childhood
307.53 Rumination disorder
F50.8 Rumination disorder of infancy
307.54 Psychogenic vomiting
F50.8 Other eating disorders
307.59 Other disorders of eating
F98.29 Other eating disorders
307.59 Other disorders of eating
F98.0 Other feeding disorders of infancy and early
childhood
307.6 Enuresis
F98.1 Enuresis not due to a substance or known
physiological condition
307.7 Encopresis
F45.41 Encopresis not due to a substance or known
physiological condition
307.80 Psychogenic pain, site unspecified
G44.209Pain disorder exclusively related to psychological
factors
307.81 Tension headache
F45.42 Tension-type headache, unspecified, not
intractable
307.89 Other pain disorders related to psychological
F63.3 Pain disorder with related psychological factors
factors
307.9 Other and unspecified special symptoms or
R45.1 Trichotillomania
syndromes, not elsewhere classified
307.9 Other and unspecified special symptoms or
R45.81 Restlessness and agitation
syndromes, not elsewhere classified
307.9 Other and unspecified special symptoms or
R45.82 Low self-esteem
syndromes, not elsewhere classified
307.9 Other and unspecified special symptoms or
F43.0 Worries
syndromes, not elsewhere classified
308.0 Predominant disturbance of emotions
F43.0 Acute stress reaction
308.1 Predominant disturbance of consciousness
F43.0 Acute stress reaction
308.2 Predominant psychomotor disturbance
F43.0 Acute stress reaction
308.3 Other acute reactions to stress
F43.0 Acute stress reaction
308.4 Mixed disorders as reaction to stress
F43.0 Acute stress reaction
308.9 Unspecified acute reaction to stress
R45.7 Acute stress reaction
308.9 Unspecified acute reaction to stress
F43.21 State of emotional shock and stress, unspecified
309.0 Adjustment disorder with depressed mood
F43.21 Adjustment disorder with depressed mood
309.1 Prolonged depressive reaction
F93.0 Adjustment disorder with depressed mood
309.21 Separation anxiety disorder
F94.8 Separation anxiety disorder of childhood
309.22 Emancipation disorder of adolescence and early F94.8 Other childhood disorders of social functioning
adult life
309.23 Specific academic or work inhibition
F43.22 Other childhood disorders of social functioning
309.24 Adjustment disorder with anxiety
F43.23 Adjustment disorder with anxiety
309.28 Adjustment disorder with mixed anxiety and
F43.29 Adjustment disorder with mixed anxiety and
depressed mood
depressed mood
309.29 Other adjustment reactions with predominant
F94.8 Adjustment disorder with other symptoms
disturbance of other emotions
PC v2014A
F51.8
365
309.29 Other adjustment reactions with predominant
disturbance of other emotions
309.3 Adjustment disorder with disturbance of conduct
309.4 Adjustment disorder with mixed disburbance of
emotions and conduct
309.81 Posttraumatic stress disorder
309.81 Posttraumatic stress disorder
309.81 Posttraumatic stress disorder
309.82 Adjustment reaction with physical symptoms
309.83 Adjustment reaction with withdrawal
309.89 Other specified adjustment reactions
309.9 Unspecified adjustment reaction
309.9 Unspecified adjustment reaction
310.0 Frontal lobe syndrome
F43.24 Other childhood disorders of social functioning
311
F91.1
F43.25 Adjustment disorder with disturbance of conduct
F43.10 Adjustment disorder with mixed disturbance of
emotions and conduct
F43.11 Post-traumatic stress disorder, unspecified
F43.12 Post-traumatic stress disorder, acute
F43.8 Post-traumatic stress disorder, chronic
F43.8 Other reactions to severe stress
F43.8 Other reactions to severe stress
F43.20 Other reactions to severe stress
F43.9 Adjustment disorder, unspecified
F07.0 Reaction to severe stress, unspecified
F07.0 Personality change due to known physiological
condition
310.1 Personality change due to conditions classified F07.81 Personality change due to known physiological
elsewhere
condition
310.2 Postconcussion syndrome
F48.2 Postconcussional syndrome
310.81 Pseudobulbar affect
F07.89 Pseudobulbar affect
310.89 Other specified nonpsychotic mental disorders F07.9 Other personality and behavioral disorders due
following organic brain damage
to known physiological condition
310.9 Unspecified nonpsychotic mental disorder
F09
Unspecified personality and behavioral disorder
following organic brain damage
due to known physiological condition
310.9 Unspecified nonpsychotic mental disorder
F32.9 Unspecified mental disorder due to known
following organic brain damage
physiological condition
Depressive disorder, not elsewhere classified
312.00 Undersocialized conduct disorder, aggressive
type, unspecified
312.01 Undersocialized conduct disorder, aggressive
type, mild
312.02 Undersocialized conduct disorder, aggressive
type, moderate
312.03 Undersocialized conduct disorder, aggressive
type, severe
312.10 Undersocialized conduct disorder, unaggressive
type, unspecified
312.11 Undersocialized conduct disorder, unaggressive
type, mild
312.12 Undersocialized conduct disorder, unaggressive
type, moderate
312.13 Undersocialized conduct disorder, unaggressive
type, severe
312.20 Socialized conduct disorder, unspecified
312.21 Socialized conduct disorder, mild
312.22 Socialized conduct disorder, moderate
312.23 Socialized conduct disorder, severe
312.30 Impulse control disorder, unspecified
312.31 Pathological gambling
312.32 Kleptomania
312.33 Pyromania
312.34 Intermittent explosive disorder
312.35 Isolated explosive disorder
PC v2014A
F91.1
Major depressive disorder, single episode,
unspecified
Conduct disorder, childhood-onset type
F91.1
Conduct disorder, childhood-onset type
F91.1
Conduct disorder, childhood-onset type
F91.8
Conduct disorder, childhood-onset type
F91.8
Other conduct disorders
F91.8
Other conduct disorders
F91.8
Other conduct disorders
F91.2
Other conduct disorders
F91.2
F91.2
F91.2
F63.9
F63.0
F63.2
F63.1
F63.81
F63.81
F63.3
Conduct disorder, adolescent-onset type
Conduct disorder, adolescent-onset type
Conduct disorder, adolescent-onset type
Conduct disorder, adolescent-onset type
Impulse disorder, unspecified
Pathological gambling
Kleptomania
Pyromania
Intermittent explosive disorder
Intermittent explosive disorder
366
312.39 Other disorders of impulse control
312.39 Other disorders of impulse control
312.4 Mixed disturbance of conduct and emotions
312.81 Conduct disorder, childhood onset type
312.82 Conduct disorder, adolescent onset type
312.89 Other conduct disorder
312.89 Other conduct disorder
312.9 Unspecified disturbance of conduct
313.0 Overanxious disorder specific to childhood and
adolescence
313.1 Misery and unhappiness disorder specific to
childhood and adolescence
313.21 Shyness disorder of childhood
313.22 Introverted disorder of childhood
313.23 Selective mutism
313.3 Relationship problems specific to childhood and
adolescence
313.81 Oppositional defiant disorder
313.82 Identity disorder of childhood or adolescence
313.83 Academic underachievement disorder of
childhood or adolescence
313.89 Other emotional disturbances of childhood or
adolescence
313.89 Other emotional disturbances of childhood or
adolescence
313.89 Other emotional disturbances of childhood or
adolescence
313.89 Other emotional disturbances of childhood or
adolescence
313.89 Other emotional disturbances of childhood or
adolescence
F63.89
F91.8
F91.1
F91.2
F91.0
F91.8
F91.9
F93.8
F93.8
Trichotillomania
Other impulse disorders
Other conduct disorders
Conduct disorder, childhood-onset type
Conduct disorder, adolescent-onset type
Conduct disorder confined to family context
Other conduct disorders
Conduct disorder, unspecified
Other childhood emotional disorders
F93.8
Other childhood emotional disorders
F93.8
F94.0
F93.8
F91.3
Other childhood emotional disorders
Other childhood emotional disorders
Selective mutism
Other childhood emotional disorders
F93.8
F93.8
Oppositional defiant disorder
Other childhood emotional disorders
F93.8
Other childhood emotional disorders
F94.1
Other childhood emotional disorders
F94.2
Reactive attachment disorder of childhood
F94.9
Disinhibited attachment disorder of childhood
F98.8
Childhood disorder of social functioning,
unspecified
Other specified behavioral and emotional
disorders with onset usually occurring in
childhood and adolescence
Childhood emotional disorder, unspecified
F93.9
313.9 Unspecified emotional disturbance of childhood F94.8
or adolescence
313.9 Unspecified emotional disturbance of childhood F98.9
or adolescence
313.9 Unspecified emotional disturbance of childhood F90.9
or adolescence
314.00 Attention deficit disorder without mention of
hyperactivity
314.01 Attention deficit disorder with hyperactivity
F90.1
314.01 Attention deficit disorder with hyperactivity
F90.2
314.01 Attention deficit disorder with hyperactivity
F90.9
314.01 Attention deficit disorder with hyperactivity
F90.8
314.1 Hyperkinesis with developmental delay
314.2 Hyperkinetic conduct disorder
314.8 Other specified manifestations of hyperkinetic
syndrome
F90.8
F90.8
F90.9
PC v2014A
F90.0
Other childhood disorders of social functioning
Unspecified behavioral and emotional disorders
with onset usually occurring in childhood and
adolescence
Attention-deficit hyperactivity disorder,
unspecified type
Attention-deficit hyperactivity disorder,
predominantly inattentive type
Attention-deficit hyperactivity disorder,
predominantly hyperactive type
Attention-deficit hyperactivity disorder, combined
type
Attention-deficit hyperactivity disorder,
unspecified type
Attention-deficit hyperactivity disorder, other type
Attention-deficit hyperactivity disorder, other type
Attention-deficit hyperactivity disorder, other type
367
314.9 Unspecified hyperkinetic syndrome
F81.0
315.00 Developmental reading disorder, unspecified
315.01 Alexia
315.02 Developmental dyslexia
315.09 Other specific developmental reading disorder
315.1 Mathematics disorder
315.2 Other specific developmental learning difficulties
315.2 Other specific developmental learning difficulties
R48.0
F81.0
F81.81
F81.2
F81.81
F81.89
F80.1
315.31 Expressive language disorder
315.32 Mixed receptive-expressive language disorder
315.32 Mixed receptive-expressive language disorder
F80.2
H93.25
F80.4
315.34 Speech and language developmental delay due
to hearing loss
315.35 Childhood onset fluency disorder
315.39 Other developmental speech or language
disorder
315.39 Other developmental speech or language
disorder
315.39 Other developmental speech or language
disorder
315.4 Developmental coordination disorder
F80.81 Speech and language development delay due to
hearing loss
F80.0 Childhood onset fluency disorder
F80.89 Phonological disorder
315.5 Mixed development disorder
315.8 Other specified delays in development
315.9 Unspecified delay in development
315.9 Unspecified delay in development
316
Psychic factors associated with diseases
classified elsewhere
317
Mild intellectual disabilities
318.0 Moderate intellectual disabilities
318.1 Severe intellectual disabilities
318.2 Profound intellectual disabilities
319
Unspecified intellectual disabilities
319
Unspecified intellectual disabilities
Attention-deficit hyperactivity disorder,
unspecified type
Specific reading disorder
Dyslexia and alexia
Specific reading disorder
Disorder of written expression
Mathematics disorder
Disorder of written expression
Other developmental disorders of scholastic
skills
Expressive language disorder
Mixed receptive-expressive language disorder
Central auditory processing disorder
F80.9
Other developmental disorders of speech and
language
F82
Developmental disorder of speech and
language, unspecified
F82
Specific developmental disorder of motor
function
F88
Specific developmental disorder of motor
function
F81.9 Other disorders of psychological development
F89
Developmental disorder of scholastic skills,
unspecified
F54
Unspecified disorder of psychological
development
F70
Psychological and behavioral factors associated
with disorders or diseases classified elsewhere
F71
Mild intellectual disabilities
F72
Moderate intellectual disabilities
F73
Severe intellectual disabilities
F78
Profound intellectual disabilities
F79
Other intellectual disabilities
F19.921 Unspecified intellectual disabilities
Table 11.01 Complication Mainly Related to Pregnancy
Code Description
ICD-9-CM
Code
640.81
HEM EARLY PREG NECDELIV
ICD-10-CM
Code Description
Code
O20.8
Other hemorrhage in early pregnancy
640.91
HEM EARLY PREGDELIVERED
O20.9
Hemorrhage in early pregnancy, unspecified
641.01
PLACENTA PREVIADELIVER
O44.01
Placenta previa specified as w/o hemorrhage, first
trimester
Placenta previa specified as w/o hemor, second
O44.02
PC v2014A
368
641.11
641.21
PLACENTA PREV HEMDELIV
PREM SEPAR PLACENDELIV
O44.03
trimester
Placenta previa specified as w/o hemorrhage, third
trimester
O44.11
Placenta previa with hemorrhage, first trimester
O44.12
O44.13
Placenta previa with hemorrhage, second trimester
Placenta previa with hemorrhage, third trimester
O45.8X1
Other premature separation of placenta, first trimester
O45.8X2
O45.93
Other premature separation of placenta, second
trimester
Other premature separation of placenta, third trimester
Premature separation of placenta, unsp, first trimester
Premature separation of placenta, unsp, second
trimester
Premature separation of placenta, unsp, third trimester
O45.001
Prem separtn of placenta w coag defect, unsp, first tri
O45.002
Prem separtn of placenta w coag defect, unsp, second
tri
Prem separtn of placenta w coag defect, unsp, third tri
Prem separtn of placenta w afibrinogenemia, first
trimester
Prem separtn of placenta w afibrinogenemia, second
trimester
Prem separtn of placenta w afibrinogenemia, third
trimester
Prem separtn of placenta w dissem intravasc coag, first
tri
Prem separtn of placenta w dissem intravasc coag,
second tri
Prem separtn of placenta w dissem intravasc coag, third
tri
Prem separtn of placenta w oth coag defect, first
trimester
Prem separtn of placenta w oth coag defect, second
trimester
Prem separtn of placenta w oth coag defect, third
trimester
Antepartum hemorrhage w coag defect, unsp, first
trimester
Antepartum hemorrhage w coag defect, unsp, second
trimester
Antepartum hemorrhage w coag defect, unsp, third
trimester
Antepartum hemorrhage with afibrinogenemia, first
trimester
Antepartum hemorrhage with afibrinogenemia, second
trimester
Antepartum hemorrhage with afibrinogenemia, third
trimester
O45.8X3
O45.91
O45.92
641.31
COAG DEF HEMORRDELIVER
O45.003
O45.011
O45.012
O45.013
O45.021
O45.022
O45.023
O45.091
O45.092
O45.093
O46.001
O46.002
O46.003
O46.011
O46.012
O46.013
PC v2014A
369
O46.021
O46.022
O46.023
O46.091
O46.092
O46.093
O67.0
641.81
641.91
642.01
Antepart hemorrhage w dissem intravasc coag, first
trimester
Antepart hemor w dissem intravasc coag, second
trimester
Antepart hemorrhage w dissem intravasc coag, third
trimester
Antepartum hemorrhage w oth coag defect, first
trimester
Antepartum hemorrhage w oth coag defect, second
trimester
Antepartum hemorrhage w oth coag defect, third
trimester
Intrapartum hemorrhage with coagulation defect
ANTEPARTUM HEM NEC- O46.8X1
DELIV
O46.8X2
O46.8X3
O67.8
Other antepartum hemorrhage, first trimester
ANTEPARTUM HEM NOS- O46.91
DELIV
O46.92
O46.93
O67.9
Antepartum hemorrhage, unspecified, first trimester
ESSEN HYPERTENDELIVERED
Pre-existing essential htn comp pregnancy, first
trimester
Pre-existing essential htn comp pregnancy, second
trimester
Pre-existing essential htn comp pregnancy, third
trimester
Pre-existing essential hypertension complicating
childbirth
Unsp pre-existing htn comp pregnancy, first trimester
Unsp pre-existing htn comp pregnancy, second trimester
Unsp pre-existing htn comp pregnancy, third trimester
Unsp pre-existing htn complicating childbirth
O10.011
O10.012
O10.013
O10.02
O10.911
O10.912
O10.913
O10.92
Other antepartum hemorrhage, second trimester
Other antepartum hemorrhage, third trimester
Other intrapartum hemorrhage
Antepartum hemorrhage, unspecified, second trimester
Antepartum hemorrhage, unspecified, third trimester
Intrapartum hemorrhage, unspecified
642.02
ESSEN HYPERTEN-DEL W O10.03
P/P
Pre-existing essential hypertension comp the
puerperium
642.11
RENAL HYPERTEN PGDELIV
O10.411
Pre-existing secondary htn comp pregnancy, first
trimester
O10.412
Pre-existing secondary htn comp pregnancy, second
trimester
Pre-existing secondary htn comp pregnancy, third
trimester
Pre-existing secondary hypertension complicating
childbirth
O10.413
O10.42
642.12
PC v2014A
RENAL HYPERTEN-DEL W O10.43
P/P
Pre-existing secondary hypertension comp the
puerperium
370
642.21
OLD HYPERTEN NECDELIVER
O10.111
O10.112
O10.113
O10.12
O10.211
O10.212
O10.213
O10.22
O10.311
O10.312
O10.313
O10.32
O11.1
O11.2
O11.3
Pre-exist hyp heart disease comp pregnancy, first
trimester
Pre-exist hyp heart disease comp pregnancy, second
trimester
Pre-exist hyp heart disease comp pregnancy, third
trimester
Pre-existing hypertensive heart disease comp childbirth
Pre-exist hyp chronic kidney disease comp preg, first tri
Pre-exist hyp chronic kidney disease comp preg,
second tri
Pre-exist hyp chronic kidney disease comp preg, third tri
Pre-existing hyp chronic kidney disease comp childbirth
Pre-exist hyp heart and chr kidney dis comp preg, first tri
Pre-exist hyp heart and chr kidney dis comp preg,
second tri
Pre-exist hyp heart and chr kidney dis comp preg, third
tri
Pre-exist hyp heart and chronic kidney disease comp
chldbrth
Pre-existing hypertension w pre-eclampsia, first
trimester
Pre-existing hypertension w pre-eclampsia, second
trimester
Pre-existing hypertension w pre-eclampsia, third
trimester
642.22
OLD HYPERTEN-DELIV W O10.13
P/P
Pre-existing hypertensive heart disease comp the
puerperium
642.31
TRANS HYPERTENDELIVERED
O13.1
Gestational htn w/o significant proteinuria, first trimester
O13.2
O13.3
O16.1
O16.2
O16.3
Gestatnl htn w/o significant proteinuria, second trimester
Gestational htn w/o significant proteinuria, third trimester
Unspecified maternal hypertension, first trimester
Unspecified maternal hypertension, second trimester
Unspecified maternal hypertension, third trimester
642.32
642.41
642.42
642.51
PC v2014A
TRANS HYPERTEN-DEL W O13.1
P/P
O13.2
O13.3
Gestational htn w/o significant proteinuria, first trimester
MILD/NOS PREECLAMPDELIV
O14.02
Mild to moderate pre-eclampsia, second trimester
O14.03
O14.92
O14.93
Mild to moderate pre-eclampsia, third trimester
Unspecified pre-eclampsia, second trimester
Unspecified pre-eclampsia, third trimester
Gestatnl htn w/o significant proteinuria, second trimester
Gestational htn w/o significant proteinuria, third trimester
MILD PREECLAMP-DEL W O14.02
P/P
O14.03
Mild to moderate pre-eclampsia, second trimester
SEVERE PREECLAMP-
Severe pre-eclampsia, second trimester
O14.12
Mild to moderate pre-eclampsia, third trimester
371
DELIVER
O14.13
O14.22
O14.23
642.52
Severe pre-eclampsia, third trimester
HELLP syndrome (HELLP), second trimester
HELLP syndrome (HELLP), third trimester
SEV PREECLAMP-DEL W O14.12
P/P
O14.13
O14.22
O14.23
Severe pre-eclampsia, second trimester
642.61
ECLAMPSIA-DELIVERED O15.02
O15.03
O15.1
Eclampsia in pregnancy, second trimester
Eclampsia in pregnancy, third trimester
Eclampsia in labor
642.62
ECLAMPSIA-DELIV W P/P O15.2
Eclampsia in the puerperium
642.71
TOX W OLD HYPERTENDELIV
Pre-existing hypertension w pre-eclampsia, first
trimester
Pre-existing hypertension w pre-eclampsia, second
trimester
Pre-existing hypertension w pre-eclampsia, third
trimester
O11.1
O11.2
O11.3
Severe pre-eclampsia, third trimester
HELLP syndrome (HELLP), second trimester
HELLP syndrome (HELLP), third trimester
642.72
TOX W OLD HYP-DEL W
P/P
O15.2
Eclampsia in the puerperium
642.91
HYPERTENS NOSDELIVERED
O16.1
Unspecified maternal hypertension, first trimester
O16.2
O16.3
Unspecified maternal hypertension, second trimester
Unspecified maternal hypertension, third trimester
642.92
HYPERTENS NOS-DEL W O16.9
P/P
Unspecified maternal hypertension, unspecified
trimester
643.01
MILD HYPEREM GRAVDELIV
Mild hyperemesis gravidarum
643.11
HYPEREM W METAB DIS- O21.1
DEL
Hyperemesis gravidarum with metabolic disturbance
643.21
LATE VOMIT OF PREGDELIV
O21.2
Late vomiting of pregnancy
643.81
VOMIT COMPL PREGDELIVER
O21.8
Other vomiting complicating pregnancy
643.91
VOMIT OF PREG NOSDELIV
O21.9
Vomiting of pregnancy, unspecified
644.21
EARLY ONSET DELIVERY- O60.12X0
DEL
PC v2014A
O21.0
Preterm labor second tri w preterm delivery second tri,
unsp
372
O60.12X1
O60.12X2
O60.12X3
O60.12X4
O60.12X5
O60.12X9
O60.13X0
O60.13X1
O60.13X2
O60.13X3
O60.13X4
O60.13X5
O60.13X9
O60.14X0
O60.14X1
O60.14X2
O60.14X3
O60.14X4
O60.14X5
O60.14X9
O60.22X0
O60.22X1
O60.22X2
O60.22X3
O60.22X4
O60.22X5
O60.22X9
O60.23X0
O60.23X1
O60.23X2
O60.23X3
O60.23X4
O60.23X5
O60.23X9
Preterm labor second tri w preterm del second tri, fetus
1
Preterm labor second tri w preterm del second tri, fetus
2
Preterm labor second tri w preterm del second tri, fetus
3
Preterm labor second tri w preterm del second tri, fetus
4
Preterm labor second tri w preterm del second tri, fetus
5
Preterm labor second tri w preterm delivery second tri,
oth
Preterm labor second tri w preterm delivery third tri, unsp
Preterm labor second tri w preterm del third tri, fetus 1
Preterm labor second tri w preterm del third tri, fetus 2
Preterm labor second tri w preterm del third tri, fetus 3
Preterm labor second tri w preterm del third tri, fetus 4
Preterm labor second tri w preterm del third tri, fetus 5
Preterm labor second tri w preterm delivery third tri, oth
Preterm labor third tri w preterm delivery third tri, unsp
Preterm labor third tri w preterm del third tri, fetus 1
Preterm labor third tri w preterm del third tri, fetus 2
Preterm labor third tri w preterm del third tri, fetus 3
Preterm labor third tri w preterm del third tri, fetus 4
Preterm labor third tri w preterm del third tri, fetus 5
Preterm labor third tri w preterm delivery third tri, oth
Term delivery w preterm labor, second trimester, unsp
Term delivery with preterm labor, second trimester, fetus
1
Term delivery with preterm labor, second trimester, fetus
2
Term delivery with preterm labor, second trimester, fetus
3
Term delivery with preterm labor, second trimester, fetus
4
Term delivery with preterm labor, second trimester, fetus
5
Term delivery w preterm labor, second trimester, oth
fetus
Term delivery w preterm labor, third trimester, unsp
Term delivery with preterm labor, third trimester, fetus 1
Term delivery with preterm labor, third trimester, fetus 2
Term delivery with preterm labor, third trimester, fetus 3
Term delivery with preterm labor, third trimester, fetus 4
Term delivery with preterm labor, third trimester, fetus 5
Term delivery with preterm labor, third trimester, oth
fetus
645.11
POST TERM PREG-DEL
O48.0
Post-term pregnancy
645.21
PROLONGED PREG-DEL O48.1
Prolonged pregnancy
646.01
PAPYRACEOUS FETUS-
Papyraceous fetus, first trimester, not applicable or unsp
PC v2014A
O31.01X0
373
DELIV
O31.01X1
O31.01X2
O31.01X3
Papyraceous fetus, first trimester, fetus 1
Papyraceous fetus, first trimester, fetus 2
Papyraceous fetus, first trimester, fetus 3
O31.01X4
O31.01X5
O31.01X9
O31.02X0
O31.03X1
O31.03X2
O31.03X3
O31.03X4
O31.03X5
O31.03X9
Papyraceous fetus, first trimester, fetus 4
Papyraceous fetus, first trimester, fetus 5
Papyraceous fetus, first trimester, other fetus
Papyraceous fetus, second trimester, not applicable or
unsp
Papyraceous fetus, second trimester, fetus 1
Papyraceous fetus, second trimester, fetus 2
Papyraceous fetus, second trimester, fetus 3
Papyraceous fetus, second trimester, fetus 4
Papyraceous fetus, second trimester, fetus 5
Papyraceous fetus, second trimester, other fetus
Papyraceous fetus, third trimester, not applicable or
unsp
Papyraceous fetus, third trimester, fetus 1
Papyraceous fetus, third trimester, fetus 2
Papyraceous fetus, third trimester, fetus 3
Papyraceous fetus, third trimester, fetus 4
Papyraceous fetus, third trimester, fetus 5
Papyraceous fetus, third trimester, other fetus
O12.01
Gestational edema, first trimester
O12.02
O12.03
O12.21
O12.22
O12.23
O26.01
O26.02
O26.03
Gestational edema, second trimester
Gestational edema, third trimester
Gestational edema with proteinuria, first trimester
Gestational edema with proteinuria, second trimester
Gestational edema with proteinuria, third trimester
Excessive weight gain in pregnancy, first trimester
Excessive weight gain in pregnancy, second trimester
Excessive weight gain in pregnancy, third trimester
O12.01
Gestational edema, first trimester
O12.02
O12.03
Gestational edema, second trimester
Gestational edema, third trimester
O12.11
Gestestational proteinuria first trimester
O12.12
O12.13
O12.21
O12.22
O12.23
O26.831
O26.832
O26.833
Gestestational proteinuria second trimester
Gestestational proteinuria third trimester
Gestational edema with proteinuria, first trimester
Gestational edema with proteinuria, second trimester
Gestational edema with proteinuria, third trimester
Pregnancy related renal disease, first trimester
Pregnancy related renal disease, second trimester
Pregnancy related renal disease, third trimester
O26.831
Pregnancy related renal disease, first trimester
O31.02X1
O31.02X2
O31.02X3
O31.02X4
O31.02X5
O31.02X9
O31.03X0
646.11
646.12
646.21
646.22
PC v2014A
EDEMA IN PREGDELIVERED
EDEMA IN PREG-DEL W
P/P
RENAL DIS NOSDELIVERED
RENAL DIS NOS-DEL W
P/P
374
646.31
RECURNT PREG LOSSDELIV
O26.832
O26.833
Pregnancy related renal disease, second trimester
Pregnancy related renal disease, third trimester
O26.21
Preg care for patient w recurrent preg loss, first trimester
O26.22
O26.23
Preg care for patient w recur preg loss, second trimester
Preg care for patient w recurrent preg loss, third
trimester
646.41
NEURITIS-DELIVERED
O26.821
O26.822
O26.823
Pregnancy related peripheral neuritis, first trimester
Pregnancy related peripheral neuritis, second trimester
Pregnancy related peripheral neuritis, third trimester
646.42
NEURITIS-DELIVERED W
P/P
O26.821
Pregnancy related peripheral neuritis, first trimester
O26.822
O26.823
Pregnancy related peripheral neuritis, second trimester
Pregnancy related peripheral neuritis, third trimester
O23.41
Unsp infct of urinary tract in pregnancy, first trimester
O23.42
O23.43
Unsp infct of urinary tract in pregnancy, second trimester
Unsp infct of urinary tract in pregnancy, third trimester
646.51
646.52
646.61
PC v2014A
ASYM BACTERIURIADELIVER
ASYM BACTERURIA-DEL O23.91
W P/P
O23.92
O23.93
Unsp GU tract infection in pregnancy, first trimester
GU INFECTIONDELIVERED
O23.01
Infections of kidney in pregnancy, first trimester
O23.02
O23.03
O23.11
O23.12
O23.13
O23.21
O23.22
O23.23
O23.31
O23.32
O23.33
O23.41
O23.42
O23.43
O23.511
O23.512
O23.513
O23.521
O23.522
O23.523
O23.591
O23.592
O23.593
Infections of kidney in pregnancy, second trimester
Infections of kidney in pregnancy, third trimester
Infections of bladder in pregnancy, first trimester
Infections of bladder in pregnancy, second trimester
Infections of bladder in pregnancy, third trimester
Infections of urethra in pregnancy, first trimester
Infections of urethra in pregnancy, second trimester
Infections of urethra in pregnancy, third trimester
Infect of prt urinary tract in pregnancy, first trimester
Infect of prt urinary tract in pregnancy, second trimester
Infect of prt urinary tract in pregnancy, third trimester
Unsp infct of urinary tract in pregnancy, first trimester
Unsp infct of urinary tract in pregnancy, second trimester
Unsp infct of urinary tract in pregnancy, third trimester
Infections of cervix in pregnancy, first trimester
Infections of cervix in pregnancy, second trimester
Infections of cervix in pregnancy, third trimester
Salpingo-oophoritis in pregnancy, first trimester
Salpingo-oophoritis in pregnancy, second trimester
Salpingo-oophoritis in pregnancy, third trimester
Infection oth prt genitl trct in pregnancy, first trimester
Infection oth prt genitl trct in pregnancy, second trimester
Infection oth prt genitl trct in pregnancy, third trimester
Unsp GU tract infection in pregnancy, second trimester
Unsp GU tract infection in pregnancy, third trimester
375
646.62
GU INFECTION-DELIV W
P/P
O23.91
O23.92
O23.93
Unsp GU tract infection in pregnancy, first trimester
Unsp GU tract infection in pregnancy, second trimester
Unsp GU tract infection in pregnancy, third trimester
O23.91
O23.91 Unsp GU tract infection in pregnancy, first
trimester
O23.92 Unsp GU tract infection in pregnancy, second
trimester
O23.93 Unsp GU tract infection in pregnancy, third
trimester
O23.92
O23.93
646.71
LIVER DISORDERDELIVERED
O26.611
O26.612
O26.613
646.81
PREG COMPL NECDELIVERED
026.62
O26.62 Liver and biliary tract disorders in childbirth
O26.11
Low weight gain in pregnancy, first trimester
O26.12
O26.13
O26.31
Low weight gain in pregnancy, second trimester
Low weight gain in pregnancy, third trimester
Retained uterin contracep dev in pregnancy, first
trimester
Retained uterin contracep dev in pregnancy, second
trimester
Retained uterin contracep dev in pregnancy, third
trimester
Herpes gestationis, first trimester
Herpes gestationis, second trimester
Herpes gestationis, third trimester
Sublux of symphysis (pubis) in pregnancy, first trimester
Sublux of symphysis (pubis) in pregnancy, second
trimester
Sublux of symphysis (pubis) in pregnancy, third trimester
Subluxation of symphysis (pubis) in childbirth
Pregnancy related exhaustion and fatigue, first trimester
Pregnancy related exhaustion and fatigue, second
trimester
Pregnancy related exhaustion and fatigue, third trimester
Pruritic urticarial papules and plaques of pregnancy
(PUPPP)
Oth pregnancy related conditions, first trimester
Oth pregnancy related conditions, second trimester
Oth pregnancy related conditions, third trimester
Pregnancy related conditions, unspecified, first trimester
Pregnancy related conditions, unspecified, second
trimester
Pregnancy related conditions, unspecified, third
trimester
Aspirat pneumonitis due to anesth during preg, first tri
Aspirat pneumonitis due to anesth during preg, second
O26.32
O26.33
O26.41
O26.42
O26.43
O26.711
O26.712
O26.713
O26.72
O26.811
O26.812
O26.813
O26.86
O26.891
O26.892
O26.893
O26.91
O26.92
O26.93
O29.011
O29.012
PC v2014A
O26.611 Liver and biliary tract disord in preg, first
trimester
O26.612 Liver and biliary tract disord in preg, second
trimester
O26.613 Liver and biliary tract disord in preg, third
trimester
376
O29.013
O29.021
O29.022
O29.023
O29.091
O29.092
O29.093
O29.111
O29.112
O29.113
O29.121
O29.122
O29.123
O29.191
O29.192
O29.193
O29.211
O29.212
O29.213
O29.291
O29.292
O29.293
O29.3X1
O29.3X2
O29.3X3
O29.41
O29.42
O29.43
O29.5X1
O29.5X2
O29.5X3
O29.61
O29.62
O29.63
PC v2014A
tri
Aspirat pneumonitis due to anesth during preg, third tri
Pressr collapse of lung due to anesth during preg, first tri
Pressr collapse of lung d/t anesth during preg, second tri
Pressr collapse of lung due to anesth during preg, third
tri
Oth pulmonary comp of anesth during preg, first
trimester
Oth pulmonary comp of anesth during preg, second
trimester
Oth pulmonary comp of anesth during preg, third
trimester
Cardiac arrest due to anesth during preg, first trimester
Cardiac arrest due to anesth during preg, second
trimester
Cardiac arrest due to anesth during preg, third trimester
Cardiac failure due to anesth during preg, first trimester
Cardiac failure due to anesth during preg, second
trimester
Cardiac failure due to anesth during preg, third trimester
Oth cardiac comp of anesth during preg, first trimester
Oth cardiac comp of anesth during preg, second
trimester
Oth cardiac comp of anesth during pregnancy, third
trimester
Cerebral anoxia due to anesth during preg, first trimester
Cerebral anoxia due to anesth during preg, second
trimester
Cerebral anoxia due to anesth during preg, third
trimester
Oth cnsl comp of anesth during pregnancy, first trimester
Oth cnsl comp of anesth during pregnancy, second
trimester
Oth cnsl comp of anesth during pregnancy, third
trimester
Toxic reaction to local anesth during preg, first trimester
Toxic reaction to local anesth during preg, second
trimester
Toxic reaction to local anesth during preg, third trimester
Spinal and epidur anesth induce hdache dur preg, first tri
Spinal and epidur anesth induce hdache dur preg,
second tri
Spinal and epidur anesth induce hdache dur preg, third
tri
Oth comp of spinal and epidur anesth during preg, first
tri
Oth comp of spinal and epidur anesth during preg,
second tri
Oth comp of spinal and epidur anesth during preg, third
tri
Fail or difficult intubation for anesth dur preg, first tri
Fail or difficult intubation for anesth dur preg, second tri
Fail or difficult intubation for anesth dur preg, third tri
377
O29.8X1
O29.8X2
O29.8X3
O29.91
O29.92
O29.93
O99.351
O99.352
O99.353
O99.354
O99.89
646.82
Oth comp of anesthesia during pregnancy, first trimester
Oth comp of anesthesia during pregnancy, second
trimester
Oth comp of anesthesia during pregnancy, third
trimester
Unsp comp of anesthesia during pregnancy, first
trimester
Unsp comp of anesthesia during pregnancy, second
trimester
Unsp comp of anesthesia during pregnancy, third
trimester
Diseases of the nervous system comp pregnancy, first
trimester
Diseases of the nervous system comp pregnancy,
second trimester
Diseases of the nervous system comp pregnancy, third
trimester
Diseases of the nervous system comp childbirth
Other diseases and conditions comp preg/childbirth
PREG COMPL NEC-DEL W O26.891
P/P
O26.892
O26.893
O99.355
Oth pregnancy related conditions, first trimester
646.91
PREG COMPL NOSDELIVERED
O99.89
Oth diseases and cond comp pregnancy, chldbrth and
the puerp
647.01
SYPHILIS-DELIVERED
O98.111
O98.112
O98.113
O98.12
Syphilis complicating pregnancy, first trimester
Syphilis complicating pregnancy, second trimester
Syphilis complicating pregnancy, third trimester
Syphilis complicating childbirth
647.02
SYPHILIS-DELIVERED W
P/P
O98.13
Syphilis complicating the puerperium
647.11
GONORRHEA-DELIVERED O98.211
O98.212
O98.213
O98.22
Gonorrhea complicating pregnancy, first trimester
Gonorrhea complicating pregnancy, second trimester
Gonorrhea complicating pregnancy, third trimester
Gonorrhea complicating childbirth
647.12
GONORRHEA-DELIVER W O98.23
P/P
Gonorrhea complicating the puerperium
647.21
OTHER VD-DELIVERED
Oth infect w sexl mode of transmiss comp preg, first tri
Oth infect w sexl mode of transmiss comp preg, second
tri
Oth infect w sexl mode of transmiss comp preg, third tri
Oth infections w sexl mode of transmiss comp childbirth
O98.311
O98.312
O98.313
O98.32
647.22
PC v2014A
OTHER VD-DELIVERED W O98.33
P/P
Oth pregnancy related conditions, second trimester
Oth pregnancy related conditions, third trimester
Diseases of the nervous system complicationg the
puerperium
Oth infections w sexl mode of transmiss comp the
puerperium
378
647.31
TUBERCULOSISDELIVERED
O98.011
Tuberculosis complicating pregnancy, first trimester
O98.012
O98.013
O98.02
Tuberculosis complicating pregnancy, second trimester
Tuberculosis complicating pregnancy, third trimester
Tuberculosis complicating childbirth
647.32
TUBERCULOSIS-DELIV W O98.03
P/P
Tuberculosis complicating the puerperium
647.41
MALARIA-DELIVERED
O98.62
Protozoal diseases complicating pregnancy first
trimester
Protozoal diseases complicating pregnancy second
trimester
Protozoal diseases complicating pregnancy third
trimester
Protozoal diseases complicating childbirth
O98.611
O98.612
O98.613
647.42
MALARIA-DELIVERED W
P/P
O98.63
Protozoal diseases complicating the puerperium
647.51
RUBELLA-DELIVERED
O98.511
Other viral diseases complicating pregnancy, first
trimester
Oth viral diseases complicating pregnancy, second
trimester
Other viral diseases complicating pregnancy, third
trimester
Other viral diseases complicating childbirth
O98.512
O98.513
O98.52
647.52
RUBELLA-DELIVERED W O98.53
P/P
Other viral diseases complicating the puerperium
647.61
OTH VIRAL DISDELIVERED
O98.411
Viral hepatitis complicating pregnancy, first trimester
O98.412
O98.413
O98.42
O98.511
Viral hepatitis complicating pregnancy, second trimester
Viral hepatitis complicating pregnancy, third trimester
Viral hepatitis complicating childbirth
Other viral diseases complicating pregnancy, first
trimester
Oth viral diseases complicating pregnancy, second
trimester
Other viral diseases complicating pregnancy, third
trimester
Other viral diseases complicating childbirth
Human immunodef virus disease comp preg, first
trimester
Human immunodef virus disease comp preg, second
trimester
Human immunodef virus disease comp preg, third
trimester
Human immunodef virus disease complicating childbirth
O98.512
O98.513
O98.52
O98.711
O98.712
O98.713
O98.72
PC v2014A
379
647.62
OTH VIRAL DIS-DEL W P/P O98.43
O98.53
Viral hepatitis complicating the puerperium
Other viral diseases complicating the puerperium
647.81
INFECT DIS NECDELIVERED
Protozoal diseases complicating pregnancy, first
trimester
Protozoal diseases complicating pregnancy, second
trimester
Protozoal diseases complicating pregnancy, third
trimester
Oth maternal infec/parastc diseases comp preg, first tri
Oth maternal infec/parastc diseases comp preg, second
tri
Oth maternal infec/parastc diseases comp preg, third tri
Oth maternal infec/parastc diseases complicating
childbirth
Other infection carrier state complicating pregnancy
Other infection carrier state complicating childbirth
O98.611
O98.612
O98.613
O98.811
O98.812
O98.813
O98.82
O99.830
O99.834
647.82
INFECT DIS NEC-DEL W
P/P
O98.83
O99.835
647.91
INFECT NOS-DELIVERED O98.911
O98.912
O98.913
O98.92
Oth maternal infec/parastc diseases comp the
puerperium
Oth infection carrier state complicating the puerperium
Unsp maternal infec/parastc disease comp preg, first tri
Unsp maternal infec/parastc disease comp preg,
second tri
Unsp maternal infec/parastc disease comp preg, third tri
Unsp maternal infec/parastc disease complicating
childbirth
647.92
INFECT NOS-DELIVER W O98.93
P/P
Unsp maternal infec/parastc disease comp the
puerperium
648.01
DIABETES-DELIVERED
Pre-existing diabetes, type 1, in pregnancy, first
trimester
Pre-exist diabetes, type 1, in pregnancy, second
trimester
Pre-existing diabetes, type 1, in pregnancy, third
trimester
Pre-existing diabetes mellitus, type 1, in childbirth
Pre-existing diabetes, type 2, in pregnancy, first
trimester
Pre-exist diabetes, type 2, in pregnancy, second
trimester
Pre-existing diabetes, type 2, in pregnancy, third
trimester
Pre-existing diabetes mellitus, type 2, in childbirth
Unsp pre-existing diabetes in pregnancy, first trimester
Unsp pre-existing diabetes in pregnancy, second
trimester
Unsp pre-existing diabetes in pregnancy, third trimester
Unspecified pre-existing diabetes mellitus in childbirth
Oth pre-existing diabetes in pregnancy, first trimester
Oth pre-existing diabetes in pregnancy, second
O24.011
O24.012
O24.013
O24.02
O24.111
O24.112
O24.113
O24.12
O24.311
O24.312
O24.313
O24.32
O24.811
O24.812
PC v2014A
380
O24.813
O24.82
O24.911
O24.912
O24.913
O24.92
trimester
Oth pre-existing diabetes in pregnancy, third trimester
Other pre-existing diabetes mellitus in childbirth
Unspecified diabetes mellitus in pregnancy, first
trimester
Unspecified diabetes mellitus in pregnancy, second
trimester
Unspecified diabetes mellitus in pregnancy, third
trimester
Unspecified diabetes mellitus in childbirth
648.02
DIABETES-DELIVERED W O24.93
P/P
Unspecified diabetes mellitus in the puerperium
648.11
THYROID DYSFUNCDELIVER
O99.281
Endo, nutritional and metab diseases comp preg, first tri
O99.282
Endo, nutritional and metab diseases comp preg,
second tri
O99.283
Endo, nutritional and metab diseases comp preg, third
tri
Endocrine, nutritional and metabolic diseases comp
chldbrth
O99.284
648.12
THYROID DYSFUN-DEL W O90.5
P/P
O99.285
Postpartum thyroiditis
Endocrine, nutritional and metabolic diseases comp the
puerperium
648.21
ANEMIA-DELIVERED
O99.011
O99.012
O99.013
O99.02
Anemia complicating pregnancy, first trimester
Anemia complicating pregnancy, second trimester
Anemia complicating pregnancy, third trimester
Anemia complicating childbirth
648.22
ANEMIA-DELIVERED W
P/P
O99.03
Anemia complicating the puerperium
648.31
DRUG DEPENDENCEDELIVER
O99.321
Drug use complicating pregnancy, first trimester
O99.322
O99.323
O99.324
Drug use complicating pregnancy, second trimester
Drug use complicating pregnancy, third trimester
Drug use complicating childbirth
648.32
DRUG DEPENDEN-DEL W O99.325
P/P
O99.311
O99.312
O99.313
O99.314
O99.341
O99.342
O99.343
PC v2014A
Drug use complicating the puerperium
Alcohol use complicating pregnancy, first trimester
Alcohol use complicating pregnancy, second trimester
Alcohol use complicating pregnancy, third trimester
Alcohol use complicating childbirth
Oth mental disorders complicating pregnancy, first
trimester
Oth mental disorders comp pregnancy, second trimester
Oth mental disorders complicating pregnancy, third
381
O99.344
trimester
Other mental disorders complicating childbirth
648.42
MENTAL DIS-DELIV W P/P O90.6
O99.345
Postpartum mood disturbance
Other mental disorders complicating the puerperium
648.51
CONGEN CV DISDELIVERED
O99.411
Diseases of the circ sys comp pregnancy, first trimester
O99.412
Diseases of the circ sys comp pregnancy, second
trimester
O99.413
O99.42
Diseases of the circ sys comp pregnancy, third trimester
Diseases of the circulatory system complicating
childbirth
648.52
CONGEN CV DIS-DEL W
P/P
O99.43
Diseases of the circ sys complicating the puerperium
648.61
CV DIS NEC PREGDELIVER
O99.411
Diseases of the circ sys comp pregnancy, first trimester
O99.412
Diseases of the circ sys comp pregnancy, second
trimester
Diseases of the circ sys comp pregnancy, third trimester
Diseases of the circulatory system complicating
childbirth
O99.413
O99.42
648.62
CV DIS NEC-DELIVER W
P/P
O99.43
Diseases of the circ sys complicating the puerperium
648.71
BONE DISORDERDELIVERED
O33.0
Matern care for disproprtn d/t deformity of matern pelv
bone
648.72
BONE DISORDER-DEL W O33.0
P/P
Matern care for disproprtn d/t deformity of matern pelv
bone
648.81
ABN GLUCOSE TOLERDELIV
O24.414
O24.419
O24.420
O24.424
O24.429
O99.810
O99.814
Gestational diabetes mellitus in pregnancy, diet
controlled
Gestational diabetes in pregnancy, insulin controlled
Gestational diabetes mellitus in pregnancy, unsp control
Gestational diabetes mellitus in childbirth, diet controlled
Gestational diabetes in childbirth, insulin controlled
Gestational diabetes mellitus in childbirth, unsp control
Abnormal glucose complicating pregnancy
Abnormal glucose complicating childbirth
O24.410
648.82
ABN GLUCOSE-DELIV W
P/P
O99.815
Abnormal glucose complicating the puerperium
648.91
OTH CURR CONDDELIVERED
O25.11
Malnutrition in pregnancy, first trimester
O25.12
O25.13
O25.2
O99.281
Malnutrition in pregnancy, second trimester
Malnutrition in pregnancy, third trimester
Malnutrition in childbirth
Endo, nutritional and metab diseases comp preg, first tri
PC v2014A
382
O99.282
O99.283
O99.284
O99.511
O99.512
O99.513
O99.52
O99.611
O99.612
O99.613
O99.62
O99.711
O99.712
O99.713
O99.72
O99.824
O9A.111
O9A.112
O9A.113
O9A.12
O9A.211
O9A.212
O9A.213
O9A.22
O9A.311
O9A.312
O9A.313
O9A.32
O9A.411
O9A.412
O9A.413
O9A.42
O9A.511
O9A.512
PC v2014A
Endo, nutritional and metab diseases comp preg,
second tri
Endo, nutritional and metab diseases comp preg, third
tri
Endocrine, nutritional and metabolic diseases comp
chldbrth
Diseases of the resp sys comp pregnancy, first trimester
Diseases of the resp sys comp pregnancy, second
trimester
Diseases of the resp sys comp pregnancy, third
trimester
Diseases of the resp system complicating childbirth
Diseases of the dgstv sys comp pregnancy, first
trimester
Diseases of the dgstv sys comp pregnancy, second
trimester
Diseases of the dgstv sys comp pregnancy, third
trimester
Diseases of the digestive system complicating childbirth
Diseases of the skin, subcu comp pregnancy, first
trimester
Diseases of the skin, subcu comp pregnancy, second
trimester
Diseases of the skin, subcu comp pregnancy, third
trimester
Diseases of the skin, subcu complicating childbirth
Streptococcus B carrier state complicating childbirth
Malignant neoplasm complicating pregnancy, first
trimester
Malignant neoplasm complicating pregnancy, second
trimester
Malignant neoplasm complicating pregnancy, third
trimester
Malignant neoplasm complicating childbirth
Inj/poisn/oth conseq of external causes comp preg, first
tri
Inj/poisn/oth conseq of extrn causes comp preg, second
tri
Inj/poisn/oth conseq of external causes comp preg, third
tri
Inj/poisn/oth conseq of external causes comp childbirth
Physical abuse complicating pregnancy, first trimester
Physical abuse complicating pregnancy, second
trimester
Physical abuse complicating pregnancy, third trimester
Physical abuse complicating childbirth
Sexual abuse complicating pregnancy, first trimester
Sexual abuse complicating pregnancy, second trimester
Sexual abuse complicating pregnancy, third trimester
Sexual abuse complicating childbirth
Psychological abuse complicating pregnancy, first
trimester
Psychological abuse complicating pregnancy, second
trimester
383
O9A.513
O9A.52
Psychological abuse complicating pregnancy, third
trimester
Psychological abuse complicating childbirth
648.92
OTH CURR COND-DEL W O99.285
P/P
Endocrine, nutritional and metabolic diseases comp the
puerp
649.01
TOBACCO USE DISORDELLIV
Smoking (tobacco) complicating pregnancy, first
trimester
Smoking (tobacco) complicating pregnancy, second
trimester
Smoking (tobacco) complicating pregnancy, third
trimester
Smoking (tobacco) complicating childbirth
O99.331
O99.332
O99.333
O99.334
649.02
TOBACCO USE DIS-DEL- O99.335
P/P
Smoking (tobacco) complicating the puerperium
649.11
OBESITY-DELIVERED
O99.211
O99.212
O99.213
O99.214
Obesity complicating pregnancy, first trimester
Obesity complicating pregnancy, second trimester
Obesity complicating pregnancy, third trimester
Obesity complicating childbirth
649.12
OBESITY-DELIVERED W
P/P
O99.215
Obesity complicating the puerperium
649.21
BARIATRIC SURG STATDEL
O99.841
Bariatric surgery status comp pregnancy, first trimester
O99.842
Bariatric surgery status comp pregnancy, second
trimester
Bariatric surgery status comp pregnancy, third trimester
Bariatric surgery status complicating childbirth
O99.843
O99.844
649.22
BARIATRIC SURG-DEL W O99.845
P/P
Bariatric surgery status complicating the puerperium
649.31
COAGULATION DEF-DELIVO99.111
Oth dis of bld/bld-form org/immun mechnsm comp preg,
1st tri
Oth dis of bld/bld-form org/immun mechnsm comp preg,
2nd tri
Oth dis of bld/bld-form org/immun mechnsm comp preg,
3rd tri
Oth dis of the bld/bld-form org/immun mechnsm comp
chldbrth
O99.112
O99.113
O99.12
649.32
COAGULATN DEF-DEL W O99.13
P/P
Oth dis of the bld/bld-form org/immun mechnsm comp
the puerp
649.41
EPILEPSY-DELIVERED
Diseases of the nervous system comp pregnancy, first
trimester
Diseases of the nervous system comp pregnancy,
second trimester
Diseases of the nervous system comp pregnancy, third
trimester
O99.351
O99.352
O99.353
PC v2014A
384
O99.354
Diseases of the nervous system complicating childbirth
649.42
EPILEPSY-DELIVERED W O99.355
P/P
Diseases of the nervous system complicating the
puerperium
649.51
SPOTTING-DELIVERED
Spotting complicating pregnancy, first trimester
Spotting complicating pregnancy, second trimester
Spotting complicating pregnancy, third trimester
649.61
UTERINE SIZE DESCREP- O26.841
DEL
O26.842
O26.843
Uterine size-date discrepancy, first trimester
UTERINE SIZE-DEL W P/P O26.841
O26.842
O26.843
Uterine size-date discrepancy, first trimester
Uterine size-date discrepancy, second trimester
Uterine size-date discrepancy, third trimester
649.62
O26.851
O26.852
O26.853
Uterine size-date discrepancy, second trimester
Uterine size-date discrepancy, third trimester
Table 11.02 Normal Delivery and Other Indications for Care
ICD-9-CM
Code Description
Code
650
NORMAL DELIVERY
651.01
TWIN PREGNANCYDELIVERED
651.01
TWIN PREGNANCYDELIVERED
651.01
TWIN PREGNANCYDELIVERED
651.01
TWIN PREGNANCYDELIVERED
651.01
TWIN PREGNANCYDELIVERED
651.01
TWIN PREGNANCYDELIVERED
651.01
TWIN PREGNANCYDELIVERED
651.01
TWIN PREGNANCYDELIVERED
651.01
TWIN PREGNANCYDELIVERED
651.01
TWIN PREGNANCYDELIVERED
651.01
TWIN PREGNANCYDELIVERED
651.01
TWIN PREGNANCYDELIVERED
651.01
TWIN PREGNANCYDELIVERED
651.01
TWIN PREGNANCYDELIVERED
651.01
TWIN PREGNANCYDELIVERED
PC v2014A
ICD-10-CM
Code Description
Code
O80
Encounter for full-term uncomplicated delivery
O30.001
Twin preg, unsp num plcnta & amnio sacs, first trimester
O30.002
O30.003
O30.011
O30.012
O30.013
O30.031
O30.032
Twin preg, unsp num plcnta & amnio sacs, second
trimester
Twin preg, unsp num plcnta & amnio sacs, third trimester
Twin pregnancy, monochorionic/monoamniotic, first
trimester
Twin pregnancy, monochorionic/monoamniotic, second
trimester
Twin pregnancy, monochorionic/monoamniotic, third
trimester
Twin pregnancy, monochorionic/diamniotic, first trimester
O30.033
Twin pregnancy, monochorionic/diamniotic, second
trimester
Twin pregnancy, monochorionic/diamniotic, third trimester
O30.041
Twin pregnancy, dichorionic/diamniotic, first trimester
O30.042
Twin pregnancy, dichorionic/diamniotic, second trimester
O30.043
Twin pregnancy, dichorionic/diamniotic, third trimester
O30.091
Twin preg, unable to dtrm num plcnta & amnio sacs, first
tri
Twin preg, unable to dtrm num plcnta & amnio sacs, 2nd
tri
Twin preg, unable to dtrm num plcnta & amnio sacs, third
tri
O30.092
O30.093
385
651.11
651.11
651.11
651.11
651.11
651.11
651.11
651.11
651.11
651.11
651.11
651.11
651.21
651.21
651.21
651.21
651.21
651.21
651.21
651.21
651.21
651.21
651.21
651.21
651.31
651.31
651.31
PC v2014A
TRIPLET PREGNANCYDELIV
TRIPLET PREGNANCYDELIV
TRIPLET PREGNANCYDELIV
TRIPLET PREGNANCYDELIV
TRIPLET PREGNANCYDELIV
TRIPLET PREGNANCYDELIV
TRIPLET PREGNANCYDELIV
TRIPLET PREGNANCYDELIV
TRIPLET PREGNANCYDELIV
TRIPLET PREGNANCYDELIV
TRIPLET PREGNANCYDELIV
TRIPLET PREGNANCYDELIV
QUADRUPLET PREGDELIVER
QUADRUPLET PREGDELIVER
QUADRUPLET PREGDELIVER
QUADRUPLET PREGDELIVER
QUADRUPLET PREGDELIVER
QUADRUPLET PREGDELIVER
QUADRUPLET PREGDELIVER
QUADRUPLET PREGDELIVER
QUADRUPLET PREGDELIVER
QUADRUPLET PREGDELIVER
QUADRUPLET PREGDELIVER
QUADRUPLET PREGDELIVER
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
O30.101
Triplet preg, unsp num plcnta & amnio sacs, first trimester
O30.102
Triplet preg, unsp num plcnta & amnio sacs, second
trimester
Triplet preg, unsp num plcnta & amnio sacs, third
trimester
Triplet preg w two or more monochorionic fetuses, first
trimester
Triplet preg w two or more monochorionic fetuses,
second trimester
Triplet preg w two or more monochorionic fetuses, third
trimester
Triplet preg w two or more monoamniotic fetuses, first
trimester
Triplet preg w two or more monoamniotic fetuses, second
trimester
Triplet preg w two or more monoamniotic fetuses, third
trimester
Triplet preg, unable to dtrm num plcnta & amnio sacs, first
trimester
Triplet preg, unable to dtrm num plcnta & amnio sacs,
second trimester
Triplet preg, unable to dtrm num plcnta & amnio sacs,
third trimester
Quad preg, unsp num plcnta & amnio sacs, first trimester
O30.103
O30.111
O30.112
O30.113
O30.121
O30.122
O30.123
O30.191
O30.192
O30.193
O30.201
O30.202
O30.203
O30.211
Quad preg, unsp num plcnta & amnio sacs, second
trimester
Quad preg, unsp num plcnta & amnio sacs, third trimester
O31.11X0
Quad preg w two or more monochorionic fetuses, first
trimester
Quad preg w two or more monochorionic fetuses, second
trimester
Quad preg w two or more monochorionic fetuses, third
trimester
Quad preg w two or more monoamniotic fetuses, first
trimester
Quad preg w two or more monoamniotic fetuses, second
trimester
Quad preg w two or more monoamniotic fetuses, third
trimester
Quad preg, unable to dtrm num plcnta & amnio sacs, first
trimester
Quad preg, unable to dtrm num plcnta & amnio sacs,
second trimester
Quad preg, unable to dtrm num plcnta & amnio sacs, third
trimester
Cont preg aft spon abort of one fts or more, first tri, unsp
O31.11X1
Cont preg aft spon abort of one fts or more, first tri, fts1
O31.11X2
Cont preg aft spon abort of one fts or more, first tri, fts2
O30.212
O30.213
O30.221
O30.222
O30.223
O30.291
O30.292
O30.293
386
651.31
651.31
651.31
651.31
651.31
651.31
651.31
651.31
651.31
651.31
651.31
651.31
651.31
651.31
651.31
651.41
651.51
651.61
PC v2014A
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TWINS W FETAL LOSSDEL
TRIPLETS W FET LOSSDEL
QUADS W FETAL LOSSDEL
O31.12X0
O31.12X1
Cont preg aft spon abort of one fetus or more, 2nd tri,
unsp
Cont preg aft spon abort of one fetus or more, 2nd tri, fts1
O31.12X2
Cont preg aft spon abort of one fetus or more, 2nd tri, fts2
O31.13X0
Cont preg aft spon abort of one fts or more, third tri, unsp
O31.13X1
Cont preg aft spon abort of one fts or more, third tri, fts1
O31.13X2
Cont preg aft spon abort of one fts or more, third tri, fts2
O31.21X0
Cont preg aft uterin dth of one fts or more, first tri, unsp
O31.21X1
Cont preg aft uterin dth of one fts or more, first tri, fts1
O31.21X2
Cont preg aft uterin dth of one fts or more, first tri, fts2
O31.22X0
Cont preg aft uterin dth of one fetus or more, 2nd tri, unsp
O31.22X1
Cont preg aft uterin dth of one fetus or more, 2nd tri, fts1
O31.22X2
Cont preg aft uterin dth of one fetus or more, 2nd tri, fts2
O31.23X0
Cont preg aft uterin dth of one fts or more, third tri, unsp
O31.23X1
Cont preg aft uterin dth of one fts or more, third tri, fts1
O31.23X2
Cont preg aft uterin dth of one fts or more, third tri, fts2
O31.11X0
Cont preg aft spon abort of one fts or more, first tri, unsp
O31.11X0
Cont preg aft spon abort of one fts or more, first tri, unsp
MULT GES W FET LOSS- O31.11X0
DEL
O31.11X1
O31.11X2
O31.11X3
O31.11X4
O31.11X5
O31.11X9
O31.12X0
O31.12X1
O31.12X2
O31.12X3
O31.12X4
O31.12X5
O31.12X9
O31.13X0
O31.13X1
O30.13X2
O30.13X3
Cont preg aft spon abort of one fts or more, first tri, unsp
Cont preg aft spon abort of one fts or more, first tri, fts1
Cont preg aft spon abort of one fts or more, first tri, fts2
Cont preg aft spon abort of one fts or more, first tri, fts3
Cont preg aft spon abort of one fts or more, first tri, fts4
Cont preg aft spon abort of one fts or more, first tri, fts5
Cont preg aft spon abort of one fts or more, first tri, oth fts
Cont preg aft spon abort of one fts or more, 2nd tri, unsp
Cont preg aft spon abort of one fts or more, 2nd tri, fts1
Cont preg aft spon abort of one fts or more, 2nd tri, fts2
Cont preg aft spon abort of one fts or more, 2nd tri, fts3
Cont preg aft spon abort of one fts or more, 2nd tri, fts4
Cont preg aft spon abort of one fts or more, 2nd tri, fts5
Cont preg aft spon abort of one fts or more, 2nd tri, oth fts
Cont preg aft spon abort of one fts or more, 3rd tri, unsp
Cont preg aft spon abort of one fts or more, 3rd tri, fts1
Cont preg aft spon abort of one fts or more, 3rd tri, fts2
Cont preg aft spon abort of one fts or more, 3rd tri, fts3
387
651.71
651.81
O30.13X4
O30.13X5
O30.13X9
O31.21X0
O31.21X1
O31.21X2
O31.21X3
O31.21X4
O31.21X5
O31.21X9
O31.22X0
O31.22X1
O31.22X2
O31.22X3
O31.22X4
O31.22X5
O31.22X9
O31.23X0
O31.23X1
Cont preg aft spon abort of one fts or more, 3rd tri, fts4
Cont preg aft spon abort of one fts or more, 3rd tri, fts5
Cont preg aft spon abort of one fts or more, 3rd tri, oth fts
Cont preg aft uterin dth of one fts or more, first tri, unsp
Cont preg aft uterin dth of one fts or more, first tri, fts1
Cont preg aft uterin dth of one fts or more, first tri, fts2
Cont preg aft uterin dth of one fts or more, first tri, fts3
Cont preg aft uterin dth of one fts or more, first tri, fts4
Cont preg aft uterin dth of one fts or more, first tri, fts5
Cont preg aft uterin dth of one fts or more, first tri, oth fts
Cont preg aft uterin dth of one fts or more, 2nd tri, unsp
Cont preg aft uterin dth of one fts or more, 2nd tri, fts1
Cont preg aft uterin dth of one fts or more, 2nd tri, fts2
Cont preg aft uterin dth of one fts or more, 2nd tri, fts3
Cont preg aft uterin dth of one fts or more, 2nd tri, fts4
Cont preg aft uterin dth of one fts or more, 2nd tri, fts5
Cont preg aft uterin dth of one fts or more, 2nd tri, oth fts
Cont preg aft uterin dth of one fts or more, 3rd tri, unsp
Cont preg aft uterin dth of one fts or more, 3rd tri, fts1
O31.23X2
O31.23X3
O31.23X4
O31.23X5
O31.23X9
Cont preg aft uterin dth of one fts or more, 3rd tri, fts2
Cont preg aft uterin dth of one fts or more, 3rd tri, fts3
Cont preg aft uterin dth of one fts or more, 3rd tri, fts4
Cont preg aft uterin dth of one fts or more, 3rd tri, fts5
Cont preg aft uterin dth of one fts or more, 3rd tri, oth fts
MULT GEST-FET REDUCT O31.31X0
DEL
O31.31X1
O31.31X2
O31.31X3
O31.31X4
O31.31X5
O31.31X9
O31.32X0
O31.32X1
O31.32X2
O31.32X3
O31.32X4
O31.32X5
O31.32X9
O31.33X0
O31.33X1
O31.33X2
O31.33X3
O31.33X4
O31.33X5
O31.33X9
Cont preg aft elctv fetl rdct of 1 fts or more,1st tri, unsp
MULTI GESTAT NECDELIVER
Oth multiple gest, unsp num plcnta and amnio sacs, first
tri
Oth multiple gest, unsp num plcnta and amnio sacs,
second tri
O30.801
O30.802
PC v2014A
Cont preg aft elctv fetl rdct of 1 fts or more,1st tri, fts1
Cont preg aft elctv fetl rdct of 1 fts or more,1st tri, fts2
Cont preg aft elctv fetl rdct of 1 fts or more,1st tri, fts3
Cont preg aft elctv fetl rdct of 1 fts or more,1st tri, fts4
Cont preg aft elctv fetl rdct of 1 fts or more,1st tri, fts5
Cont preg aft elctv fetl rdct of 1 fts or more, 1st tri, oth
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, unsp
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts1
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts2
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts3
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts4
Cont preg aft elctv fetl rdct of 1 fts or more,2nd tri, fts5
Cont preg aft elctv fetl rdct of 1 fts or more, 2nd tri, oth
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, unsp
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts1
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts2
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts3
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts4
Cont preg aft elctv fetl rdct of 1 fts or more,3rd tri, fts5
Cont preg aft elctv fetl rdct of 1 fts or more, 3rd tri, oth
388
O30.803
O31.8X10
O31.8X11
O31.8X12
O31.8X13
O31.8X14
O31.8X15
O31.8X19
O31.8X20
O31.8X21
O31.8X22
O31.8X23
O31.8X24
O31.8X25
O31.8X29
O31.8X30
Oth multiple gest, unsp num plcnta and amnio sacs, third
tri
Oth mult gest w two or more monochorionic fetuses, first
tri
Oth mult gest w two or more monochorionic fetuses, 2nd
tri
Oth mult gest w two or more monochorionic fetuses, third
tri
Oth mult gest w two or more monoamniotic fetuses, first tri
Oth mult gest w two or more monoamniotic fetuses,
second tri
Oth mult gest w two or more monoamniotic fetuses, third
tri
Oth multiple gest, unable to dtrm num plcnta and amnio
sacs, 1st tri
Oth multiple gest, unable to dtrm num plcnta and amnio
sacs, 2nd tri
Oth multiple gest, unable to dtrm num plcnta and amnio
sacs, 3rd tri
Oth comp specific to multiple gest, first tri, unsp
Oth comp specific to multiple gest, first trimester, fts1
Oth comp specific to multiple gest, first trimester, fts2
Oth comp specific to multiple gest, first trimester, fts3
Oth comp specific to multiple gest, first trimester, fts4
Oth comp specific to multiple gest, first trimester, fts5
Oth comp specific to multiple gest, first trimester, oth fts
Oth comp specific to multiple gest, second tri, unsp
Oth comp specific to multiple gest, second tri, fetus 1
Oth comp specific to multiple gest, second tri, fetus 2
Oth comp specific to multiple gest, second tri, fetus 3
Oth comp specific to multiple gest, second tri, fetus 4
Oth comp specific to multiple gest, second tri, fetus 5
Oth comp specific to multiple gest, second trimester, oth
Oth comp specific to multiple gest, third trimester, unsp
O31.8X31
O31.8X32
O31.8X33
O31.8X34
O31.8X35
O31.8X39
Oth comp specific to multiple gest, third trimester, fetus 1
Oth comp specific to multiple gest, third trimester, fetus 2
Oth comp specific to multiple gest, third trimester, fetus 3
Oth comp specific to multiple gest, third trimester, fetus 4
Oth comp specific to multiple gest, third trimester, fetus 5
Oth comp specific to multiple gest, third trimester, oth
O30.91
Multiple gestation, unspecified, first trimester
O30.92
O30.93
Multiple gestation, unspecified, second trimester
Multiple gestation, unspecified, third trimester
O32.0XX0
Maternal care for unstable lie, not applicable or unsp
O32.0XX1
O32.0XX2
O32.0XX3
O32.0XX4
O32.0XX5
Maternal care for unstable lie, fetus 1
Maternal care for unstable lie, fetus 2
Maternal care for unstable lie, fetus 3
Maternal care for unstable lie, fetus 4
Maternal care for unstable lie, fetus 5
O30.811
O30.812
O30.813
O30.821
O30.822
O30.823
O30.891
O30.892
O30.893
651.91
652.01
PC v2014A
MULT GESTATION NOSDELIV
UNSTABLE LIEDELIVERED
389
652.11
652.21
652.31
652.41
CEPHALIC VERS NOSDELIV
BREECH PRESENTATDELIVER
TRANSVER/OBLIQ LIEDELIV
O32.0XX9
Maternal care for unstable lie, other fetus
O32.1XX0
Maternal care for breech presentation, unsp
O32.1XX1
O32.1XX2
O32.1XX3
O32.1XX4
O32.1XX5
O32.1XX9
Maternal care for breech presentation, fetus 1
Maternal care for breech presentation, fetus 2
Maternal care for breech presentation, fetus 3
Maternal care for breech presentation, fetus 4
Maternal care for breech presentation, fetus 5
Maternal care for breech presentation, other fetus
O32.1XX0
Maternal care for breech presentation, unsp
O32.1XX1
O32.1XX2
O32.1XX3
O32.1XX4
O32.1XX5
O32.1XX9
O64.1XX0
O64.1XX1
O64.1XX2
O64.1XX3
O64.1XX4
O64.1XX5
O64.1XX9
Maternal care for breech presentation, fetus 1
Maternal care for breech presentation, fetus 2
Maternal care for breech presentation, fetus 3
Maternal care for breech presentation, fetus 4
Maternal care for breech presentation, fetus 5
Maternal care for breech presentation, other fetus
Obstructed labor due to breech presentation, unsp
Obstructed labor due to breech presentation, fetus 1
Obstructed labor due to breech presentation, fetus 2
Obstructed labor due to breech presentation, fetus 3
Obstructed labor due to breech presentation, fetus 4
Obstructed labor due to breech presentation, fetus 5
Obstructed labor due to breech presentation, other fetus
O32.2XX0
Maternal care for transverse and oblique lie, unsp
O32.2XX1
O32.2XX2
O32.2XX3
O32.2XX4
O32.2XX5
O32.2XX9
Maternal care for transverse and oblique lie, fetus 1
Maternal care for transverse and oblique lie, fetus 2
Maternal care for transverse and oblique lie, fetus 3
Maternal care for transverse and oblique lie, fetus 4
Maternal care for transverse and oblique lie, fetus 5
Maternal care for transverse and oblique lie, other fetus
FACE/BROW PRESENT- O32.3xx0
DELIV
O32.3xx1
O32.3xx2
O32.3xx3
O32.3xx4
O32.3xx5
O32.3xx9
O64.2XX0
O64.2XX1
O64.2XX2
O64.2XX3
PC v2014A
Maternal care for face, brow and chin presentation, unsp
Maternal care for face, brow and chin presentation, fetus
1
Maternal care for face, brow and chin presentation, fetus
2
Maternal care for face, brow and chin presentation, fetus
3
Maternal care for face, brow and chin presentation, fetus
4
Maternal care for face, brow and chin presentation, fetus
5
Maternal care for face, brow and chin presentation, oth
Obstructed labor due to face presentation, unsp
Obstructed labor due to face presentation, fetus 1
Obstructed labor due to face presentation, fetus 2
Obstructed labor due to face presentation, fetus 3
390
652.51
652.61
HIGH HEAD AT TERMDELIV
MULT GEST MALPRESDELIV
O64.2XX4
O64.2XX5
O64.2XX9
O64.3XX0
O64.3XX1
O64.3XX2
O64.3XX3
Obstructed labor due to face presentation, fetus 4
Obstructed labor due to face presentation, fetus 5
Obstructed labor due to face presentation, other fetus
Obstructed labor due to brow presentation, unsp
Obstructed labor due to brow presentation, fetus 1
Obstructed labor due to brow presentation, fetus 2
Obstructed labor due to brow presentation, fetus 3
O64.3XX4
O64.3XX5
O64.3XX9
Obstructed labor due to brow presentation, fetus 4
Obstructed labor due to brow presentation, fetus 5
Obstructed labor due to brow presentation, other fetus
O32.4XX0
O32.4XX1
O32.4XX2
O32.4XX3
O32.4XX4
O32.4XX5
O32.4XX9
Maternal care for high head at term, not applicable or
unsp
Maternal care for high head at term, fetus 1
Maternal care for high head at term, fetus 2
Maternal care for high head at term, fetus 3
Maternal care for high head at term, fetus 4
Maternal care for high head at term, fetus 5
Maternal care for high head at term, other fetus
O32.9XX0
Maternal care for malpresentation of fetus, unsp, unsp
O32.9XX1
O32.9XX2
O32.9XX3
O32.9XX4
O32.9XX5
O32.9XX9
O66.6
Maternal care for malpresentation of fetus, unsp, fetus 1
Maternal care for malpresentation of fetus, unsp, fetus 2
Maternal care for malpresentation of fetus, unsp, fetus 3
Maternal care for malpresentation of fetus, unsp, fetus 4
Maternal care for malpresentation of fetus, unsp, fetus 5
Maternal care for malpresentation of fetus, unsp, oth fetus
Obstructed labor due to other multiple fetuses
652.71
PROLAPSED ARMDELIVERED
O32.8XX0
Maternal care for oth malpresentation of fetus, unsp
652.81
MALPOSITION NECDELIVER
O32.6XX0
Maternal care for compound presentation, unsp
O32.6XX1
O32.6XX2
O32.6XX3
O32.6XX4
O32.6XX5
O32.6XX9
O32.8XX0
O32.8XX1
O32.8XX2
O32.8XX3
O32.8XX4
O32.8XX5
O32.8XX9
O64.4XX0
O64.4XX1
O64.4XX2
O64.4XX3
O64.4XX4
Maternal care for compound presentation, fetus 1
Maternal care for compound presentation, fetus 2
Maternal care for compound presentation, fetus 3
Maternal care for compound presentation, fetus 4
Maternal care for compound presentation, fetus 5
Maternal care for compound presentation, other fetus
Maternal care for oth malpresentation of fetus, unsp
Maternal care for other malpresentation of fetus, fetus 1
Maternal care for other malpresentation of fetus, fetus 2
Maternal care for other malpresentation of fetus, fetus 3
Maternal care for other malpresentation of fetus, fetus 4
Maternal care for other malpresentation of fetus, fetus 5
Maternal care for oth malpresentation of fetus, other fetus
Obstructed labor due to shoulder presentation, unsp
Obstructed labor due to shoulder presentation, fetus 1
Obstructed labor due to shoulder presentation, fetus 2
Obstructed labor due to shoulder presentation, fetus 3
Obstructed labor due to shoulder presentation, fetus 4
PC v2014A
391
O64.4XX5
O64.4XX9
O64.5XX0
O64.5XX1
O64.5XX2
O64.5XX3
O64.5XX4
O64.5XX5
O64.5XX9
O64.8XX0
O64.8XX1
O64.8XX2
O64.8XX3
O64.8XX4
O64.8XX5
O64.8XX9
652.91
MALPOSITION NOSDELIVER
O32.9XX0
Maternal care for malpresentation of fetus, unsp, unsp
O32.9XX1
O32.9XX2
Maternal care for malpresentation of fetus, unsp, fetus 1
Maternal care for malpresentation of fetus, unsp, fetus 2
O32.9XX3
O32.9XX4
O32.9XX5
O32.9XX9
O64.9XX0
Maternal care for malpresentation of fetus, unsp, fetus 3
Maternal care for malpresentation of fetus, unsp, fetus 4
Maternal care for malpresentation of fetus, unsp, fetus 5
Maternal care for malpresentation of fetus, unsp, oth fetus
Obstructed labor due to malpos and malpresent, unsp,
unsp
Obstructed labor due to malpos and malpresent, unsp,
fetus 1
Obstructed labor due to malpos and malpresent, unsp,
fetus 2
Obstructed labor due to malpos and malpresent, unsp,
fetus 3
Obstructed labor due to malpos and malpresent, unsp,
fetus 4
Obstructed labor due to malpos and malpresent, unsp,
fetus 5
Obstructed labor due to malpos and malpresent, unsp,
oth
O64.9XX1
O64.9XX2
O64.9XX3
O64.9XX4
O64.9XX5
O64.9XX9
653.01
653.11
PC v2014A
PELVIC DEFORM NOSDELIV
CONTRACT PELV NOS-
Obstructed labor due to shoulder presentation, fetus 5
Obstructed labor due to shoulder presentation, other fetus
Obstructed labor due to compound presentation, unsp
Obstructed labor due to compound presentation, fetus 1
Obstructed labor due to compound presentation, fetus 2
Obstructed labor due to compound presentation, fetus 3
Obstructed labor due to compound presentation, fetus 4
Obstructed labor due to compound presentation, fetus 5
Obstructed labor due to compound presentation, other
fetus
Obstructed labor due to oth malposition and malpresent,
unsp
Obstructed labor due to oth malpos and malpresent, fetus
1
Obstructed labor due to oth malpos and malpresent, fetus
2
Obstructed labor due to oth malpos and malpresent, fetus
3
Obstructed labor due to oth malpos and malpresent, fetus
4
Obstructed labor due to oth malpos and malpresent, fetus
5
Obstructed labor due to oth malposition and malpresent,
oth
O33.0
O65.0
Matern care for disproprtn d/t deformity of matern pelv
bone
Obstructed labor due to deformed pelvis
O33.1
Matern care for disproprtn d/t generally contracted pelvis
392
DELIV
653.21
653.31
INLET CONTRACTIONDELIV
O65.1
Obstructed labor due to generally contracted pelvis
O33.2
Maternal care for disproprtn due to inlet contrctn of pelvis
O65.2
Obstructed labor due to pelvic inlet contraction
OUTLET CONTRACTION- O33.3XX0
DELIV
O33.3XX1
O33.3XX2
O33.3XX3
O33.3XX4
O33.3XX5
O33.3XX9
O65.3
Maternal care for disproprtn d/t outlet contrctn of pelv,
unsp
Maternal care for disproprtn d/t outlet contrctn of pelv, fts1
Maternal care for disproprtn d/t outlet contrctn of pelv, fts2
Maternal care for disproprtn d/t outlet contrctn of pelv, fts3
Maternal care for disproprtn d/t outlet contrctn of pelv, fts4
Maternal care for disproprtn d/t outlet contrctn of pelv, fts5
Maternal care for disproprtn d/t outlet contrctn of pelv, oth
fts
Obst labor due to pelvic outlet and mid-cavity contrctn
653.41
FETOPELV DISPROPOR- O33.4XX0
DELIV
O33.4XX1
O33.4XX2
O33.4XX3
O33.4XX4
O33.4XX5
O33.4XX9
O65.4
Matern care for disproprtn of mix matern & fetl origin,
unsp
Matern care for disproprtn of mix matern & fetl origin, fts1
Matern care for disproprtn of mix matern & fetl origin, fts2
Matern care for disproprtn of mix matern & fetl origin, fts3
Matern care for disproprtn of mix matern & fetl origin, fts4
Matern care for disproprtn of mix matern & fetl origin, fts5
Matern care for disproprtn of mix matern & fetl origin, oth
Obstructed labor due to fetopelvic disproportion, unsp
653.51
FETAL DISPROP NOSDELIV
O33.5XX0
Matern care for disproprtn d/t unusually large fetus, unsp
O33.5XX1
O33.5XX2
O33.5XX3
O33.5XX4
O33.5XX5
O33.5XX9
O66.2
Matern care for disproprtn d/t unusually large fetus, fts1
Matern care for disproprtn d/t unusually large fetus, fts2
Matern care for disproprtn d/t unusually large fetus, fts3
Matern care for disproprtn d/t unusually large fetus, fts4
Matern care for disproprtn d/t unusually large fetus, fts5
Matern care for disproprtn due to unusually large fetus, oth
Obstructed labor due to unusually large fetus
O33.6XX0
Matern care for disproprtn due to hydrocephalic fetus,
unsp
Matern care for disproprtn due to hydrocephalic fetus, fts1
Matern care for disproprtn due to hydrocephalic fetus, fts2
Matern care for disproprtn due to hydrocephalic fetus, fts3
Matern care for disproprtn due to hydrocephalic fetus, fts4
Matern care for disproprtn due to hydrocephalic fetus, fts5
Maternal care for disproprtn due to hydrocephalic fetus,
oth
653.61
HYDROCEPH FETUSDELIVER
O33.6XX1
O33.6XX2
O33.6XX3
O33.6XX4
O33.6XX5
O33.6XX9
653.71
OTH ABN FET DISPRODELIV
O33.7
Maternal care for disproportion due to oth fetal
deformities
653.81
DISPROPORTION NECDELIV
O33.8
Maternal care for disproportion of other origin
PC v2014A
393
653.91
DISPROPORTION NOSDELIV
O33.9
Maternal care for disproportion, unspecified
654.01
CONGEN ABN UTERUSDELIV
O34.01
Maternal care for unsp congen malform of uterus, first tri
O34.02
Maternal care for unsp congen malform of uterus, second
tri
Maternal care for unsp congen malform of uterus, third tri
O34.03
654.02
654.11
654.12
CONG ABN UTER-DEL W O34.01
P/P
O34.02
UTERINE TUMORDELIVERED
Maternal care for unsp congen malform of uterus, first tri
O34.03
Maternal care for unsp congen malform of uterus, second
tri
Maternal care for unsp congen malform of uterus, third tri
O34.11
Maternal care for benign tumor of corpus uteri, first tri
O34.12
O34.13
Maternal care for benign tumor of corpus uteri, second tri
Maternal care for benign tumor of corpus uteri, third tri
UTERINE TUMOR-DEL W O34.11
P/P
O34.12
O34.13
Maternal care for benign tumor of corpus uteri, first tri
654.21
PREV C-DELIVERYDELIVRD
O34.21
Maternal care for scar from previous cesarean delivery
654.31
RETROVERT UTERUSDELIVER
O34.511
Maternal care for incarceration of gravid uterus, first tri
O34.512
O34.513
O34.531
O34.532
O34.533
Maternal care for incarceration of gravid uterus, second tri
Maternal care for incarceration of gravid uterus, third tri
Maternal care for retroversion of gravid uterus, first tri
Maternal care for retroversion of gravid uterus, second tri
Maternal care for retroversion of gravid uterus, third tri
O34.511
Maternal care for incarceration of gravid uterus, first tri
O34.512
O34.513
O34.531
O34.532
O34.533
Maternal care for incarceration of gravid uterus, second tri
Maternal care for incarceration of gravid uterus, third tri
Maternal care for retroversion of gravid uterus, first tri
Maternal care for retroversion of gravid uterus, second tri
Maternal care for retroversion of gravid uterus, third tri
O34.521
Maternal care for prolapse of gravid uterus, first tri
O34.522
O34.523
O34.591
O34.592
O34.593
Maternal care for prolapse of gravid uterus, second tri
Maternal care for prolapse of gravid uterus, third tri
Maternal care for oth abnlt of gravid uterus, first tri
Maternal care for oth abnlt of gravid uterus, second tri
Maternal care for oth abnlt of gravid uterus, third tri
654.32
654.41
654.42
PC v2014A
RETROVERT UTER-DEL
W P/P
ABN UTERUS NECDELIVERED
ABN UTERUS NEC-DEL WO34.591
Maternal care for benign tumor of corpus uteri, second tri
Maternal care for benign tumor of corpus uteri, third tri
Maternal care for oth abnlt of gravid uterus, first tri
394
P/P
654.51
CERVICAL INCOMPETDELIV
O34.592
O34.593
Maternal care for oth abnlt of gravid uterus, second tri
Maternal care for oth abnlt of gravid uterus, third tri
O34.31
Maternal care for cervical incompetence, first trimester
O34.32
Maternal care for cervical incompetence, second
trimester
Maternal care for cervical incompetence, third trimester
O34.33
654.52
654.61
654.62
654.71
654.72
654.81
654.82
654.91
CERV INCOMPET-DEL W O34.31
P/P
O34.32
ABN CERVIX NECDELIVERED
O34.33
Maternal care for cervical incompetence, second
trimester
Maternal care for cervical incompetence, third trimester
O34.41
Maternal care for oth abnlt of cervix, first trimester
O34.42
O34.43
Maternal care for oth abnlt of cervix, second trimester
Maternal care for oth abnlt of cervix, third trimester
ABN CERVIX NEC-DEL W O34.41
P/P
O34.42
O34.43
Maternal care for oth abnlt of cervix, first trimester
ABNORM VAGINADELIVERED
O34.61
Maternal care for abnormality of vagina, first trimester
O34.62
O34.63
Maternal care for abnormality of vagina, second trimester
Maternal care for abnormality of vagina, third trimester
Maternal care for oth abnlt of cervix, second trimester
Maternal care for oth abnlt of cervix, third trimester
ABNORM VAGINA-DEL W O34.61
P/P
O34.62
O34.63
Maternal care for abnormality of vagina, first trimester
ABNORMAL VULVADELIVERED
O34.71
Maternal care for abnlt of vulva and perineum, first tri
O34.72
O34.73
Maternal care for abnlt of vulva and perineum, second tri
Maternal care for abnlt of vulva and perineum, third tri
Maternal care for abnormality of vagina, second trimester
Maternal care for abnormality of vagina, third trimester
ABNORMAL VULVA-DEL O34.71
W P/P
O34.72
O34.73
Maternal care for abnlt of vulva and perineum, first tri
ABN PELV ORG NECDELIVER
Maternal care due to uterine scar from oth previous
surgery
Maternal care for oth abnlt of pelvic organs, first tri
Maternal care for oth abnlt of pelvic organs, second tri
Maternal care for oth abnlt of pelvic organs, third tri
Maternal care for abnlt of pelvic organ, unsp, first tri
Maternal care for abnlt of pelvic organ, unsp, second tri
O34.29
O34.81
O34.82
O34.83
O34.91
O34.92
PC v2014A
Maternal care for cervical incompetence, first trimester
Maternal care for abnlt of vulva and perineum, second tri
Maternal care for abnlt of vulva and perineum, third tri
395
O34.93
O65.8
O65.9
654.92
655.01
ABN PELV NEC-DELIV W O34.81
P/P
O34.82
O34.83
O34.91
O34.92
O34.93
Maternal care for oth abnlt of pelvic organs, first tri
FETAL CNS MALFORMDELIV
O35.0XX0
Maternal care for (suspected) cnsl malform in fetus, unsp
O35.0XX1
Maternal care for (suspected) cnsl malform in fetus, fetus
1
Maternal care for (suspected) cnsl malform in fetus, fetus
2
Maternal care for (suspected) cnsl malform in fetus, fetus
3
Maternal care for (suspected) cnsl malform in fetus, fetus
4
Maternal care for (suspected) cnsl malform in fetus, fetus
5
Maternal care for (suspected) cnsl malform in fetus, oth
O35.0XX2
O35.0XX3
O35.0XX4
O35.0XX5
O35.0XX9
655.11
FETAL CHROMOSO ABN- O35.1XX0
DELIV
O35.1XX1
O35.2XX0
Maternal care for hereditary disease in fetus, unsp
O35.2XX1
O35.2XX2
O35.2XX3
O35.2XX4
O35.2XX5
O35.2XX9
Maternal care for hereditary disease in fetus, fetus 1
Maternal care for hereditary disease in fetus, fetus 2
Maternal care for hereditary disease in fetus, fetus 3
Maternal care for hereditary disease in fetus, fetus 4
Maternal care for hereditary disease in fetus, fetus 5
Maternal care for hereditary disease in fetus, oth
O35.3XX0
Matern care for damag to fts from viral dis in mother, unsp
O35.3XX1
O35.3XX2
Matern care for damag to fts from viral dis in mother, fts1
Matern care for damag to fts from viral dis in mother, fts2
O35.1XX4
O35.1XX5
655.31
PC v2014A
FET DAMG D/T VIRUSDELIV
Maternal care for chromosomal abnormality in fetus, unsp
O35.1XX9
O35.1XX3
FAMIL HEREDIT DISDELIV
Maternal care for oth abnlt of pelvic organs, second tri
Maternal care for oth abnlt of pelvic organs, third tri
Maternal care for abnlt of pelvic organ, unsp, first tri
Maternal care for abnlt of pelvic organ, unsp, second tri
Maternal care for abnlt of pelvic organ, unsp, third tri
Maternal care for chromosomal abnormality in fetus, fetus
1
Maternal care for chromosomal abnormality in fetus, fetus
2
Maternal care for chromosomal abnormality in fetus, fetus
3
Maternal care for chromosomal abnormality in fetus, fetus
4
Maternal care for chromosomal abnormality in fetus, fetus
5
Maternal care for chromosomal abnormality in fetus, oth
O35.1XX2
655.21
Maternal care for abnlt of pelvic organ, unsp, third tri
Obstructed labor due to other maternal pelvic
abnormalities
Obstructed labor due to maternal pelvic abnormality, unsp
396
655.41
655.51
FET DAMG D/T DISDELIVER
FET DAMAG D/T DRUGDELIV
O35.3XX3
O35.3XX4
O35.3XX5
O35.3XX9
Matern care for damag to fts from viral dis in mother, fts3
Matern care for damag to fts from viral dis in mother, fts4
Matern care for damag to fts from viral dis in mother, fts5
Matern care for damag to fetus from viral dis in mother,
oth
O35.4XX0
Maternal care for damage to fetus from alcohol, unsp
O35.4XX1
O35.4XX2
O35.4XX3
O35.4XX4
O35.4XX5
O35.4XX9
Maternal care for damage to fetus from alcohol, fetus 1
Maternal care for damage to fetus from alcohol, fetus 2
Maternal care for damage to fetus from alcohol, fetus 3
Maternal care for damage to fetus from alcohol, fetus 4
Maternal care for damage to fetus from alcohol, fetus 5
Maternal care for damage to fetus from alcohol, oth
O35.5XX0
Maternal care for (suspected) damage to fetus by drugs,
unsp
Maternal care for damage to fetus by drugs, fetus 1
Maternal care for damage to fetus by drugs, fetus 2
Maternal care for damage to fetus by drugs, fetus 3
Maternal care for damage to fetus by drugs, fetus 4
Maternal care for damage to fetus by drugs, fetus 5
Maternal care for (suspected) damage to fetus by drugs,
oth
O35.5XX1
O35.5XX2
O35.5XX3
O35.5XX4
O35.5XX5
O35.5XX9
655.61
655.71
655.81
PC v2014A
RADIAT FETAL DAMAGDELIV
DECREASE FETAL
MOVMT DEL
FETAL ABNORM NECDELIVER
O35.6XX0
Maternal care for damage to fetus by radiation, unsp
O35.6XX1
O35.6XX2
O35.6XX3
O35.6XX4
O35.6XX5
O35.6XX9
Maternal care for damage to fetus by radiation, fetus 1
Maternal care for damage to fetus by radiation, fetus 2
Maternal care for damage to fetus by radiation, fetus 3
Maternal care for damage to fetus by radiation, fetus 4
Maternal care for damage to fetus by radiation, fetus 5
Maternal care for damage to fetus by radiation, oth
O36.8120
Decreased fetal movements, second trimester, unsp
O36.8121
O36.8122
O36.8123
O36.8124
O36.8125
O36.8129
O36.8130
O36.8131
O36.8132
O36.8133
O36.8134
O36.8135
O36.8139
Decreased fetal movements, second trimester, fetus 1
Decreased fetal movements, second trimester, fetus 2
Decreased fetal movements, second trimester, fetus 3
Decreased fetal movements, second trimester, fetus 4
Decreased fetal movements, second trimester, fetus 5
Decreased fetal movements, second trimester, other
fetus
Decreased fetal movements, third trimester, unsp
Decreased fetal movements, third trimester, fetus 1
Decreased fetal movements, third trimester, fetus 2
Decreased fetal movements, third trimester, fetus 3
Decreased fetal movements, third trimester, fetus 4
Decreased fetal movements, third trimester, fetus 5
Decreased fetal movements, third trimester, other fetus
O35.8XX0
Maternal care for oth fetal abnormality and damage, unsp
397
O35.8XX1
O35.8XX2
O35.8XX3
O35.8XX4
O35.8XX5
O35.8XX9
655.91
656.01
FETAL ABNORM NOSDELIVER
O35.9XX0
O35.9XX1
O35.9XX2
O35.9XX3
Maternal care for fetal abnormality and damage, unsp,
unsp
Maternal care for fetal abnlt and damage, unsp, fetus 1
Maternal care for fetal abnlt and damage, unsp, fetus 2
Maternal care for fetal abnlt and damage, unsp, fetus 3
O35.9XX4
O35.9XX5
O35.9XX9
Maternal care for fetal abnlt and damage, unsp, fetus 4
Maternal care for fetal abnlt and damage, unsp, fetus 5
Maternal care for fetal abnormality and damage, unsp, oth
FETAL-MATERNAL HEM- O43.011
DELIV
O43.012
O43.013
043.021
043.022
043.023
656.11
RH ISOIMMUNIZATDELIVER
Fetomaternal placental transfusion syndrome, first
trimester
Fetomaternal placental transfuse syndrome, second
trimester
Fetomaternal placental transfusion syndrome, third
trimester
Fetus-to-fetus placental transfuse syndrome, first
trimester
Fetus-to-fetus placental transfuse syndrome, second
trimester
Fetus-to-fetus placental transfuse syndrome, third
trimester
O36.0110
Maternal care for anti-D antibodies, first trimester, unsp
O36.0111
O36.0112
O36.0113
O36.0114
O36.0115
O36.0119
O36.0120
Maternal care for anti-D antibodies, first tri, fetus 1
Maternal care for anti-D antibodies, first tri, fetus 2
Maternal care for anti-D antibodies, first tri, fetus 3
Maternal care for anti-D antibodies, first tri, fetus 4
Maternal care for anti-D antibodies, first tri, fetus 5
Maternal care for anti-D antibodies, first trimester, oth
Maternal care for anti-D antibodies, second trimester,
unsp
Maternal care for anti-D antibodies, second tri, fetus 1
Maternal care for anti-D antibodies, second tri, fetus 2
Maternal care for anti-D antibodies, second tri, fetus 3
Maternal care for anti-D antibodies, second tri, fetus 4
Maternal care for anti-D antibodies, second tri, fetus 5
Maternal care for anti-D antibodies, second trimester, oth
Maternal care for anti-D antibodies, third trimester, unsp
Maternal care for anti-D antibodies, third tri, fetus 1
Maternal care for anti-D antibodies, third tri, fetus 2
O36.0121
O36.0122
O36.0123
O36.0124
O36.0125
O36.0129
O36.0130
O36.0131
O36.0132
PC v2014A
Maternal care for oth fetal abnormality and damage, fetus
1
Maternal care for oth fetal abnormality and damage, fetus
2
Maternal care for oth fetal abnormality and damage, fetus
3
Maternal care for oth fetal abnormality and damage, fetus
4
Maternal care for oth fetal abnormality and damage, fetus
5
Maternal care for oth fetal abnormality and damage, oth
398
O36.0133
O36.0134
O36.0135
O36.0139
O36.0910
O36.0931
O36.0932
O36.0933
O36.0934
O36.0935
O36.0939
Maternal care for anti-D antibodies, third tri, fetus 3
Maternal care for anti-D antibodies, third tri, fetus 4
Maternal care for anti-D antibodies, third tri, fetus 5
Maternal care for anti-D antibodies, third trimester, oth
Maternal care for oth rhesus isoimmun, first trimester,
unsp
Maternal care for oth rhesus isoimmun, first tri, fetus 1
Maternal care for oth rhesus isoimmun, first tri, fetus 2
Maternal care for oth rhesus isoimmun, first tri, fetus 3
Maternal care for oth rhesus isoimmun, first tri, fetus 4
Maternal care for oth rhesus isoimmun, first tri, fetus 5
Maternal care for oth rhesus isoimmun, first trimester, oth
Maternal care for oth rhesus isoimmun, second tri, unsp
Maternal care for oth rhesus isoimmun, second tri, fetus 1
Maternal care for oth rhesus isoimmun, second tri, fetus 2
Maternal care for oth rhesus isoimmun, second tri, fetus 3
Maternal care for oth rhesus isoimmun, second tri, fetus 4
Maternal care for oth rhesus isoimmun, second tri, fetus 5
Maternal care for oth rhesus isoimmun, second trimester,
oth
Maternal care for oth rhesus isoimmun, third trimester,
unsp
Maternal care for oth rhesus isoimmun, third tri, fetus 1
Maternal care for oth rhesus isoimmun, third tri, fetus 2
Maternal care for oth rhesus isoimmun, third tri, fetus 3
Maternal care for oth rhesus isoimmun, third tri, fetus 4
Maternal care for oth rhesus isoimmun, third tri, fetus 5
Maternal care for oth rhesus isoimmun, third trimester, oth
O36.1110
Maternal care for Anti-A sensitization, first tri, unsp
O36.1111
Maternal care for Anti-A sensitization, first tri, fetus 1
O36.1112
O36.1113
O36.1114
O36.1115
O36.1119
O36.1120
O36.1121
O36.1122
O36.1123
O36.1124
O36.1125
O36.1129
O36.1130
O36.1131
O36.1132
O36.1133
O36.1134
O36.1135
O36.1139
O36.1910
O36.1911
Maternal care for Anti-A sensitization, first tri, fetus 2
Maternal care for Anti-A sensitization, first tri, fetus 3
Maternal care for Anti-A sensitization, first tri, fetus 4
Maternal care for Anti-A sensitization, first tri, fetus 5
Maternal care for Anti-A sensitization, first trimester, oth
Maternal care for Anti-A sensitization, second tri, unsp
Maternal care for Anti-A sensitization, second tri, fetus 1
Maternal care for Anti-A sensitization, second tri, fetus 2
Maternal care for Anti-A sensitization, second tri, fetus 3
Maternal care for Anti-A sensitization, second tri, fetus 4
Maternal care for Anti-A sensitization, second tri, fetus 5
Maternal care for Anti-A sensitization, second tri, oth
Maternal care for Anti-A sensitization, third tri, unsp
Maternal care for Anti-A sensitization, third tri, fetus 1
Maternal care for Anti-A sensitization, third tri, fetus 2
Maternal care for Anti-A sensitization, third tri, fetus 3
Maternal care for Anti-A sensitization, third tri, fetus 4
Maternal care for Anti-A sensitization, third tri, fetus 5
Maternal care for Anti-A sensitization, third trimester, oth
Maternal care for oth isoimmunization, first trimester, unsp
Maternal care for oth isoimmun, first trimester, fetus 1
O36.0911
O36.0912
O36.0913
O36.0914
O36.0915
O36.0919
O36.0920
O36.0921
O36.0922
O36.0923
O36.0924
O36.0925
O36.0929
O36.0930
656.21
PC v2014A
ABO ISOIMMUNIZATDELIVER
399
O36.1912
O36.1913
O36.1914
O36.1915
O36.1919
O36.1920
Maternal care for oth isoimmun, first trimester, fetus 2
Maternal care for oth isoimmun, first trimester, fetus 3
Maternal care for oth isoimmun, first trimester, fetus 4
Maternal care for oth isoimmun, first trimester, fetus 5
Maternal care for oth isoimmunization, first trimester, oth
Maternal care for oth isoimmun, second trimester, unsp
O36.1921
O36.1922
O36.1923
O36.1924
O36.1925
O36.1929
Maternal care for oth isoimmun, second trimester, fetus 1
Maternal care for oth isoimmun, second trimester, fetus 2
Maternal care for oth isoimmun, second trimester, fetus 3
Maternal care for oth isoimmun, second trimester, fetus 4
Maternal care for oth isoimmun, second trimester, fetus 5
Maternal care for oth isoimmunization, second trimester,
oth
Maternal care for oth isoimmunization, third trimester,
unsp
Maternal care for oth isoimmun, third trimester, fetus 1
Maternal care for oth isoimmun, third trimester, fetus 2
Maternal care for oth isoimmun, third trimester, fetus 3
Maternal care for oth isoimmun, third trimester, fetus 4
Maternal care for oth isoimmun, third trimester, fetus 5
Maternal care for oth isoimmunization, third trimester, oth
O36.1930
O36.1931
O36.1932
O36.1933
O36.1934
O36.1935
O36.1939
656.31
FETAL DISTRESSDELIVERED
O68
Labor and delivery comp by abnlt of fetal acid-base
balance
656.41
INTRAUTER DEATHDELIVER
O36.4XX0
O36.4XX1
O36.4XX2
O36.4XX3
O36.4XX4
O36.4XX5
O36.4XX9
Maternal care for intrauterine death, not applicable or
unsp
Maternal care for intrauterine death, fetus 1
Maternal care for intrauterine death, fetus 2
Maternal care for intrauterine death, fetus 3
Maternal care for intrauterine death, fetus 4
Maternal care for intrauterine death, fetus 5
Maternal care for intrauterine death, other fetus
O36.5110
Matern care for known or susp placntl insuff, 1st tri, unsp
O36.5111
O36.5112
O36.5113
O36.5114
O36.5115
O36.5119
Matern care for known or susp placntl insuff, 1st tri, fts1
Matern care for known or susp placntl insuff, 1st tri, fts2
Matern care for known or susp placntl insuff, 1st tri, fts3
Matern care for known or susp placntl insuff, 1st tri, fts4
Matern care for known or susp placntl insuff, 1st tri, fts5
Matern care for known or susp placntl insuff, first tri, oth
O36.5120
O36.5121
O36.5122
O36.5123
O36.5124
O36.5125
O36.5129
O36.5130
O36.5131
O36.5132
Matern care for known or susp placntl insuff, 2nd tri, unsp
Matern care for known or susp placntl insuff, 2nd tri, fts1
Matern care for known or susp placntl insuff, 2nd tri, fts2
Matern care for known or susp placntl insuff, 2nd tri, fts3
Matern care for known or susp placntl insuff, 2nd tri, fts4
Matern care for known or susp placntl insuff, 2nd tri, fts5
Matern care for known or susp placntl insuff, 2nd tri, oth
Matern care for or susp placntl insuff, third tri, unsp
Matern care for or susp placntl insuff, third tri, fts1
Matern care for or susp placntl insuff, third tri, fts2
656.51
PC v2014A
POOR FETAL GROWTHDELIV
400
656.61
656.71
PC v2014A
EXCESS FETAL GRTHDELIV
OTH PLACENT CONDDELIVER
O36.5133
O36.5134
O36.5135
O36.5139
O36.5910
O36.5911
O36.5912
O36.5913
O36.5914
O36.5915
O36.5919
O36.5920
O36.5921
O36.5922
O36.5923
O36.5924
O36.5925
O36.5929
O36.5930
O36.5931
O36.5932
O36.5933
O36.5934
O36.5935
O36.5939
Matern care for or susp placntl insuff, third tri, fts3
Matern care for or susp placntl insuff, third tri, fts4
Matern care for or susp placntl insuff, third tri, fts5
Matern care for known or susp placntl insuff, third tri, oth
Matern care for oth or susp poor fetl grth, 1st tri, unsp
Matern care for oth or susp poor fetl grth, 1st tri, fts1
Matern care for oth or susp poor fetl grth, 1st tri, fts2
Matern care for oth or susp poor fetl grth, 1st tri, fts3
Matern care for oth or susp poor fetl grth, 1st tri, fts4
Matern care for oth or susp poor fetl grth, 1st tri, fts5
Matern care for oth or susp poor fetl grth, 1st tri, oth
Matern care for oth or susp poor fetl grth, 2nd tri, unsp
Matern care for oth or susp poor fetl grth, 2nd tri, fts1
Matern care for oth or susp poor fetl grth, 2nd tri, fts2
Matern care for oth or susp poor fetl grth, 2nd tri, fts3
Matern care for oth or susp poor fetl grth, 2nd tri, fts4
Matern care for oth or susp poor fetl grth, 2nd tri, fts5
Matern care for oth or susp poor fetl grth, 2nd tri, oth
Matern care for oth or susp poor fetl grth, third tri, unsp
Matern care for oth or susp poor fetl grth, third tri, fts1
Matern care for oth or susp poor fetl grth, third tri, fts2
Matern care for oth or susp poor fetl grth, third tri, fts3
Matern care for oth or susp poor fetl grth, third tri, fts4
Matern care for oth or susp poor fetl grth, third tri, fts5
Matern care for oth or susp poor fetl grth, third tri, oth
O36.61X0
Maternal care for excess fetal growth, first trimester, unsp
O36.61X1
O36.61X2
O36.61X3
O36.61X4
O36.61X5
O36.61X9
O36.62X0
O36.62X1
O36.62X2
O36.62X3
O36.62X4
O36.62X5
O36.62X9
O36.63X0
O36.63X1
O36.63X2
O36.63X3
O36.63X4
O36.63X5
O36.63X9
Maternal care for excess fetal growth, first tri, fetus 1
Maternal care for excess fetal growth, first tri, fetus 2
Maternal care for excess fetal growth, first tri, fetus 3
Maternal care for excess fetal growth, first tri, fetus 4
Maternal care for excess fetal growth, first tri, fetus 5
Maternal care for excess fetal growth, first trimester, oth
Maternal care for excess fetal growth, second tri, unsp
Maternal care for excess fetal growth, second tri, fetus 1
Maternal care for excess fetal growth, second tri, fetus 2
Maternal care for excess fetal growth, second tri, fetus 3
Maternal care for excess fetal growth, second tri, fetus 4
Maternal care for excess fetal growth, second tri, fetus 5
Maternal care for excess fetal growth, second trimester,
oth
Maternal care for excess fetal growth, third trimester, unsp
Maternal care for excess fetal growth, third tri, fetus 1
Maternal care for excess fetal growth, third tri, fetus 2
Maternal care for excess fetal growth, third tri, fetus 3
Maternal care for excess fetal growth, third tri, fetus 4
Maternal care for excess fetal growth, third tri, fetus 5
Maternal care for excess fetal growth, third trimester, oth
O43.101
Malformation of placenta, unspecified, first trimester
O43.102
Malformation of placenta, unspecified, second trimester
401
656.81
FET/PLAC PROB NECDELIV
O43.103
O43.111
O43.112
O43.113
O43.191
O43.192
O43.193
O43.811
O43.812
O43.813
O43.91
O43.92
O43.93
Malformation of placenta, unspecified, third trimester
Circumvallate placenta, first trimester
Circumvallate placenta, second trimester
Circumvallate placenta, third trimester
Other malformation of placenta, first trimester
Other malformation of placenta, second trimester
Other malformation of placenta, third trimester
Placental infarction, first trimester
Placental infarction, second trimester
Placental infarction, third trimester
Unspecified placental disorder, first trimester
Unspecified placental disorder, second trimester
Unspecified placental disorder, third trimester
O36.21x0
Maternal care for hydrops fetalis, first trimester, unsp
O36.21x1
O36.21x2
O36.21x3
O36.21x4
O36.21x5
O36.21x9
O36.22x0
O36.22x1
Maternal care for hydrops fetalis, first trimester, fetus 1
Maternal care for hydrops fetalis, first trimester, fetus 2
Maternal care for hydrops fetalis, first trimester, fetus 3
Maternal care for hydrops fetalis, first trimester, fetus 4
Maternal care for hydrops fetalis, first trimester, fetus 5
Maternal care for hydrops fetalis, first trimester, oth
Maternal care for hydrops fetalis, second trimester, unsp
Maternal care for hydrops fetalis, second trimester, fetus
1
Maternal care for hydrops fetalis, second trimester, fetus
2
Maternal care for hydrops fetalis, second trimester, fetus
3
Maternal care for hydrops fetalis, second trimester, fetus
4
Maternal care for hydrops fetalis, second trimester, fetus
5
Maternal care for hydrops fetalis, second trimester, oth
Maternal care for hydrops fetalis, third trimester, unsp
Maternal care for hydrops fetalis, third trimester, fetus 1
Maternal care for hydrops fetalis, third trimester, fetus 2
Maternal care for hydrops fetalis, third trimester, fetus 3
Maternal care for hydrops fetalis, third trimester, fetus 4
Maternal care for hydrops fetalis, third trimester, fetus 5
Maternal care for hydrops fetalis, third trimester, oth
Maternal care for viable fetus in abd preg, first tri, unsp
Maternal care for viable fetus in abd preg, first tri, fetus 1
Maternal care for viable fetus in abd preg, first tri, fetus 2
Maternal care for viable fetus in abd preg, first tri, fetus 3
Maternal care for viable fetus in abd preg, first tri, fetus 4
Maternal care for viable fetus in abd preg, first tri, fetus 5
Maternal care for viable fetus in abd preg, first tri, oth
fetus
Maternal care for viable fetus in abd preg, second tri,
unsp
Maternal care for viable fetus in abd preg, second tri,
fetus 1
Maternal care for viable fetus in abd preg, second tri,
O36.22x2
O36.22x3
O36.22x4
O36.22x5
O36.22x9
O36.23x0
O36.23x1
O36.23x2
O36.23x3
O36.23x4
O36.23x5
O36.23x9
O36.71X0
O36.71X1
O36.71X2
O36.71X3
O36.71X4
O36.71X5
O36.71X9
O36.72X0
O36.72X1
PC v2014A
O36.72X2
402
O36.72X3
O36.72X4
O36.72X5
O36.72X9
O36.73X0
O36.73X1
O36.73X2
O36.73X3
O36.73X4
O36.73X5
O36.73X9
O36.8910
O36.8911
O36.8912
O36.8913
O36.8914
O36.8915
O36.8919
O36.8920
O36.8921
O36.8922
O36.8923
O36.8924
O36.8925
O36.8929
O36.8930
O36.8931
O36.8932
O36.8933
O36.8934
PC v2014A
fetus 2
Maternal care for viable fetus in abd preg, second tri,
fetus 3
Maternal care for viable fetus in abd preg, second tri,
fetus 4
Maternal care for viable fetus in abd preg, second tri,
fetus 5
Maternal care for viable fetus in abd preg, second tri, oth
fetus
Maternal care for viable fetus in abd preg, third tri, unsp
Maternal care for viable fetus in abd preg, third tri, fetus 1
Maternal care for viable fetus in abd preg, third tri, fetus 2
Maternal care for viable fetus in abd preg, third tri, fetus 3
Maternal care for viable fetus in abd preg, third tri, fetus 4
Maternal care for viable fetus in abd preg, third tri, fetus 5
Maternal care for viable fetus in abd preg, third tri, oth
fetus
Maternal care for other fetal problems, first trimester, unsp
Maternal care for other fetal problems, first trimester, fetus
1
Maternal care for other fetal problems, first trimester, fetus
2
Maternal care for other fetal problems, first trimester, fetus
3
Maternal care for other fetal problems, first trimester, fetus
4
Maternal care for other fetal problems, first trimester, fetus
5
Maternal care for other fetal problems, first trimester, oth
fetus
Maternal care for other fetal problems, second trimester,
unsp
Maternal care for other fetal problems, second trimester,
fetus 1
Maternal care for other fetal problems, second trimester,
fetus 2
Maternal care for other fetal problems, second trimester,
fetus 3
Maternal care for other fetal problems, second trimester,
fetus 4
Maternal care for other fetal problems, second trimester,
fetus 5
Maternal care for other fetal problems, second trimester,
oth fetus
Maternal care for other fetal problems, third trimester,
unsp
Maternal care for other fetal problems, third trimester,
fetus 1
Maternal care for other fetal problems, third trimester,
fetus 2
Maternal care for other fetal problems, third trimester,
fetus 3
Maternal care for other fetal problems, third trimester,
fetus 4
403
O36.8935
O36.8939
O43.891
O43.892
O43.893
O68
O77.0
O77.1
O77.8
O77.9
656.91
657.01
PC v2014A
FET/PLAC PROB NOSDELIV
POLYHYDRAMNIOSDELIVERED
Maternal care for other fetal problems, third trimester,
fetus 5
Maternal care for other fetal problems, third trimester, oth
fetus
Other placental disorders, first trimester
Other placental disorders, second trimester
Other placental disorders, third trimester
Labor and delivery comp by abnlt of fetal acid-base
balance
Labor and delivery complicated by meconium in amniotic
fluid
Fetal stress in labor or delivery due to drug administration
Labor and delivery comp by oth evidence of fetal stress
Labor and delivery complicated by fetal stress,
unspecified
O36.91X0
Maternal care for fetal problem, unsp, first trimester, unsp
O36.91X1
O36.91X2
O36.91X3
O36.91X4
O36.91X5
O36.91X9
O36.92X0
O36.92X1
O36.92X2
O36.92X3
O36.92X4
O36.92X5
O36.92X9
O36.93X0
O36.93X1
O36.93X2
O36.93X3
O36.93X4
O36.93X5
O36.93X9
Maternal care for fetal problem, unsp, first tri, fetus 1
Maternal care for fetal problem, unsp, first tri, fetus 2
Maternal care for fetal problem, unsp, first tri, fetus 3
Maternal care for fetal problem, unsp, first tri, fetus 4
Maternal care for fetal problem, unsp, first tri, fetus 5
Maternal care for fetal problem, unsp, first trimester, oth
Maternal care for fetal problem, unsp, second tri, unsp
Maternal care for fetal problem, unsp, second tri, fetus 1
Maternal care for fetal problem, unsp, second tri, fetus 2
Maternal care for fetal problem, unsp, second tri, fetus 3
Maternal care for fetal problem, unsp, second tri, fetus 4
Maternal care for fetal problem, unsp, second tri, fetus 5
Maternal care for fetal problem, unsp, second trimester,
oth
Maternal care for fetal problem, unsp, third trimester, unsp
Maternal care for fetal problem, unsp, third tri, fetus 1
Maternal care for fetal problem, unsp, third tri, fetus 2
Maternal care for fetal problem, unsp, third tri, fetus 3
Maternal care for fetal problem, unsp, third tri, fetus 4
Maternal care for fetal problem, unsp, third tri, fetus 5
Maternal care for fetal problem, unsp, third trimester, oth
O40.1XX0
Polyhydramnios, first trimester, not applicable or unsp
O40.1XX1
O40.1XX2
O40.1XX3
O40.1XX4
O40.1XX5
O40.1XX9
O40.2XX0
O40.2XX1
O40.2XX2
O40.2XX3
O40.2XX4
Polyhydramnios, first trimester, fetus 1
Polyhydramnios, first trimester, fetus 2
Polyhydramnios, first trimester, fetus 3
Polyhydramnios, first trimester, fetus 4
Polyhydramnios, first trimester, fetus 5
Polyhydramnios, first trimester, other fetus
Polyhydramnios, second trimester, not applicable or unsp
Polyhydramnios, second trimester, fetus 1
Polyhydramnios, second trimester, fetus 2
Polyhydramnios, second trimester, fetus 3
Polyhydramnios, second trimester, fetus 4
404
658.01
OLIGOHYDRAMNIOSDELIVER
O40.2XX5
O40.2XX9
O40.3XX0
O40.3XX1
O40.3XX2
O40.3XX3
O40.3XX4
O40.3XX5
O40.3XX9
Polyhydramnios, second trimester, fetus 5
Polyhydramnios, second trimester, other fetus
Polyhydramnios, third trimester, not applicable or unsp
Polyhydramnios, third trimester, fetus 1
Polyhydramnios, third trimester, fetus 2
Polyhydramnios, third trimester, fetus 3
Polyhydramnios, third trimester, fetus 4
Polyhydramnios, third trimester, fetus 5
Polyhydramnios, third trimester, other fetus
O41.01X0
Oligohydramnios, first trimester, not applicable or unsp
O41.01X1
O41.01X2
O41.01X3
O41.01X4
O41.01X5
O41.01X9
O41.02X0
Oligohydramnios, first trimester, fetus 1
Oligohydramnios, first trimester, fetus 2
Oligohydramnios, first trimester, fetus 3
Oligohydramnios, first trimester, fetus 4
Oligohydramnios, first trimester, fetus 5
Oligohydramnios, first trimester, other fetus
Oligohydramnios, second trimester, not applicable or
unsp
Oligohydramnios, second trimester, fetus 1
Oligohydramnios, second trimester, fetus 2
Oligohydramnios, second trimester, fetus 3
Oligohydramnios, second trimester, fetus 4
Oligohydramnios, second trimester, fetus 5
Oligohydramnios, second trimester, other fetus
Oligohydramnios, third trimester, not applicable or unsp
Oligohydramnios, third trimester, fetus 1
Oligohydramnios, third trimester, fetus 2
Oligohydramnios, third trimester, fetus 3
Oligohydramnios, third trimester, fetus 4
Oligohydramnios, third trimester, fetus 5
Oligohydramnios, third trimester, other fetus
O41.02X1
O41.02X2
O41.02X3
O41.02X4
O41.02X5
O41.02X9
O41.03X0
O41.03X1
O41.03X2
O41.03X3
O41.03X4
O41.03X5
O41.03X9
658.11
PREM RUPT MEMBRAN- O42.00
DELIV
O42.011
O42.012
O42.013
O42.02
O42.911
O42.912
O42.913
O42.92
PC v2014A
Prem ROM. Onset labor w/n 24 hr of rupt, unsp weeks
gest
Pretrm prem ROM, onset labor w/n 24 hours of rupt, first
tri
Pretrm prem ROM, onset labor w/n 24 hours of rupt, 2nd
tri
Pretrm prem ROM, onset labor w/n 24 hours of rupt, third
tri
Full-term prem ROM, onset labor within 24 hours of
rupture
Pretrm prem ROM, unsp time betw rupt and onset labr,
1st tri
Pretrm prem ROM, unsp time betw rupt and onset labr,
2nd tri
Pretrm prem ROM, unsp time betw rupt and onst labr, 3rd
tri
Full-term prem ROM, unsp time betw rupture and onset
labor
405
658.21
PROLONG RUPT MEMB- O42.10
DELIV
O42.111
O42.112
O42.113
O42.12
Prem ROM, onset labor > 24 hr fol rupt, unsp weeks of
gest
Pretrm prem ROM, onset labor > 24 hours fol rupt, first tri
Pretrm prem ROM, onset labor > 24 hours fol rupt,
second tri
Pretrm prem ROM, onset labor > 24 hours fol rupt, third tri
Full-term premature ROM, onset labor > 24 hr fol rupt
658.31
ARTIFIC RUPT MEMBRDELIV
O75.5
Delayed delivery after artificial rupture of membranes
658.41
AMNIOTIC INFECTIONDELIV
O41.1010
Infct of amniotic sac and membrns, unsp, first tri, unsp
O41.1011
O41.1012
O41.1013
O41.1014
O41.1015
O41.1019
O41.1020
O41.1021
Infct of amniotic sac and membrns, unsp, first tri, fetus 1
Infct of amniotic sac and membrns, unsp, first tri, fetus 2
Infct of amniotic sac and membrns, unsp, first tri, fetus 3
Infct of amniotic sac and membrns, unsp, first tri, fetus 4
Infct of amniotic sac and membrns, unsp, first tri, fetus 5
Infct of amniotic sac and membrns, unsp, first tri, oth
Infct of amniotic sac and membrns, unsp, second tri, unsp
Infct of amniotic sac and membrns, unsp, second tri, fetus
1
Infct of amniotic sac and membrns, unsp, second tri, fetus
2
Infct of amniotic sac and membrns, unsp, second tri, fetus
3
Infct of amniotic sac and membrns, unsp, second tri, fetus
4
Infct of amniotic sac and membrns, unsp, second tri, fetus
5
Infct of amniotic sac and membrns, unsp, second tri, oth
Infct of amniotic sac and membrns, unsp, third tri, unsp
Infct of amniotic sac and membrns, unsp, third tri, fetus 1
Infct of amniotic sac and membrns, unsp, third tri, fetus 2
Infct of amniotic sac and membrns, unsp, third tri, fetus 3
Infct of amniotic sac and membrns, unsp, third tri, fetus 4
Infct of amniotic sac and membrns, unsp, third tri, fetus 5
Infct of amniotic sac and membrns, unsp, third tri, oth
Chorioamnionitis, first trimester, not applicable or unsp
Chorioamnionitis, first trimester, fetus 1
Chorioamnionitis, first trimester, fetus 2
Chorioamnionitis, first trimester, fetus 3
Chorioamnionitis, first trimester, fetus 4
Chorioamnionitis, first trimester, fetus 5
Chorioamnionitis, first trimester, other fetus
Chorioamnionitis, second trimester, not applicable or
unsp
Chorioamnionitis, second trimester, fetus 1
Chorioamnionitis, second trimester, fetus 2
Chorioamnionitis, second trimester, fetus 3
Chorioamnionitis, second trimester, fetus 4
Chorioamnionitis, second trimester, fetus 5
Chorioamnionitis, second trimester, other fetus
Chorioamnionitis, third trimester, not applicable or unsp
O41.1022
O41.1023
O41.1024
O41.1025
O41.1029
O41.1030
O41.1031
O41.1032
O41.1033
O41.1034
O41.1035
O41.1039
O41.1210
O41.1211
O41.1212
O41.1213
O41.1214
O41.1215
O41.1219
O41.1220
PC v2014A
O41.1221
O41.1222
O41.1223
O41.1224
O41.1225
O41.1229
O41.1230
406
O41.1231
O41.1232
O41.1233
O41.1234
O41.1235
O41.1239
O41.1410
O41.1411
O41.1412
O41.1413
O41.1414
O41.1415
O41.1419
O41.1420
658.81
AMNIOTIC PROB NECDELIV
O41.1421
O41.1422
O41.1423
O41.1424
O41.1425
O41.1429
O41.1430
O41.1431
O41.1432
O41.1433
Chorioamnionitis, third trimester, fetus 1
Chorioamnionitis, third trimester, fetus 2
Chorioamnionitis, third trimester, fetus 3
Chorioamnionitis, third trimester, fetus 4
Chorioamnionitis, third trimester, fetus 5
Chorioamnionitis, third trimester, other fetus
Placentitis, first trimester, not applicable or unspecified
Placentitis, first trimester, fetus 1
Placentitis, first trimester, fetus 2
Placentitis, first trimester, fetus 3
Placentitis, first trimester, fetus 4
Placentitis, first trimester, fetus 5
Placentitis, first trimester, other fetus
Placentitis, second trimester, not applicable or
unspecified
Placentitis, second trimester, fetus 1
Placentitis, second trimester, fetus 2
Placentitis, second trimester, fetus 3
Placentitis, second trimester, fetus 4
Placentitis, second trimester, fetus 5
Placentitis, second trimester, other fetus
Placentitis, third trimester, not applicable or unspecified
Placentitis, third trimester, fetus 1
Placentitis, third trimester, fetus 2
Placentitis, third trimester, fetus 3
O41.1434
O41.1435
O41.1439
Placentitis, third trimester, fetus 4
Placentitis, third trimester, fetus 5
Placentitis, third trimester, other fetus
O41.8X10
Oth disrd of amniotic fluid and membrns, first tri, unsp
O41.8X11
O41.8X12
O41.8X13
O41.8X14
O41.8X15
O41.8X19
O41.8X20
O41.8X21
Oth disrd of amniotic fluid and membrns, first tri, fetus 1
Oth disrd of amniotic fluid and membrns, first tri, fetus 2
Oth disrd of amniotic fluid and membrns, first tri, fetus 3
Oth disrd of amniotic fluid and membrns, first tri, fetus 4
Oth disrd of amniotic fluid and membrns, first tri, fetus 5
Oth disrd of amniotic fluid and membrns, first tri, oth
Oth disrd of amniotic fluid and membrns, second tri, unsp
Oth disrd of amniotic fluid and membrns, second tri, fetus
1
Oth disrd of amniotic fluid and membrns, second tri, fetus
2
Oth disrd of amniotic fluid and membrns, second tri, fetus
3
Oth disrd of amniotic fluid and membrns, second tri, fetus
4
Oth disrd of amniotic fluid and membrns, second tri, fetus
5
Oth disrd of amniotic fluid and membrns, second tri, oth
Oth disrd of amniotic fluid and membrns, third tri, unsp
Oth disrd of amniotic fluid and membrns, third tri, fetus 1
Oth disrd of amniotic fluid and membrns, third tri, fetus 2
Oth disrd of amniotic fluid and membrns, third tri, fetus 3
O41.8X22
O41.8X23
O41.8X24
O41.8X25
O41.8X29
O41.8X30
O41.8X31
O41.8X32
O41.8X33
PC v2014A
407
658.91
AMNIOTIC PROB NOSDELIV
O41.8X34
O41.8X35
O41.8X39
Oth disrd of amniotic fluid and membrns, third tri, fetus 4
Oth disrd of amniotic fluid and membrns, third tri, fetus 5
Oth disrd of amniotic fluid and membrns, third tri, oth
O41.91X0
Disorder of amnio fluid and membrns, unsp, first tri, unsp
O41.91X1
O41.91X2
O41.91X3
O41.91X4
O41.91X5
O41.91X9
O41.92X0
O41.93X0
O41.93X1
O41.93X2
O41.93X3
O41.93X4
O41.93X5
O41.93X9
Disord of amnio fluid and membrns, unsp, first tri, fetus 1
Disord of amnio fluid and membrns, unsp, first tri, fetus 2
Disord of amnio fluid and membrns, unsp, first tri, fetus 3
Disord of amnio fluid and membrns, unsp, first tri, fetus 4
Disord of amnio fluid and membrns, unsp, first tri, fetus 5
Disorder of amniotic fluid and membrns, unsp, first tri, oth
Disorder of amnio fluid and membrns, unsp, second tri,
unsp
Disord of amnio fluid and membrns, unsp, second tri,
fetus 1
Disord of amnio fluid and membrns, unsp, second tri,
fetus 2
Disord of amnio fluid and membrns, unsp, second tri,
fetus 3
Disord of amnio fluid and membrns, unsp, second tri,
fetus 4
Disord of amnio fluid and membrns, unsp, second tri,
fetus 5
Disorder of amnio fluid and membrns, unsp, second tri,
oth
Disorder of amnio fluid and membrns, unsp, third tri, unsp
Disord of amnio fluid and membrns, unsp, third tri, fetus 1
Disord of amnio fluid and membrns, unsp, third tri, fetus 2
Disord of amnio fluid and membrns, unsp, third tri, fetus 3
Disord of amnio fluid and membrns, unsp, third tri, fetus 4
Disord of amnio fluid and membrns, unsp, third tri, fetus 5
Disorder of amniotic fluid and membrns, unsp, third tri, oth
O41.92X1
O41.92X2
O41.92X3
O41.92X4
O41.92X5
O41.92X9
659.01
FAIL MECH INDUCTDELIVER
O61.1
Failed instrumental induction of labor
659.11
FAIL INDUCTION NOSDELIV
O61.0
Failed medical induction of labor
O61.8
O61.9
Other failed induction of labor
Failed induction of labor, unspecified
659.21
PYREXIA IN LABORDELIVER
O75.2
Pyrexia during labor, not elsewhere classified
659.31
SEPTICEM IN LABORDELIV
O75.3
Other infection during labor
659.41
GRAND MULTIPARITYDELIV
O09.941
Suprvsn of pregnancy w grand multiparity, first trimester
O09.942
Suprvsn of pregnancy w grand multiparity, second
trimester
O09.943
Suprvsn of pregnancy w grand multiparity, third trimester
PC v2014A
408
659.51
659.61
ELDERLY PRIMIGRAVIDA- O09.511
DEL
O09.512
O09.513
Supervision of elderly primigravida, first trimester
ELDERLY
MULTIGRAVIDA-DEL
O09.521
Supervision of elderly multigravida, first trimester
O09.522
O09.523
Supervision of elderly multigravida, second trimester
Supervision of elderly multigravida, third trimester
Supervision of elderly primigravida, second trimester
Supervision of elderly primigravida, third trimester
659.71
ABN FTL HRT RATE/RHY- O76
DEL
Abnlt in fetal heart rate and rhythm comp labor and
delivery
659.81
COMPLIC LABOR NECDELIV
O75.89
Other specified complications of labor and delivery
O77.0
Labor and delivery complicated by meconium in amniotic
fluid
Fetal stress in labor or delivery due to drug administration
Labor and delivery comp by oth evidence of fetal stress
Labor and delivery complicated by fetal stress,
unspecified
O77.1
O77.8
O77.9
659.91
COMPLIC LABOR NOSDELIV
O75.9
Labor and delivery complicated by meconium in amniotic
fluid?
Table 11.03 Complications Mainly in the Course of Labor and
Delivery
Code Description
ICD-9-CM
Code
660.01
OBSTRUC/FET MALPOSDELIV
660.01
OBSTRUC/FET MALPOSDELIV
660.01
OBSTRUC/FET MALPOSDELIV
660.01
OBSTRUC/FET MALPOSDELIV
660.01
OBSTRUC/FET MALPOSDELIV
660.01
OBSTRUC/FET MALPOSDELIV
660.01
OBSTRUC/FET MALPOSDELIV
660.01
OBSTRUC/FET MALPOSDELIV
660.01
OBSTRUC/FET MALPOSDELIV
660.01
OBSTRUC/FET MALPOSDELIV
660.01
OBSTRUC/FET MALPOSDELIV
PC v2014A
ICD-10-CM
Code Description
Code
O64.1XX0
Obstructed labor due to breech presentation, unsp
O64.1XX1
Obstructed labor due to breech presentation, fetus 1
O64.1XX2
Obstructed labor due to breech presentation, fetus 2
O64.1XX3
Obstructed labor due to breech presentation, fetus 3
O64.1XX4
Obstructed labor due to breech presentation, fetus 4
O64.1XX5
Obstructed labor due to breech presentation, fetus 5
O64.1XX9
O64.2XX0
Obstructed labor due to breech presentation, other
fetus
Obstructed labor due to face presentation, unsp
O64.2XX1
Obstructed labor due to face presentation, fetus 1
O64.2XX2
Obstructed labor due to face presentation, fetus 2
O64.2XX3
Obstructed labor due to face presentation, fetus 3
409
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
PC v2014A
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
O64.2XX4
Obstructed labor due to face presentation, fetus 4
O64.2XX5
Obstructed labor due to face presentation, fetus 5
O64.2XX9
Obstructed labor due to face presentation, other fetus
O64.3XX0
Obstructed labor due to brow presentation, unsp
O64.3XX1
Obstructed labor due to brow presentation, fetus 1
O64.3XX2
Obstructed labor due to brow presentation, fetus 2
O64.3XX3
Obstructed labor due to brow presentation, fetus 3
O64.3XX4
Obstructed labor due to brow presentation, fetus 4
O64.3XX5
Obstructed labor due to brow presentation, fetus 5
O64.3XX9
Obstructed labor due to brow presentation, other fetus
O64.4XX0
Obstructed labor due to shoulder presentation, unsp
O64.4XX1
Obstructed labor due to shoulder presentation, fetus 1
O64.4XX2
Obstructed labor due to shoulder presentation, fetus 2
O64.4XX3
Obstructed labor due to shoulder presentation, fetus 3
O64.4XX4
Obstructed labor due to shoulder presentation, fetus 4
O64.4XX5
Obstructed labor due to shoulder presentation, fetus 5
O64.4XX9
Obstructed labor due to shoulder presentation, other
fetus
Obstructed labor due to compound presentation, unsp
O64.5XX0
O64.5XX1
O64.5XX2
O64.5XX3
O64.5XX4
O64.5XX5
O64.5XX9
O64.8XX0
O64.8XX1
O64.8XX2
Obstructed labor due to compound presentation, fetus
1
Obstructed labor due to compound presentation, fetus
2
Obstructed labor due to compound presentation, fetus
3
Obstructed labor due to compound presentation, fetus
4
Obstructed labor due to compound presentation, fetus
5
Obstructed labor due to compound presentation, other
fetus
Obstructed labor due to oth malposition and
malpresent, unsp
Obstructed labor due to oth malpos and malpresent,
fetus 1
Obstructed labor due to oth malpos and malpresent,
fetus 2
410
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.01
660.11
660.11
660.11
660.11
660.11
660.21
660.21
660.21
660.31
660.31
660.31
660.31
660.31
660.31
660.31
660.41
PC v2014A
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
OBSTRUC/FET MALPOSDELIV
BONY PELV OBSTRUCTDELIV
BONY PELV OBSTRUCTDELIV
BONY PELV OBSTRUCTDELIV
BONY PELV OBSTRUCTDELIV
BONY PELV OBSTRUCTDELIV
ABN PELV TIS OBSTRDELIV
ABN PELV TIS OBSTRDELIV
ABN PELV TIS OBSTRDELIV
PERSIST OCCIPTPOSTDELIV
PERSIST OCCIPTPOSTDELIV
PERSIST OCCIPTPOSTDELIV
PERSIST OCCIPTPOSTDELIV
PERSIST OCCIPTPOSTDELIV
PERSIST OCCIPTPOSTDELIV
PERSIST OCCIPTPOSTDELIV
SHOULDER DYSTOCIADELIV
O64.8XX3
O65.0
Obstructed labor due to oth malpos and malpresent,
fetus 3
Obstructed labor due to oth malpos and malpresent,
fetus 4
Obstructed labor due to oth malpos and malpresent,
fetus 5
Obstructed labor due to oth malposition and
malpresent, oth
Obstructed labor due to malpos and malpresent, unsp,
unsp
Obstructed labor due to malpos and malpresent, unsp,
fetus 1
Obstructed labor due to malpos and malpresent, unsp,
fetus 2
Obstructed labor due to malpos and malpresent, unsp,
fetus 3
Obstructed labor due to malpos and malpresent, unsp,
fetus 4
Obstructed labor due to malpos and malpresent, unsp,
fetus 5
Obstructed labor due to malpos and malpresent, unsp,
oth
Obstructed labor due to deformed pelvis
O65.1
Obstructed labor due to generally contracted pelvis
O65.2
Obstructed labor due to pelvic inlet contraction
O65.3
Obst labor due to pelvic outlet and mid-cavity contrctn
O65.4
Obstructed labor due to fetopelvic disproportion, unsp
O65.5
Obstructed labor due to abnlt of maternal pelvic organs
O65.8
O64.0XX1
Obstructed labor due to other maternal pelvic
abnormalities
Obstructed labor due to maternal pelvic abnormality,
unsp
Obstructed labor due to incmpl rotation of fetal head,
unsp
Obst labor due to incmpl rotation of fetal head, fetus 1
O64.0XX2
Obst labor due to incmpl rotation of fetal head, fetus 2
O64.0XX3
Obst labor due to incmpl rotation of fetal head, fetus 3
O64.0XX4
Obst labor due to incmpl rotation of fetal head, fetus 4
O64.0XX5
Obst labor due to incmpl rotation of fetal head, fetus 5
O64.0XX9
Obstructed labor due to incmpl rotation of fetal head,
oth
Obstructed labor due to shoulder dystocia
O64.8XX4
O64.8XX5
O64.8XX9
O64.9XX0
O64.9XX1
O64.9XX2
O64.9XX3
O64.9XX4
O64.9XX5
O64.9XX9
O65.9
O64.0XX0
O66.0
411
660.51
660.61
660.61
660.71
660.81
660.81
660.81
660.81
660.91
661.01
661.11
661.21
661.31
661.41
661.91
661.91
662.01
662.11
662.21
662.31
663.01
663.01
663.01
663.01
663.01
663.01
663.01
663.11
663.11
PC v2014A
LOCKED TWINSO66.1
DELIVERED
FAIL TRIAL LAB NOS-DELIV O66.40
FAIL TRIAL LAB NOS-DELIV O66.41
FAILED FORCEPS NOSO66.5
DELIV
OBSTRUCT LABOR NEC- O66.2
DELIV
OBSTRUCT LABOR NEC- O66.3
DELIV
OBSTRUCT LABOR NEC- O66.6
DELIV
OBSTRUCT LABOR NEC- O66.8
DELIV
OBSTRUCT LABOR NOS- O66.9
DELIV
PRIM UTERINE INERTO62.0
DELIV
SEC UTERINE INERT-DELIVO62.1
UTERINE INERT NEC-DELIVO62.2
PRECIPITATE LABORO62.3
DELIV
UTER DYSTOCIA NOSO62.4
DELIV
ABNORMAL LABOR NOS- O62.8
DELIV
ABNORMAL LABOR NOS- O62.9
DELIV
PROLONG 1ST STAGEO63.0
DELIV
PROLONG LABOR NOSO63.9
DELIV
PROLONG 2ND STAGEO63.1
DELIV
DELAY DEL 2ND TWINO63.2
DELIV
CORD PROLAPSEO69.0XX0
DELIVERED
CORD PROLAPSEO69.0XX1
DELIVERED
CORD PROLAPSEO69.0XX2
DELIVERED
CORD PROLAPSEO69.0XX3
DELIVERED
CORD PROLAPSEO69.0XX4
DELIVERED
CORD PROLAPSEO69.0XX5
DELIVERED
CORD PROLAPSEO69.0XX9
DELIVERED
CORD AROUND NECKO69.1XX0
DELIVER
CORD AROUND NECK-
O69.1XX1
Obstructed labor due to locked twins
Failed trial of labor, unspecified
Failed attempt vaginal birth after previous cesarean
del
Attempted application of vacuum extractor and forceps
Obstructed labor due to unusually large fetus
Obstructed labor due to other abnormalities of fetus
Obstructed labor due to other multiple fetuses
Other specified obstructed labor
Obstructed labor, unspecified
Primary inadequate contractions
Secondary uterine inertia
Other uterine inertia
Precipitate labor
Hypertonic, incoordinate, and prolonged uterine
contractions
Other abnormalities of forces of labor
Abnormality of forces of labor, unspecified
Prolonged first stage (of labor)
Long labor, unspecified
Prolonged second stage (of labor)
Delayed delivery of second twin, triplet, etc.
Labor and delivery complicated by prolapse of cord,
unsp
Labor and delivery complicated by prolapse of cord,
fetus 1
Labor and delivery complicated by prolapse of cord,
fetus 2
Labor and delivery complicated by prolapse of cord,
fetus 3
Labor and delivery complicated by prolapse of cord,
fetus 4
Labor and delivery complicated by prolapse of cord,
fetus 5
Labor and delivery complicated by prolapse of cord,
oth
Labor and delivery comp by cord around neck, w
comprsn, unsp
Labor and del comp by cord around neck, w comprsn,
412
663.11
663.11
663.11
663.11
663.11
663.21
663.21
663.21
663.21
663.21
663.21
663.21
663.31
663.31
663.31
663.31
663.31
663.31
663.31
663.31
663.31
663.31
663.31
663.31
663.31
663.31
663.31
PC v2014A
DELIVER
CORD AROUND NECKDELIVER
CORD AROUND NECKDELIVER
CORD AROUND NECKDELIVER
CORD AROUND NECKDELIVER
CORD AROUND NECKDELIVER
CORD COMPRESS NECDELIV
CORD COMPRESS NECDELIV
CORD COMPRESS NECDELIV
CORD COMPRESS NECDELIV
CORD COMPRESS NECDELIV
CORD COMPRESS NECDELIV
CORD COMPRESS NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NEC-
O69.1XX2
O69.1XX3
O69.1XX4
O69.1XX5
O69.1XX9
O69.2XX0
O69.2XX1
O69.2XX2
O69.2XX3
O69.2XX4
O69.2XX5
O69.2XX9
O69.81X0
O69.81X1
O69.81X2
O69.81X3
O69.81X4
O69.81X5
O69.81X9
O69.82X0
O69.82X1
O69.82X2
O69.82X3
O69.82X4
O69.82X5
O69.82X9
O69.89X0
fetus 1
Labor and del comp by cord around neck, w comprsn,
fetus 2
Labor and del comp by cord around neck, w comprsn,
fetus 3
Labor and del comp by cord around neck, w comprsn,
fetus 4
Labor and del comp by cord around neck, w comprsn,
fetus 5
Labor and delivery comp by cord around neck, w
comprsn, oth
Labor and del comp by oth cord entangle, w comprsn,
unsp
Labor and del comp by oth cord entangle, w comprsn,
fetus 1
Labor and del comp by oth cord entangle, w comprsn,
fetus 2
Labor and del comp by oth cord entangle, w comprsn,
fetus 3
Labor and del comp by oth cord entangle, w comprsn,
fetus 4
Labor and del comp by oth cord entangle, w comprsn,
fetus 5
Labor and delivery comp by oth cord entangle, w
comprsn, oth
Labor and del comp by cord around neck, w/o
comprsn, unsp
Labor and del comp by cord around neck, w/o
comprsn, fetus 1
Labor and del comp by cord around neck, w/o
comprsn, fetus 2
Labor and del comp by cord around neck, w/o
comprsn, fetus 3
Labor and del comp by cord around neck, w/o
comprsn, fetus 4
Labor and del comp by cord around neck, w/o
comprsn, fetus 5
Labor and del comp by cord around neck, w/o
comprsn, oth
Labor and del comp by oth cord entangle, w/o
comprsn, unsp
Labor and del comp by oth cord entangle, w/o
comprsn, fts1
Labor and del comp by oth cord entangle, w/o
comprsn, fts2
Labor and del comp by oth cord entangle, w/o
comprsn, fts3
Labor and del comp by oth cord entangle, w/o
comprsn, fts4
Labor and del comp by oth cord entangle, w/o
comprsn, fts5
Labor and del comp by oth cord entangle, w/o
comprsn, oth
Labor and delivery complicated by oth cord comp,
413
663.41
663.41
663.41
663.41
663.41
663.41
663.41
DELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
CORD ENTANGLE NECDELIV
SHORT CORD-DELIVERED
SHORT CORD-DELIVERED
SHORT CORD-DELIVERED
SHORT CORD-DELIVERED
SHORT CORD-DELIVERED
SHORT CORD-DELIVERED
SHORT CORD-DELIVERED
663.51
663.51
663.51
663.51
663.51
663.51
663.51
VASA PREVIA-DELIVERED O69.4XX0
VASA PREVIA-DELIVERED O69.4XX1
VASA PREVIA-DELIVERED O69.4XX2
VASA PREVIA-DELIVERED O69.4XX3
VASA PREVIA-DELIVERED O69.4XX4
VASA PREVIA-DELIVERED O69.4XX5
VASA PREVIA-DELIVERED O69.4XX9
663.61
VASC LESION CORDDELIVER
VASC LESION CORDDELIVER
VASC LESION CORDDELIVER
VASC LESION CORDDELIVER
VASC LESION CORDDELIVER
VASC LESION CORDDELIVER
VASC LESION CORDDELIVER
CORD COMPLICAT NECDELIV
CORD COMPLICAT NECDELIV
CORD COMPLICAT NECDELIV
CORD COMPLICAT NECDELIV
CORD COMPLICAT NECDELIV
CORD COMPLICAT NEC-
663.31
663.31
663.31
663.31
663.31
663.31
663.61
663.61
663.61
663.61
663.61
663.61
663.81
663.81
663.81
663.81
663.81
663.81
PC v2014A
O69.89X1
O69.89X2
O69.89X3
O69.89X4
O69.89X5
O69.89X9
O69.3XX0
O69.3XX1
O69.3XX2
O69.3XX3
O69.3XX4
O69.3XX5
O69.3XX9
unsp
Labor and delivery complicated by oth cord comp,
fetus 1
Labor and delivery complicated by oth cord comp,
fetus 2
Labor and delivery complicated by oth cord comp,
fetus 3
Labor and delivery complicated by oth cord comp,
fetus 4
Labor and delivery complicated by oth cord comp,
fetus 5
Labor and delivery complicated by oth cord comp, oth
O69.5XX9
Labor and delivery complicated by short cord, unsp
Labor and delivery complicated by short cord, fetus 1
Labor and delivery complicated by short cord, fetus 2
Labor and delivery complicated by short cord, fetus 3
Labor and delivery complicated by short cord, fetus 4
Labor and delivery complicated by short cord, fetus 5
Labor and delivery complicated by short cord, other
fetus
Labor and delivery complicated by vasa previa, unsp
Labor and delivery complicated by vasa previa, fetus 1
Labor and delivery complicated by vasa previa, fetus 2
Labor and delivery complicated by vasa previa, fetus 3
Labor and delivery complicated by vasa previa, fetus 4
Labor and delivery complicated by vasa previa, fetus 5
Labor and delivery complicated by vasa previa, other
fetus
Labor and delivery comp by vascular lesion of cord,
unsp
Labor and delivery comp by vascular lesion of cord,
fetus 1
Labor and delivery comp by vascular lesion of cord,
fetus 2
Labor and delivery comp by vascular lesion of cord,
fetus 3
Labor and delivery comp by vascular lesion of cord,
fetus 4
Labor and delivery comp by vascular lesion of cord,
fetus 5
Labor and delivery comp by vascular lesion of cord, oth
O43.121
Velamentous insertion of umbilical cord, first trimester
O43.122
Velamentous insertion of umbilical cord, second
trimester
Velamentous insertion of umbilical cord, third trimester
O69.5XX0
O69.5XX1
O69.5XX2
O69.5XX3
O69.5XX4
O69.5XX5
O43.123
O69.89X0
O69.89X1
O69.89X2
Labor and delivery complicated by oth cord comp,
unsp
Labor and delivery complicated by oth cord comp,
fetus 1
Labor and delivery complicated by oth cord comp,
414
663.81
663.81
663.81
663.81
663.91
663.91
663.91
663.91
663.91
663.91
663.91
664.01
664.11
664.21
664.31
664.41
664.51
664.81
664.91
665.01
665.01
665.11
665.22
665.31
665.41
665.51
665.61
PC v2014A
DELIV
CORD COMPLICAT NEC- O69.89X3
DELIV
CORD COMPLICAT NEC- O69.89X4
DELIV
CORD COMPLICAT NEC- O69.89X5
DELIV
CORD COMPLICAT NEC- O69.89X9
DELIV
CORD COMPLICAT NOS- O69.9XX0
DELIV
CORD COMPLICAT NOS- O69.9XX1
DELIV
CORD COMPLICAT NOS- O69.9XX2
DELIV
CORD COMPLICAT NOS- O69.9XX3
DELIV
CORD COMPLICAT NOS- O69.9XX4
DELIV
CORD COMPLICAT NOS- O69.9XX5
DELIV
CORD COMPLICAT NOS- O69.9XX9
DELIV
DEL W 1 DEG LACERAT- O70.0
DEL
DEL W 2 DEG LACERAT- O70.1
DEL
DEL W 3 DEG LACERAT- O70.2
DEL
DEL W 4 DEG LACERAT- O70.3
DEL
OB PERINEAL LAC NOS- O70.9
DEL
OB PERINEAL HEMATOMA- O90.2
DEL
OB PERINEAL TRAU NEC- O71.89
DEL
OB PERINEAL TRAU NOS- O71.9
DEL
PRELABOR RUPT UTERUS-O71.02
DEL
PRELABOR RUPT UTERUS-O71.03
DEL
RUPTURE UTERUS NOS- O71.1
DELIV
INVERS UTERUS-DEL W
O71.2
P/P
LACERAT OF CERVIXO71.3
DELIV
HIGH VAGINAL LACERO71.4
DELIV
OB INJ PELV ORG NECO71.5
DEL
DAMAGE TO PELVIC JT- O71.6
fetus 2
Labor and delivery complicated by oth cord comp,
fetus 3
Labor and delivery complicated by oth cord comp,
fetus 4
Labor and delivery complicated by oth cord comp,
fetus 5
Labor and delivery complicated by oth cord comp, oth
Labor and delivery complicated by cord comp, unsp,
unsp
Labor and delivery complicated by cord comp, unsp,
fetus 1
Labor and delivery complicated by cord comp, unsp,
fetus 2
Labor and delivery complicated by cord comp, unsp,
fetus 3
Labor and delivery complicated by cord comp, unsp,
fetus 4
Labor and delivery complicated by cord comp, unsp,
fetus 5
Labor and delivery complicated by cord comp, unsp,
oth
First degree perineal laceration during delivery
Second degree perineal laceration during delivery
Third degree perineal laceration during delivery
Fourth degree perineal laceration during delivery
Perineal laceration during delivery, unspecified
Obstetric hematoma of pelvis
Other specified trauma to perineum and vulva
Obstetric trauma, unspecified
Rupture of uterus before onset of labor, second
trimester
Rupture of uterus before onset of labor, third trimester
Rupture of uterus during labor
Postpartum inversion of uterus
Obstetric laceration of cervix
Obstetric high vaginal laceration alone
Other obstetric injury to pelvic organs
Obstetric damage to pelvic joints and ligaments
415
665.71
665.72
665.81
665.81
665.82
665.82
665.91
665.92
666.02
666.12
666.22
666.32
667.02
667.02
667.02
667.02
667.02
667.02
667.02
667.02
DEL
OB PELVIC HEMATOMADELIV
PELVIC HEMATOM-DEL W
PP
OB TRAUMA NECDELIVERED
OB TRAUMA NECDELIVERED
OB TRAUMA NEC-DEL W
P/P
OB TRAUMA NEC-DEL W
P/P
OB TRAUMA NOSDELIVERED
OB TRAUMA NOS-DEL W
P/P
THRD-STAGE HEM-DEL W
P/P
POSTPA HEM NEC-DEL W
P/P
DELAY P/P HEM-DEL W
P/P
P/P COAG DEF-DEL W P/P
RETND PLAC NOS-DEL W
P/P
RETND PLAC NOS-DEL W
P/P
RETND PLAC NOS-DEL W
P/P
RETND PLAC NOS-DEL W
P/P
RETND PLAC NOS-DEL W
P/P
RETND PLAC NOS-DEL W
P/P
RETND PLAC NOS-DEL W
P/P
O71.7
Obstetric hematoma of pelvis
O71.7
Obstetric hematoma of pelvis
O71.81
Laceration of uterus, not elsewhere classified
O71.89
Other specified obstetric trauma
O71.81
Laceration of uterus, not elsewhere classified
O71.89
Other specified obstetric trauma
O71.9
Obstetric trauma, unspecified
O71.9
Obstetric trauma, unspecified
O72.0
Third-stage hemorrhage
O72.1
Other immediate postpartum hemorrhage
O72.2
Delayed and secondary postpartum hemorrhage
O72.3
O43.211
Postpartum coagulation defects
Placenta accreta, first trimester
O43.212
Placenta accreta, second trimester
O43.213
Placenta accreta, third trimester
O43.221
Placenta increta, first trimester
O43.222
Placenta increta, second trimester
O43.223
Placenta increta, third trimester
O43.231
Placenta percreta, first trimester
668.02
RETND PLAC NOS-DEL W O43.232
P/P
RETND PLAC NOS-DEL W O43.233
P/P
RETND PLAC NOS-DEL W O73.0
P/P
RET PROD CONC-DEL W O73.1
P/P
PULM COMPL IN DELO74.0
DELIV
PULM COMPL IN DELO74.1
DELIV
PULM COMPLIC-DEL W P/PO74.0
668.02
PULM COMPLIC-DEL W P/PO74.1
667.02
667.02
667.12
668.01
668.01
PC v2014A
Placenta percreta, second trimester
Placenta percreta, third trimester
Retained placenta without hemorrhage
Retained portions of placenta and membranes, w/o
hemorrhage
Aspirat pneumonitis due to anesth during labor and
delivery
Oth pulmonary comp of anesthesia during labor and
delivery
Aspirat pneumonitis due to anesth during labor and
delivery
Oth pulmonary comp of anesthesia during labor and
delivery
416
668.02
PULM COMPLIC-DEL W P/PO89.09
668.11
HEART COMPL IN DELDELIV
HEART COMPL-DEL W P/P
CNS COMPL LAB/DELDELIV
CNS COMPLIC-DEL W P/P
668.12
668.21
668.22
668.81
668.81
668.81
668.81
668.81
668.82
668.82
668.82
668.82
668.82
668.82
668.91
668.92
668.92
669.01
669.02
669.11
669.12
669.21
669.21
669.21
669.22
669.22
PC v2014A
O74.2
O74.2
O74.3
O74.3
Oth pulmonary comp of anesthesia during the
puerperium
Cardiac comp of anesthesia during labor and delivery
Cardiac comp of anesthesia during labor and delivery
Cnsl complications of anesthesia during labor and
delivery
Cnsl complications of anesthesia during labor and
delivery
Toxic reaction to local anesthesia during labor and
delivery
Spinal and epidur anesthesia-induced hdache dur labr
and del
Oth comp of spinal and epidural anesth during labor
and del
Failed or difficult intubation for anesth dur labor and del
ANESTH COMPL NECDELIVER
ANESTH COMPL NECDELIVER
ANESTH COMPL NECDELIVER
ANESTH COMPL NECDELIVER
ANESTH COMPL NECDELIVER
ANESTH COMPL NEC-DEL
P/P
ANESTH COMPL NEC-DEL
P/P
ANESTH COMPL NEC-DEL
P/P
ANESTH COMPL NEC-DEL
P/P
ANESTH COMPL NEC-DEL
P/P
ANESTH COMPL NEC-DEL
P/P
ANESTH COMPL NOSDELIVER
ANESTH COMPL NOS-DEL
P/P
ANESTH COMPL NOS-DEL
P/P
O74.4
MATERNAL DISTRESSDELIV
MATERN DISTRES-DEL W
P/P
OBSTETRIC SHOCKDELIVER
OBSTET SHOCK-DELIV W
P/P
MATERN HYPOTEN SYNDELIV
MATERN HYPOTEN SYNDELIV
MATERN HYPOTEN SYNDELIV
MATERN HYPOTEN-DEL W
P/P
MATERN HYPOTEN-DEL W
O75.0
Maternal distress during labor and delivery
O75.0
Maternal distress during labor and delivery
O75.1
Shock during or following labor and delivery
O75.1
Shock during or following labor and delivery
O26.51
Maternal hypotension syndrome, first trimester
O26.52
Maternal hypotension syndrome, second trimester
O26.53
Maternal hypotension syndrome, third trimester
O26.51
Maternal hypotension syndrome, first trimester
O26.52
Maternal hypotension syndrome, second trimester
O74.5
O74.6
O74.7
O74.8
O74.4
O74.5
O74.6
O74.7
O74.8
O89.8
O74.9
O74.9
O89.9
Other complications of anesthesia during labor and
delivery
Toxic reaction to local anesthesia during labor and
delivery
Spinal and epidur anesthesia-induced hdache dur labr
and del
Oth comp of spinal and epidural anesth during labor
and del
Failed or difficult intubation for anesth dur labor and del
Other complications of anesthesia during labor and
delivery
Other complications of anesthesia during the
puerperium
Complication of anesthesia during labor and delivery,
unsp
Complication of anesthesia during labor and delivery,
unsp
Complication of anesthesia during the puerperium,
unsp
417
669.22
669.32
669.41
669.42
669.51
669.61
669.71
669.81
669.81
669.82
669.82
669.91
669.92
P/P
MATERN HYPOTEN-DEL W
P/P
AC REN FAIL-DELIV W P/P
OTH OB COMPLDELIVERED
OTH OB COMPL-DELIV W
P/P
FORCEP DELIV NOSDELIVER
BREECH EXTR NOSDELIVER
CESAREAN DELIVERY
NOS
COMP LAB/DELIV NECDELIV
COMP LAB/DELIV NECDELIV
COMPL DEL NEC-DEL W
P/P
COMPL DEL NEC-DEL W
P/P
COMP LAB/DELIV NOSDELIV
COMPL DEL NOS-DEL W
P/P
O26.53
Maternal hypotension syndrome, third trimester
O90.4
O75.4
O66.5
Postpartum acute kidney failure
Other complications of obstetric surgery and
procedures
Other complications of obstetric surgery and
procedures
Attempted application of vacuum extractor and forceps
O64.1XX0
Obstructed labor due to breech presentation, unsp
O82
Encounter for cesarean delivery without indication
O75.81
Maternal exhaustion complicating labor and delivery
O75.89
Other specified complications of labor and delivery
O75.81
Maternal exhaustion complicating labor and delivery
O75.89
Other specified complications of labor and delivery
O75.9
Complication of labor and delivery, unspecified
O75.9
Complication of labor and delivery, unspecified
O75.4
Table 11.04 Complication of the Puerperium
Code Description
ICD-9CM
Code
670.02 Major puerperal infection, delivered, with mention of
postpartum complication
670.12 Puerperal endometritis, delivered, with mention of postpartum
complication
670.22 Puerperal sepsis, delivered, with mention of postpartum
complication
670.32 Puerperal septic thrombophlebitis, delivered, with mention of
postpartum complication
670.82 Other major puerperal infection, delivered, with mention of
postpartum complication
671.01 Varicose veins of legs complicating pregnancy and the
puerperium, delivered, with or without mention of antepartum
condition
671.01 Varicose veins of legs complicating pregnancy and the
puerperium, delivered, with or without mention of antepartum
condition
671.01 Varicose veins of legs complicating pregnancy and the
puerperium, delivered, with or without mention of antepartum
condition
671.02 Varicose veins of legs complicating pregnancy and the
puerperium, delivered, with or without mention of antepartum
condition
PC v2014A
ICD-10Code Description
CM
Code
O86.89 Other specified puerperal infections
O86.12 Endometritis following delivery
O85
Puerperal sepsis
O86.81 Puerperal septic thrombophlebitis
O86.89 Other specified puerperal infections
O22.01 Varicose veins of lower extremity in
pregnancy, first trimester
O22.02 Varicose veins of lower extremity in
pregnancy, second trimester
O22.03 Varicose veins of lower extremity in
pregnancy, third trimester
O87.4
Varicose veins of lower extremity in
the puerperium
418
671.11 Varicose veins of legs complicating pregnancy and the
O22.11
puerperium, delivered, with or without mention of antepartum
condition
671.11 Varicose veins of legs complicating pregnancy and the
O22.12
puerperium, delivered, with or without mention of antepartum
condition
671.11 Varicose veins of legs complicating pregnancy and the
O22.13
puerperium, delivered, with or without mention of antepartum
condition
671.12 Varicose veins of legs complicating pregnancy and the
O22.11
puerperium, delivered, with or without mention of antepartum
condition
671.12 Varicose veins of legs complicating pregnancy and the
O22.12
puerperium, delivered, with or without mention of antepartum
condition
671.12 Varicose veins of legs complicating pregnancy and the
O22.12
puerperium, delivered, with or without mention of antepartum
condition
671.21 Varicose veins of legs complicating pregnancy and the
O22.13
puerperium, delivered, with or without mention of antepartum
condition
671.21 Varicose veins of legs complicating pregnancy and the
O22.22
puerperium, delivered, with or without mention of antepartum
condition
671.21 Varicose veins of legs complicating pregnancy and the
O22.23
puerperium, delivered, with or without mention of antepartum
condition
671.22 Varicose veins of legs complicating pregnancy and the
O87.0
puerperium, delivered, with or without mention of antepartum
condition
671.31 Deep phlebothrombosis, antepartum, delivered, with or
O22.31
without mention of antepartum condition
671.31 Deep phlebothrombosis, antepartum, delivered, with or
O22.32
without mention of antepartum condition
671.31 Deep phlebothrombosis, antepartum, delivered, with or
O22.33
without mention of antepartum condition
671.42 Deep phlebothrombosis, postpartum, delivered, with mention O87.1
of postpartum complication
671.51 Other phlebitis and thrombosis complicating pregnancy and O22.51
the puerperium, delivered, with or without mention of
antepartum condition
671.51 Other phlebitis and thrombosis complicating pregnancy and O22.52
the puerperium, delivered, with or without mention of
antepartum condition
671.51 Other phlebitis and thrombosis complicating pregnancy and O22.53
the puerperium, delivered, with or without mention of
antepartum condition
671.52 Other phlebitis and thrombosis complicating pregnancy and O87.3
the puerperium, delivered, with mention of postpartum
complication
671.81 Other venous complications of pregnancy and the puerperium, O22.41
delivered, with or without mention of antepartum condition
671.81 Other venous complications of pregnancy and the puerperium, O22.42
delivered, with or without mention of antepartum condition
671.81 Other venous complications of pregnancy and the puerperium,O22.43
PC v2014A
Genital varices in pregnancy, first
trimester
Genital varices in pregnancy,
second trimester
Genital varices in pregnancy, third
trimester
Genital varices in pregnancy, first
trimester
Genital varices in pregnancy,
second trimester
Genital varices in pregnancy, third
trimester
Superficial thrombophlebitis in
pregnancy, first trimester
Superficial thrombophlebitis in
pregnancy, second trimester
Superficial thrombophlebitis in
pregnancy, third trimester
Superficial thrombophlebitis in the
puerperium
Deep phlebothrombosis in
pregnancy, first trimester
Deep phlebothrombosis in
pregnancy, second trimester
Deep phlebothrombosis in
pregnancy, third trimester
Deep phlebothrombosis in the
puerperium
Cerebral venous thrombosis in
pregnancy, first trimester
Cerebral venous thrombosis in
pregnancy, second trimester
Cerebral venous thrombosis in
pregnancy, third trimester
Cerebral venous thrombosis in the
puerperium
Hemorrhoids in pregnancy, first
trimester
Hemorrhoids in pregnancy, second
trimester
Hemorrhoids in pregnancy, third
419
delivered, with or without mention of antepartum condition
trimester
671.81 Other venous complications of pregnancy and the puerperium, O22.8X1Other venous complications in
delivered, with or without mention of antepartum condition
pregnancy, first trimester
671.81 Other venous complications of pregnancy and the puerperium, O22.8X2Other venous complications in
delivered, with or without mention of antepartum condition
pregnancy, second trimester
671.81 Other venous complications of pregnancy and the puerperium, O22.8X3Other venous complications in
delivered, with or without mention of antepartum condition
pregnancy, third trimester
671.82 Other venous complications of pregnancy and the puerperium, O87.2 Hemorrhoids in the puerperium
delivered, with mention of postpartum complication
671.82 Other venous complications of pregnancy and the puerperium, O87.8 Other venous complications in the
delivered, with mention of postpartum complication
puerperium
671.91 Unspecified venous complication of pregnancy and the
O22.91 Venous complication in pregnancy,
puerperium, delivered, with or without mention of antepartum
unspecified, first trimester
condition
671.91 Unspecified venous complication of pregnancy and the
O22.92 Venous complication in pregnancy,
puerperium, delivered, with or without mention of antepartum
unspecified, second trimester
condition
671.91 Unspecified venous complication of pregnancy and the
O22.93 Venous complication in pregnancy,
puerperium, delivered, with or without mention of antepartum
unspecified, third trimester
condition
671.92 Unspecified venous complication of pregnancy and the
O87.9 Venous complication in the
puerperium, delivered, with mention of postpartum
puerperium, unspecified
complication
672.02 Pyrexia of unknown origin during the puerperium, delivered, O86.4 Pyrexia of unknown origin following
with mention of postpartum complication
delivery
673.01 Obstetrical air embolism, delivered, with or without mention of O88.011 Air embolism in pregnancy, first
antepartum condition
trimester
673.01 Obstetrical air embolism, delivered, with or without mention of O88.012 Air embolism in pregnancy, second
antepartum condition
trimester
673.01 Obstetrical air embolism, delivered, with or without mention of O88.013 Air embolism in pregnancy, third
antepartum condition
trimester
673.01 Obstetrical air embolism, delivered, with or without mention of O88.02 Air embolism in childbirth
antepartum condition
673.02 Obstetrical air embolism, delivered, with mention of
O88.02 Air embolism in childbirth
postpartum complication
673.02 Obstetrical air embolism, delivered, with mention of
O88.03 Air embolism in the puerperium
postpartum complication
673.11 Amniotic fluid embolism, delivered, with or without mention of O88.111 Amniotic fluid embolism in
antepartum condition
pregnancy, first trimester
673.11 Amniotic fluid embolism, delivered, with or without mention of O88.111 Amniotic fluid embolism in
antepartum condition
pregnancy, second trimester
673.11 Amniotic fluid embolism, delivered, with or without mention of O88.111 Amniotic fluid embolism in
antepartum condition
pregnancy, third trimester
673.11 Amniotic fluid embolism, delivered, with or without mention of O88.12 Amniotic fluid embolism in
antepartum condition
childbirth
673.12 Amniotic fluid embolism, delivered, with mention of
O88.12 Amniotic fluid embolism in
postpartum complication
childbirth
673.12 Amniotic fluid embolism, delivered, with mention of
postpartum complication
673.21 Obstetrical blood-clot embolism, delivered, with or without
mention of antepartum condition
673.21 Obstetrical blood-clot embolism, delivered, with or without
mention of antepartum condition
673.21 Obstetrical blood-clot embolism, delivered, with or without
PC v2014A
O88.13 Amniotic fluid embolism in the
puerperium
O88.211 Thromboembolism in pregnancy,
first trimester
O88.212 Thromboembolism in pregnancy,
second trimester
O88.213 Thromboembolism in pregnancy,
420
mention of antepartum condition
third trimester
673.21 Obstetrical blood-clot embolism, delivered, with or without
O88.22 Thromboembolism in childbirth
mention of antepartum condition
673.22 Obstetrical blood-clot embolism, delivered, with mention of
O88.22 Thromboembolism in childbirth
postpartum complication
673.22 Obstetrical blood-clot embolism, delivered, with mention of
O88.23 Thromboembolism in the
postpartum complication
puerperium
673.31 Obstetrical pyemic and septic embolism, delivered, with or
O88.311 Pyemic and septic embolism in
without mention of antepartum condition
pregnancy, first trimester
673.31 Obstetrical pyemic and septic embolism, delivered, with or
O88.312 Pyemic and septic embolism in
without mention of antepartum condition
pregnancy, second trimester
673.31 Obstetrical pyemic and septic embolism, delivered, with or
O88.313 Pyemic and septic embolism in
without mention of antepartum condition
pregnancy, third trimester
673.31 Obstetrical pyemic and septic embolism, delivered, with or
O88.32 Pyemic and septic embolism in
without mention of antepartum condition
childbirth
673.32 Obstetrical pyemic and septic embolism, delivered, with
O88.32 Pyemic and septic embolism in
mention of postpartum complicaton
childbirth
673.32 Obstetrical pyemic and septic embolism, delivered, with
O88.33 Pyemic and septic embolism in the
mention of postpartum complicaton
puerperium
673.81 Other obstetrical pulmonary embolism, delivered, with or
O88.811 Other embolism in pregnancy, first
without mention of antepartum condition
trimester
673.81 Other obstetrical pulmonary embolism, delivered, with or
O88.812 Other embolism in pregnancy,
without mention of antepartum condition
second trimester
673.81 Other obstetrical pulmonary embolism, delivered, with or
O88.813 Other embolism in pregnancy, third
without mention of antepartum condition
trimester
673.81 Other obstetrical pulmonary embolism, delivered, with or
O88.813 Other embolism in childbirth
without mention of antepartum condition
673.82 Other obstetrical pulmonary embolism, delivered, with mentionO88.811 Other embolism in pregnancy, first
of postpartum complication
trimester
673.82 Other obstetrical pulmonary embolism, delivered, with mentionO88.812 Other embolism in pregnancy,
of postpartum complication
second trimester
673.82 Other obstetrical pulmonary embolism, delivered, with mentionO88.812 Other embolism in pregnancy, third
of postpartum complication
trimester
673.82 Other obstetrical pulmonary embolism, delivered, with mentionO88.82 Other embolism in childbirth
of postpartum complication
673.82 Other obstetrical pulmonary embolism, delivered, with mentionO88.83 Other embolism in the puerperium
of postpartum complication
674.01 Cerebrovascular disorders in the puerperium, delivered, with O99.411 Diseases of the circulatory system
or without mention of antepartum condition
complicating pregnancy, first
trimester
674.01 Cerebrovascular disorders in the puerperium, delivered, with O99.412 Diseases of the circulatory system
or without mention of antepartum condition
complicating pregnancy, second
trimester
674.01 Cerebrovascular disorders in the puerperium, delivered, with O99.413 Diseases of the circulatory system
or without mention of antepartum condition
complicating pregnancy, third
trimester
674.01 Cerebrovascular disorders in the puerperium, delivered, with
or without mention of antepartum condition
674.02 Disruption of cesarean wound, delivered, with mention of
postpartum complication
674.02 Cerebrovascular disorders in the puerperium, delivered, with
mention of postpartum complication
674.22 Disruption of perineal wound, delivered, with mention of
postpartum complication
PC v2014A
O99.42 Diseases of the circulatory system
complicating childbirth
O90.0 Disruption of cesarean delivery
wound
O99.42 Diseases of the circulatory system
complicating childbirth
O90.1 Disruption of perineal obstetric
wound
421
674.32 Other complications of obstetrical surgical wounds, delivered, O86.0
with mention of postpartum complication
674.32 Other complications of obstetrical surgical wounds, delivered, O90.2
with mention of postpartum complication
674.42 Placental polyp, delivered, with mention of postpartum
O90.89
complication
Infection of obstetric surgical wound
Hematoma of obstetric wound
Other complications of the
puerperium, not elsewhere
classified
674.82 Other complications of puerperium, delivered, with mention of O90.89 Other complications of the
postpartum complication
puerperium, not elsewhere
classified
674.92 Unspecified complications of puerperium, delivered, with
O90.9 Complication of the puerperium,
mention of postpartum complication
unspecified
675.01 Infections of nipple associated with childbirth, delivered, with O91.011 Infection of nipple associated with
or without mention of antepartum condition
pregnancy, first trimester
675.01 Infections of nipple associated with childbirth, delivered, with O91.012 Infection of nipple associated with
or without mention of antepartum condition
pregnancy, second trimester
675.01 Infections of nipple associated with childbirth, delivered, with O91.013 Infection of nipple associated with
or without mention of antepartum condition
pregnancy, third trimester
675.02 Infections of nipple associated with childbirth, delivered, with O91.02 Infection of nipple associated with
mention of postpartum complication
the puerperium
675.11 Abscess of breast associated with childbirth, delivered, with O91.111 Abscess of breast associated with
or without mention of antepartum condition
pregnancy, first trimester
675.11 Abscess of breast associated with childbirth, delivered, with O91.112 Abscess of breast associated with
or without mention of antepartum condition
pregnancy, second trimester
675.11 Abscess of breast associated with childbirth, delivered, with O91.113 Abscess of breast associated with
or without mention of antepartum condition
pregnancy, third trimester
675.12 Abscess of breast associated with childbirth, delivered, with O91.12 Abscess of breast associated with
mention of postpartum complication
the puerperium
675.21 Nonpurulent mastitis associated with childbirth, delivered, with O91.211 Nonpurulent mastitis associated
or without mention of antepartum condition
with pregnancy, first trimester
675.21 Nonpurulent mastitis associated with childbirth, delivered, with O91.212 Nonpurulent mastitis associated
or without mention of antepartum condition
with pregnancy, second trimester
675.21 Nonpurulent mastitis associated with childbirth, delivered, with O91.213 Nonpurulent mastitis associated
or without mention of antepartum condition
with pregnancy, third trimester
675.22 Nonpurulent mastitis associated with childbirth, delivered, with O91.22 Nonpurulent mastitis associated
mention of postpartum complication
with the puerperium
675.81 Other specified infections of the breast and nipple associated O91.23 Nonpurulent mastitis associated
with childbirth, delivered, with or without mention of antepartum
with lactation
condition
675.82 Other specified infections of the breast and nipple associated O91.23 Nonpurulent mastitis associated
with childbirth, delivered, with mention of postpartum
with lactation
complication
675.91 Unspecified infection of the breast and nipple associated with O91.23 Nonpurulent mastitis associated
childbirth, delivered, with or without mention of antepartum
with lactation
condition
675.92 Unspecified infection of the breast and nipple associated with O91.23 Nonpurulent mastitis associated
childbirth, delivered, with mention of postpartum complication
with lactation
676.01 Retracted nipple associated with childbirth, delivered, with or O92.011 Retracted nipple associated with
without mention of antepartum condition
pregnancy, first trimester
676.01 Retracted nipple associated with childbirth, delivered, with or O92.012 Retracted nipple associated with
without mention of antepartum condition
pregnancy, second trimester
676.01 Retracted nipple associated with childbirth, delivered, with or O92.013 Retracted nipple associated with
without mention of antepartum condition
pregnancy, third trimester
676.02 Retracted nipple associated with childbirth, delivered, with
O92.03 Retracted nipple associated with
PC v2014A
422
mention of postpartum complication
676.11 Cracked nipple associated with childbirth, delivered, with or
without mention of antepartum condition
676.11 Cracked nipple associated with childbirth, delivered, with or
without mention of antepartum condition
676.11 Cracked nipple associated with childbirth, delivered, with or
without mention of antepartum condition
676.12 Cracked nipple associated with childbirth, delivered, with
mention of postpartum complication
676.21 Engorgement of breasts associated with childbirth, delivered,
with or without mention of antepartum condition
lactation
O92.111 Cracked nipple associated with
pregnancy, first trimester
O92.112 Cracked nipple associated with
pregnancy, second trimester
O92.113 Cracked nipple associated with
pregnancy, third trimester
O92.13 Cracked nipple associated with
lactation
O92.29 Other disorders of breast
associated with pregnancy and the
puerperium
676.22 Engorgement of breasts associated with childbirth, delivered, O92.29 Other disorders of breast
with mention of postpartum complication
associated with pregnancy and the
puerperium
676.31 Other and unspecified disorder of breast associated with
O92.20 Unspecified disorder of breast
childbirth, delivered, with or without mention of antepartum
associated with pregnancy and the
condition
puerperium
676.31 Other and unspecified disorder of breast associated with
O92.29 Other disorders of breast
childbirth, delivered, with or without mention of antepartum
associated with pregnancy and the
condition
puerperium
676.32 Other and unspecified disorder of breast associated with
O92.20 Unspecified disorder of breast
childbirth, delivered, with mention of postpartum complication
associated with pregnancy and the
puerperium
676.32 Other and unspecified disorder of breast associated with
O92.29 Other disorders of breast
childbirth, delivered, with mention of postpartum complication
associated with pregnancy and the
puerperium
676.41 Failure of lactation, delivered, with or without mention of
O92.3 Agalactia
antepartum condition
676.42 Failure of lactation, delivered, with mention of postpartum
O92.3 Agalactia
complication
676.51 Suppressed lactation, delivered, with or without mention of
O92.5 Suppressed lactation
antepartum condition
676.52 Suppressed lactation, delivered, with mention of postpartum O92.5 Suppressed lactation
complication
676.61 Galactorrhea associated with childbirth, delivered, with or
O92.6 Galactorrhea
without mention of antepartum condition
676.62 Galactorrhea associated with childbirth, delivered, with
O92.6 Galactorrhea
mention of postpartum complication
676.81 Other disorders of lactation, delivered, with or without mention O92.79 Other disorders of lactation
of antepartum condition
676.82 Other disorders of lactation, delivered, with mention of
O92.79 Other disorders of lactation
postpartum complication
676.91 Unspecified disorder of lactation, delivered, with or without
O92.70 Unspecified disorders of lactation
mention of antepartum condition
676.92 Unspecified disorder of lactation, delivered, with mention of O92.70 Unspecified disorders of lactation
postpartum complication
Table 11.05 Medical Induction of Labor
ICD-9CM
Code
PC v2014A
Code Description
ICD-10CM Code
Code Description
423
73.01
73.4
Induction of labor by artificial 10900ZC
rupture of membranes
Induction of labor by artificial 10903ZC
rupture of membranes
Induction of labor by artificial 10904ZC
rupture of membranes
Induction of labor by artificial 10907ZC
rupture of membranes
Induction of labor by artificial 10908ZC
rupture of membranes
Other Surgical Induction of 0U7C7ZZ
Labor
Medical induction of labor 3E053VJ
73.4
Medical induction of labor
73.01
73.01
73.01
73.01
73.1
Drainage of Amniotic Fluid, Therapeutic from Products of
Conception, Open Approach
Drainage of Amniotic Fluid, Therapeutic from Products of
Conception, Percutaneous Approach
Drainage of Amniotic Fluid, Therapeutic from Products of
Conception, Percutaneous Endoscopic Approach
Drainage of Amniotic Fluid, Therapeutic from Products of
Conception, Via Natural or Artificial Opening
Drainage of Amniotic Fluid, Therapeutic from Products of
Conception, Via Natural or Artificial Opening Endoscopic
Dilation of Cervix, Via Natural or Artificial Opening
Introduction of Other Hormone into Peripheral Artery,
Percutaneous Approach
3E0DXGCIntroduction of Other Therapeutic Substance into Mouth and
Pharynx, External Approach
Table 11.06.1 Planned Cesarean Section in Labor
Code Description
ICD9-CM
Code
64981Onset (spontaneous) of labor after 37 completed weeks of
gestation but before 39 completed weeks gestation, with
delivery by (planned) cesarean section, delivered, with or
without mention of antepartum condition
64982Onset (spontaneous) of labor after 37 completed weeks of
gestation but before 39 completed weeks gestation, with
delivery by (planned) cesarean section, delivered, with
mention of postpartum complication
ICDCode Description
10-CM
Code
O7582Onset (spontaneous) of labor after 37
completed weeks of gestation but before
39 completed weeks gestation, with
delivery by (planned) cesarean section
O7582Onset (spontaneous) of labor after 37
completed weeks of gestation but before
39 completed weeks gestation, with
delivery by (planned) cesarean section
Table 11.06 Cesarean Section
Code Description
ICD-9-CM
Code
74.0
Classical cesarean section
74.1
74.2
74.4
74.99
74.99
74.99
ICD-10-CM
Code Description
Code
10D00Z0
Extraction of Products of Conception, Classical, Open
Approach
Low cervical cesarean section 10D00Z1
Extraction of Products of Conception, Low Cervical,
Open Approach
Extraperitoneal cesarean section10D00Z2
Extraction of Products of Conception, Extraperitoneal,
Open Approach
Cesarean section of other
10D00Z0
Extraction of Products of Conception, Classical, Open
specified type
Approach
Other cesarean section of
10D00Z0
Extraction of Products of Conception, Classical, Open
unspecified type
Approach
Other cesarean section of
10D00Z1
Extraction of Products of Conception, Low Cervical,
unspecified type
Open Approach
Other cesarean section of
10D00Z2
Extraction of Products of Conception, Extraperitoneal,
unspecified type
Open Approach
Table 11.07 Conditions Possibly Justifying Elective Delivery Prior to
39 Weeks Gestation
PC v2014A
424
ICD-9Code Description
CM
Code
042 Human immunodeficiency virus [HIV] disease
ICD-10CM Code
B20
641.01Placenta previa without hemorrhage, delivered, with O44.01
or without mention of antepartum condition
641.01Placenta previa without hemorrhage, delivered, with O44.02
or without mention of antepartum condition
641.01Placenta previa without hemorrhage, delivered, with O44.03
or without mention of antepartum condition
641.11Hemorrhage from placenta previa, delivered, with or O44.11
without mention of antepartum condition
641.11Hemorrhage from placenta previa, delivered, with or O44.12
without mention of antepartum condition
641.11Hemorrhage from placenta previa, delivered, with or O44.13
without mention of antepartum condition
641.21Premature separation of placenta, delivered, with or O45.8X1
without mention of antepartum condition
641.21Premature separation of placenta, delivered, with or O45.8X2
without mention of antepartum condition
641.21Premature separation of placenta, delivered, with or O45.8X3
without mention of antepartum condition
641.21Premature separation of placenta, delivered, with or O45.91
without mention of antepartum condition
641.21Premature separation of placenta, delivered, with or O45.92
without mention of antepartum condition
641.21Premature separation of placenta, delivered, with or O45.93
without mention of antepartum condition
641.31Antepartum hemorrhage associated with
O45.001
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
O45.002
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
O45.003
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
O45.011
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
O45.012
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
O45.013
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
O45.021
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
O45.022
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
O45.023
PC v2014A
Code Description
Human immunodeficiency virus [HIV]
disease
Placenta previa specified as without
hemorrhage, first trimester
Placenta previa specified as without
hemorrhage, second trimester
Placenta previa specified as without
hemorrhage, third trimester
Placenta previa with hemorrhage, first
trimester
Placenta previa with hemorrhage, second
trimester
Placenta previa with hemorrhage, third
trimester
Other premature separation of placenta, first
trimester
Other premature separation of placenta,
second trimester
Other premature separation of placenta,
third trimester
Premature separation of placenta,
unspecified, first trimester
Premature separation of placenta,
unspecified, second trimester
Premature separation of placenta,
unspecified, third trimester
Premature separation of placenta with
coagulation defect, unspecified, first
trimester
Premature separation of placenta with
coagulation defect, unspecified, second
trimester
Premature separation of placenta with
coagulation defect, unspecified, third
trimester
Premature separation of placenta with
afibrinogenemia, first trimester
Premature separation of placenta with
afibrinogenemia, second trimester
Premature separation of placenta with
afibrinogenemia, third trimester
Premature separation of placenta with
disseminated intravascular coagulation, first
trimester
Premature separation of placenta with
disseminated intravascular coagulation,
second trimester
Premature separation of placenta with
425
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
disseminated intravascular coagulation, third
trimester
O45.091 Premature separation of placenta with other
coagulation defect, first trimester
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.31Antepartum hemorrhage associated with
coagulation defects, delivered, with or without
mention of antepartum condition
641.81Other antepartum hemorrhage, delivered, with or
without mention of antepartum condition
641.81Other antepartum hemorrhage, delivered, with or
without mention of antepartum condition
O46.093 Antepartum hemorrhage with other
coagulation defect, third trimester
PC v2014A
O45.092 Premature separation of placenta with other
coagulation defect, second trimester
O45.093 Premature separation of placenta with other
coagulation defect, third trimester
O46.001 Antepartum hemorrhage with coagulation
defect, unspecified, first trimester
O46.002 Antepartum hemorrhage with coagulation
defect, unspecified, second trimester
O46.003 Antepartum hemorrhage with coagulation
defect, unspecified, third trimester
O46.011 Antepartum hemorrhage with
afibrinogenemia, first trimester
O46.012 Antepartum hemorrhage with
afibrinogenemia, second trimester
O46.013 Antepartum hemorrhage with
afibrinogenemia, third trimester
O46.021 Antepartum hemorrhage with disseminated
intravascular coagulation, first trimester
O46.022 Antepartum hemorrhage with disseminated
intravascular coagulation, second trimester
O46.023 Antepartum hemorrhage with disseminated
intravascular coagulation, third trimester
O46.091 Antepartum hemorrhage with other
coagulation defect, first trimester
O46.092 Antepartum hemorrhage with other
coagulation defect, second trimester
O67.0
Intrapartum hemorrhage with coagulation
defect
O46.8X1 Other antepartum hemorrhage, first trimester
O46.8X2 Other antepartum hemorrhage, second
trimester
426
641.81Other antepartum hemorrhage, delivered, with or
without mention of antepartum condition
641.81Other antepartum hemorrhage, delivered, with or
without mention of antepartum condition
641.91Unspecified antepartum hemorrhage, delivered,
with or without mention of antepartum condition
641.91Unspecified antepartum hemorrhage, delivered,
with or without mention of antepartum condition
641.91Unspecified antepartum hemorrhage, delivered,
with or without mention of antepartum condition
641.91Unspecified antepartum hemorrhage, delivered,
with or without mention of antepartum condition
642.01Benign essential hypertension complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.01Benign essential hypertension complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.01Benign essential hypertension complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.01Benign essential hypertension complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.01Benign essential hypertension complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.01Benign essential hypertension complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
O46.8X3 Other antepartum hemorrhage, third
trimester
O67.8
Other intrapartum hemorrhage
642.01Benign essential hypertension complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.01Benign essential hypertension complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.11Hypertension secondary to renal disease,
complicating pregnancy, childbirth, and the
puerperium, delivered, with or without mention of
antepartum condition
642.11Hypertension secondary to renal disease,
complicating pregnancy, childbirth, and the
puerperium, delivered, with or without mention of
antepartum condition
642.11Hypertension secondary to renal disease,
complicating pregnancy, childbirth, and the
puerperium, delivered, with or without mention of
O10.913 Unspecified pre-existing hypertension
complicating pregnancy, third trimester
PC v2014A
O46.91
O46.92
O46.93
O67.9
Antepartum hemorrhage, unspecified, first
trimester
Antepartum hemorrhage, unspecified,
second trimester
Antepartum hemorrhage, unspecified, third
trimester
Intrapartum hemorrhage, unspecified
O10.011 Pre-existing essential hypertension
complicating pregnancy, first trimester
O10.012 Pre-existing essential hypertension
complicating pregnancy, second trimester
O10.013 Pre-existing essential hypertension
complicating pregnancy, third trimester
O10.02
Pre-existing essential hypertension
complicating childbirth
O10.911 Unspecified pre-existing hypertension
complicating pregnancy, first trimester
O10.912 Unspecified pre-existing hypertension
complicating pregnancy, second trimester
O10.92
Unspecified pre-existing hypertension
complicating childbirth
O10.411 Pre-existing secondary hypertension
complicating pregnancy, first trimester
O10.412 Pre-existing secondary hypertension
complicating pregnancy, second trimester
O10.413 Pre-existing secondary hypertension
complicating pregnancy, third trimester
427
antepartum condition
642.11Hypertension secondary to renal disease,
complicating pregnancy, childbirth, and the
puerperium, delivered, with or without mention of
antepartum condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
PC v2014A
O10.42
Pre-existing secondary hypertension
complicating childbirth
O10.111 Pre-existing hypertensive heart disease
complicating pregnancy, first trimester
O10.112 Pre-existing hypertensive heart disease
complicating pregnancy, second trimester
O10.113 Pre-existing hypertensive heart disease
complicating pregnancy, third trimester
O10.12
Pre-existing hypertensive heart disease
complicating childbirth
O10.211 Pre-existing hypertensive chronic kidney
disease complicating pregnancy, first
trimester
O10.212 Pre-existing hypertensive chronic kidney
disease complicating pregnancy, second
trimester
O10.212 Pre-existing hypertensive chronic kidney
disease complicating pregnancy, second
trimester
O10.213 Pre-existing hypertensive chronic kidney
disease complicating pregnancy, third
trimester
O10.22
Pre-existing hypertensive chronic kidney
disease complicating childbirth
O10.311 Pre-existing hypertensive heart and chronic
kidney disease complicating pregnancy, first
trimester
O10.312 Pre-existing hypertensive heart and chronic
kidney disease complicating pregnancy,
second trimester
O10.313 Pre-existing hypertensive heart and chronic
kidney disease complicating pregnancy,
third trimester
O10.32
Pre-existing hypertensive heart and chronic
kidney disease complicating childbirth
428
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Other pre-existing hypertension, complicating
pregnancy, childbirth, and the puerperium,
delivered, with or without mention of antepartum
condition
642.21Unspecified renal disease in pregnancy, without
mention of hypertension, delivered, with or without
mention of antepartum condition
642.21Unspecified renal disease in pregnancy, without
mention of hypertension, delivered, with or without
mention of antepartum condition
642.21Unspecified renal disease in pregnancy, without
mention of hypertension, delivered, with or without
mention of antepartum condition
642.21Unspecified renal disease in pregnancy, without
mention of hypertension, delivered, with or without
mention of antepartum condition
642.21Unspecified renal disease in pregnancy, without
mention of hypertension, delivered, with or without
mention of antepartum condition
642.21Unspecified renal disease in pregnancy, without
mention of hypertension, delivered, with or without
mention of antepartum condition
O11.1
Pre-existing hypertension with preeclampsia, first trimester
O11.2
Pre-existing hypertension with preeclampsia, second trimester
O11.3
Pre-existing hypertension with preeclampsia, third trimester
O12.11
Gestational proteinuria, first trimester
O12.12
Gestational proteinuria, second trimester
O12.13
Gestational proteinuria, third trimester
O12.21
Gestational edema with proteinuria, first
trimester
O12.22
Gestational edema with proteinuria, second
trimester
O12.23
Gestational edema with proteinuria, third
trimester
642.31Transient hypertension of pregnancy, delivered ,
with or without mention of antepartum condition
O13.1
642.31Transient hypertension of pregnancy, delivered ,
with or without mention of antepartum condition
O13.2
642.31Transient hypertension of pregnancy, delivered ,
with or without mention of antepartum condition
O13.3
Gestational [pregnancy-induced]
hypertension without significant proteinuria,
first trimester
Gestational [pregnancy-induced]
hypertension without significant proteinuria,
second trimester
Gestational [pregnancy-induced]
hypertension without significant proteinuria,
third trimester
Gestational [pregnancy-induced]
hypertension without significant proteinuria,
first trimester
Gestational [pregnancy-induced]
hypertension without significant proteinuria,
second trimester
Gestational [pregnancy-induced]
hypertension without significant proteinuria,
third trimester
Mild to moderate pre-eclampsia, second
trimester
Mild to moderate pre-eclampsia, third
trimester
Unspecified pre-eclampsia, second
642.32Transient hypertension of pregnancy, delivered, with O13.1
mention of postpartum complication
642.32Transient hypertension of pregnancy, delivered, with O13.2
mention of postpartum complication
642.32Transient hypertension of pregnancy, delivered, with O13.3
mention of postpartum complication
642.41Mild or unspecified pre-eclampsia, delivered, with
or without mention of antepartum condition
642.41Mild or unspecified pre-eclampsia, delivered, with
or without mention of antepartum condition
642.41Mild or unspecified pre-eclampsia, delivered, with
PC v2014A
O14.02
O14.03
O14.92
429
or without mention of antepartum condition
642.41Mild or unspecified pre-eclampsia, delivered, with
or without mention of antepartum condition
642.42Mild or unspecified pre-eclampsia, delivered, with
mention of postpartum complication
642.42Mild or unspecified pre-eclampsia, delivered, with
mention of postpartum complication
642.51Severe pre-eclampsia, delivered, with or without
mention of antepartum condition
642.51Severe pre-eclampsia, delivered, with or without
mention of antepartum condition
642.51Severe pre-eclampsia, delivered, with or without
mention of antepartum condition
642.51Severe pre-eclampsia, delivered, with or without
mention of antepartum condition
642.52Severe pre-eclampsia, delivered, with mention of
postpartum complication
642.52Severe pre-eclampsia, delivered, with mention of
postpartum complication
642.52Severe pre-eclampsia, delivered, with mention of
postpartum complication
642.52Severe pre-eclampsia, delivered, with mention of
postpartum complication
642.61Eclampsia, delivered, with or without mention of
antepartum condition
642.61Eclampsia, delivered, with or without mention of
antepartum condition
642.61Eclampsia, delivered, with or without mention of
antepartum condition
642.62Eclampsia, delivered, with mention of postpartum
complication
642.71Pre-eclampsia or eclampsia superimposed on preexisting hypertension, delivered, with or without
mention of antepartum condition
642.71Pre-eclampsia or eclampsia superimposed on preexisting hypertension, delivered, with or without
mention of antepartum condition
642.71Pre-eclampsia or eclampsia superimposed on preexisting hypertension, delivered, with or without
mention of antepartum condition
642.72Pre-eclampsia or eclampsia superimposed on preexisting hypertension, delivered, with mention of
postpartum complication
642.91Unspecified hypertension,complicating pregnancy,
childbirth, or the puerperium, delivered, with or
without mention of antepartum condition
642.91Unspecified hypertension,complicating pregnancy,
childbirth, or the puerperium, delivered, with or
without mention of antepartum condition
642.91Unspecified hypertension,complicating pregnancy,
childbirth, or the puerperium, delivered, with or
without mention of antepartum condition
645.11Post term pregnancy, delivered, with or without
mention of antepartum condition
PC v2014A
O14.93
O14.02
trimester
Unspecified pre-eclampsia, third trimester
O14.12
Mild to moderate pre-eclampsia, second
trimester
Mild to moderate pre-eclampsia, third
trimester
Severe pre-eclampsia, second trimester
O14.13
Severe pre-eclampsia, third trimester
O14.22
O14.23
HELLP syndrome (HELLP), second
trimester
HELLP syndrome (HELLP), third trimester
O14.12
Severe pre-eclampsia, second trimester
O14.13
Severe pre-eclampsia, third trimester
O14.22
O14.23
HELLP syndrome (HELLP), second
trimester
HELLP syndrome (HELLP), third trimester
O15.02
Eclampsia in pregnancy, second trimester
O15.03
Eclampsia in pregnancy, third trimester
O15.1
Eclampsia in labor
O15.2
Eclampsia in the puerperium
O11.1
Pre-existing hypertension with preeclampsia, first trimester
O11.2
Pre-existing hypertension with preeclampsia, second trimester
O11.3
Pre-existing hypertension with preeclampsia, third trimester
O15.2
Eclampsia in the puerperium
O16.1
Unspecified maternal hypertension, first
trimester
O16.2
Unspecified maternal hypertension, second
trimester
O16.3
Unspecified maternal hypertension, third
trimester
O48.0
Post-term pregnancy
O14.03
430
646.21Unspecified renal disease in pregnancy, without
mention of hypertension, delivered, with or without
mention of antepartum condition
646.21Unspecified renal disease in pregnancy, without
mention of hypertension, delivered, with or without
mention of antepartum condition
646.21Unspecified renal disease in pregnancy, without
mention of hypertension, delivered, with or without
mention of antepartum condition
646.22Unspecified renal disease in pregnancy, without
mention of hypertension, delivered, with mention of
postpartum complication
646.22Unspecified renal disease in pregnancy, without
mention of hypertension, delivered, with mention of
postpartum complication
646.22Unspecified renal disease in pregnancy, without
mention of hypertension, delivered, with mention of
postpartum complication
646.71Liver and biliary tract disorders in pregnancy,
delivered, with or without mention of antepartum
condition
646.71Liver and biliary tract disorders in pregnancy,
delivered, with or without mention of antepartum
condition
646.71Liver and biliary tract disorders in pregnancy,
delivered, with or without mention of antepartum
condition
646.71Liver and biliary tract disorders in pregnancy,
delivered, with or without mention of antepartum
condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
PC v2014A
O26.831 Pregnancy related renal disease, first
trimester
O26.832 Pregnancy related renal disease, second
trimester
O26.833 Pregnancy related renal disease, third
trimester
O26.831 Pregnancy related renal disease, first
trimester
O26.832 Pregnancy related renal disease, second
trimester
O26.833 Pregnancy related renal disease, third
trimester
O26.611 Liver and biliary tract disorders in
pregnancy, first trimester
O26.612 Liver and biliary tract disorders in
pregnancy, second trimester
O26.613 Liver and biliary tract disorders in
pregnancy, third trimester
O2.662
Liver and biliary tract disorders in childbirth
O24.011 Pre-existing diabetes mellitus, type 1, in
pregnancy, first trimester
O24.012 Pre-existing diabetes mellitus, type 1, in
pregnancy, second trimester
O24.013 Pre-existing diabetes mellitus, type 1, in
pregnancy, third trimester
O24.02
Pre-existing diabetes mellitus, type 1, in
childbirth
O24.111 Pre-existing diabetes mellitus, type 2, in
pregnancy, first trimester
O24.112 Pre-existing diabetes mellitus, type 2, in
pregnancy, second trimester
O24.113 Pre-existing diabetes mellitus, type 2, in
pregnancy, third trimester
O24.12
Pre-existing diabetes mellitus, type 2, in
childbirth
O24.311 Unspecified pre-existing diabetes mellitus in
431
pregnancy, childbirth, or the puerperium, delivered,
pregnancy, first trimester
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
O24.312 Unspecified pre-existing diabetes mellitus in
pregnancy, childbirth, or the puerperium, delivered,
pregnancy, second trimester
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
O24.313 Unspecified pre-existing diabetes mellitus in
pregnancy, childbirth, or the puerperium, delivered,
pregnancy, third trimester
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.01Diabetes mellitus of mother, complicating
pregnancy, childbirth, or the puerperium, delivered,
with or without mention of antepartum condition
648.81Abnormal glucose tolerance of mother, delivered,
with or without mention of antepartum condition
648.81Abnormal glucose tolerance of mother, delivered,
with or without mention of antepartum condition
648.81Abnormal glucose tolerance of mother, delivered,
with or without mention of antepartum condition
648.81Abnormal glucose tolerance of mother, delivered,
with or without mention of antepartum condition
648.81Abnormal glucose tolerance of mother, delivered,
with or without mention of antepartum condition
648.81Abnormal glucose tolerance of mother, delivered,
with or without mention of antepartum condition
O24.32
648.81Abnormal glucose tolerance of mother, delivered,
with or without mention of antepartum condition
648.81Abnormal glucose tolerance of mother, delivered,
with or without mention of antepartum condition
648.82Abnormal glucose tolerance of mother, delivered,
with mention of postpartum complication
649.31Coagulation defects complicating pregnancy,
O99.810 Abnormal glucose complicating pregnancy
PC v2014A
Unspecified pre-existing diabetes mellitus in
childbirth
O24.811 Other pre-existing diabetes mellitus in
pregnancy, first trimester
O24.812 Other pre-existing diabetes mellitus in
pregnancy, second trimester
O24.813 Other pre-existing diabetes mellitus in
pregnancy, third trimester
O24.82
Other pre-existing diabetes mellitus in
childbirth
O24.911 Unspecified diabetes mellitus in pregnancy,
first trimester
O24.912 Unspecified diabetes mellitus in pregnancy,
second trimester
O24.913 Unspecified diabetes mellitus in pregnancy,
third trimester
O24.92
Unspecified diabetes mellitus in childbirth
O24.410 Gestational diabetes mellitus in pregnancy,
diet controlled
O24.414 Gestational diabetes mellitus in pregnancy,
insulin controlled
O24.419 Gestational diabetes mellitus in pregnancy,
unspecified control
O24.420 Gestational diabetes mellitus in childbirth,
diet controlled
O24.424 Gestational diabetes mellitus in childbirth,
insulin controlled
O24.429 Gestational diabetes mellitus in childbirth,
unspecified control
O99.814 Abnormal glucose complicating childbirth
O99.815 Abnormal glucose complicating the
puerperium
O99.111 Other diseases of the blood and blood432
childbirth, or the puerperium, delivered, with or
without mention of antepartum condition
649.31Coagulation defects complicating pregnancy,
childbirth, or the puerperium, delivered, with or
without mention of antepartum condition
O99.112
649.31Coagulation defects complicating pregnancy,
childbirth, or the puerperium, delivered, with or
without mention of antepartum condition
O99.113
649.31Coagulation defects complicating pregnancy,
childbirth, or the puerperium, delivered, with or
without mention of antepartum condition
O99.12
651.01Twin pregnancy, delivered, with or without mention O30.001
of antepartum condition
651.01Twin pregnancy, delivered, with or without mention O30.002
of antepartum condition
651.01Twin pregnancy, delivered, with or without mention O30.003
of antepartum condition
651.01Twin pregnancy, delivered, with or without mention O30.011
of antepartum condition
651.01Twin pregnancy, delivered, with or without mention O30.012
of antepartum condition
651.01Twin pregnancy, delivered, with or without mention O30.013
of antepartum condition
651.01Twin pregnancy, delivered, with or without mention O30.031
of antepartum condition
forming organs and certain disorders
involving the immune mechanism
complicating pregnancy, first trimester
Other diseases of the blood and bloodforming organs and certain disorders
involving the immune mechanism
complicating pregnancy, second trimester
Other diseases of the blood and bloodforming organs and certain disorders
involving the immune mechanism
complicating pregnancy, third trimester
Other diseases of the blood and bloodforming organs and certain disorders
involving the immune mechanism
complicating childbirth
Twin pregnancy, unspecified number of
placenta and unspecified number of
amniotic sacs, first trimester
Twin pregnancy, unspecified number of
placenta and unspecified number of
amniotic sacs, second trimester
Twin pregnancy, unspecified number of
placenta and unspecified number of
amniotic sacs, third trimester
Twin pregnancy,
monochorionic/monoamniotic, first trimester
Twin pregnancy,
monochorionic/monoamniotic, second
trimester
Twin pregnancy,
monochorionic/monoamniotic, third trimester
Twin pregnancy, monochorionic/diamniotic,
first trimester
651.01Twin pregnancy, delivered, with or without mention
of antepartum condition
651.01Twin pregnancy, delivered, with or without mention
of antepartum condition
651.01Twin pregnancy, delivered, with or without mention
of antepartum condition
651.01Twin pregnancy, delivered, with or without mention
of antepartum condition
651.01Twin pregnancy, delivered, with or without mention
of antepartum condition
651.01Twin pregnancy, delivered, with or without mention
of antepartum condition
O30.032 Twin pregnancy, monochorionic/diamniotic,
second trimester
O30.033 Twin pregnancy, monochorionic/diamniotic,
third trimester
O30.041 Twin pregnancy, dichorionic/diamniotic, first
trimester
O30.042 Twin pregnancy, dichorionic/diamniotic,
second trimester
O30.043 Twin pregnancy, dichorionic/diamniotic, third
trimester
O30.091 Twin pregnancy, unable to determine
number of placenta and number of amniotic
sacs, first trimester
651.01Twin pregnancy, delivered, with or without mention O30.092 Twin pregnancy, unable to determine
of antepartum condition
number of placenta and number of amniotic
sacs, second trimester
651.01Twin pregnancy, delivered, with or without mention O30.093 Twin pregnancy, unable to determine
of antepartum condition
number of placenta and number of amniotic
sacs, third trimester
651.11Triplet pregnancy, delivered, with or without mention O30.101 Triplet pregnancy, unspecified number of
of antepartum condition
placenta and unspecified number of
PC v2014A
433
651.11Triplet pregnancy, delivered, with or without mention O30.102
of antepartum condition
651.11Triplet pregnancy, delivered, with or without mention O30.103
of antepartum condition
651.11Triplet pregnancy, delivered, with or without mention O30.111
of antepartum condition
651.11Triplet pregnancy, delivered, with or without mention O30.112
of antepartum condition
651.11Triplet pregnancy, delivered, with or without mention O30.113
of antepartum condition
651.11Triplet pregnancy, delivered, with or without mention O30.121
of antepartum condition
651.11Triplet pregnancy, delivered, with or without mention O30.122
of antepartum condition
651.11Triplet pregnancy, delivered, with or without mention O30.123
of antepartum condition
651.11Triplet pregnancy, delivered, with or without mention O30.191
of antepartum condition
651.11Triplet pregnancy, delivered, with or without mention O30.192
of antepartum condition
651.11Triplet pregnancy, delivered, with or without mention O30.193
of antepartum condition
651.21Quadruplet pregnancy, delivered, with or without
mention of antepartum condition
O30.201
651.21Quadruplet pregnancy, delivered, with or without
mention of antepartum condition
O30.202
651.21Quadruplet pregnancy, delivered, with or without
mention of antepartum condition
O30.203
651.21Quadruplet pregnancy, delivered, with or without
mention of antepartum condition
651.21Quadruplet pregnancy, delivered, with or without
mention of antepartum condition
651.21Quadruplet pregnancy, delivered, with or without
mention of antepartum condition
651.21Quadruplet pregnancy, delivered, with or without
mention of antepartum condition
651.21Quadruplet pregnancy, delivered, with or without
mention of antepartum condition
651.21Quadruplet pregnancy, delivered, with or without
mention of antepartum condition
651.21Quadruplet pregnancy, delivered, with or without
mention of antepartum condition
O30.211
651.21Quadruplet pregnancy, delivered, with or without
mention of antepartum condition
O30.292
PC v2014A
O30.212
O30.213
O30.221
O30.222
O30.223
O30.291
amniotic sacs, first trimester
Triplet pregnancy, unspecified number of
placenta and unspecified number of
amniotic sacs, second trimester
Triplet pregnancy, unspecified number of
placenta and unspecified number of
amniotic sacs, third trimester
Triplet pregnancy with two or more
monochorionic fetuses, first trimester
Triplet pregnancy with two or more
monochorionic fetuses, second trimester
Triplet pregnancy with two or more
monochorionic fetuses, third trimester
Triplet pregnancy with two or more
monoamniotic fetuses, first trimester
Triplet pregnancy with two or more
monoamniotic fetuses, second trimester
Triplet pregnancy with two or more
monoamniotic fetuses, third trimester
Triplet pregnancy, unable to determine
number of placenta and number of amniotic
sacs, first trimester
Triplet pregnancy, unable to determine
number of placenta and number of amniotic
sacs, second trimester
Triplet pregnancy, unable to determine
number of placenta and number of amniotic
sacs, third trimester
Quadruplet pregnancy, unspecified number
of placenta and unspecified number of
amniotic sacs, first trimester
Quadruplet pregnancy, unspecified number
of placenta and unspecified number of
amniotic sacs, second trimester
Quadruplet pregnancy, unspecified number
of placenta and unspecified number of
amniotic sacs, third trimester
Quadruplet pregnancy with two or more
monochorionic fetuses, first trimester
Quadruplet pregnancy with two or more
monochorionic fetuses, second trimester
Quadruplet pregnancy with two or more
monochorionic fetuses, third trimester
Quadruplet pregnancy with two or more
monoamniotic fetuses, first trimester
Quadruplet pregnancy with two or more
monoamniotic fetuses, second trimester
Quadruplet pregnancy with two or more
monoamniotic fetuses, third trimester
Quadruplet pregnancy, unable to determine
number of placenta and number of amniotic
sacs, first trimester
Quadruplet pregnancy, unable to determine
number of placenta and number of amniotic
sacs, second trimester
434
651.21Quadruplet pregnancy, delivered, with or without
mention of antepartum condition
O30.293 Quadruplet pregnancy, unable to determine
number of placenta and number of amniotic
sacs, third trimester
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
651.31Twin pregnancy with fetal loss and retention of one
fetus, delivered, with or without mention of
antepartum condition
O31.11X0 Continuing pregnancy after spontaneous
abortion of one fetus or more, first trimester,
not applicable or unspecified
O31.11X1 Continuing pregnancy after spontaneous
abortion of one fetus or more, first trimester,
fetus 1
O31.11X2 Continuing pregnancy after spontaneous
abortion of one fetus or more, first trimester,
fetus 2
O31.12X0 Continuing pregnancy after spontaneous
abortion of one fetus or more, second
trimester, not applicable or unspecified
O31.12X1 Continuing pregnancy after spontaneous
abortion of one fetus or more, second
trimester, fetus 1
O31.12X2 Continuing pregnancy after spontaneous
abortion of one fetus or more, second
trimester, fetus 2
O31.13X0 Continuing pregnancy after spontaneous
abortion of one fetus or more, third trimester,
not applicable or unspecified
O31.13X1 Continuing pregnancy after spontaneous
abortion of one fetus or more, third trimester,
fetus 1
O31.13X2 Continuing pregnancy after spontaneous
abortion of one fetus or more, third trimester,
fetus 2
O31.21X0 Continuing pregnancy after intrauterine
death of one fetus or more, first trimester, not
applicable or unspecified
O31.21X1 Continuing pregnancy after intrauterine
death of one fetus or more, first trimester,
fetus 1
O31.21X2 Continuing pregnancy after intrauterine
death of one fetus or more, first trimester,
fetus 2
O31.22X0 Continuing pregnancy after intrauterine
death of one fetus or more, second
trimester, not applicable or unspecified
O31.22X1 Continuing pregnancy after intrauterine
death of one fetus or more, second
trimester, fetus 1
O31.22X2 Continuing pregnancy after intrauterine
death of one fetus or more, second
trimester, fetus 2
O31.23X0 Continuing pregnancy after intrauterine
death of one fetus or more, third trimester,
not applicable or unspecified
O31.23X1 Continuing pregnancy after intrauterine
death of one fetus or more, third trimester,
fetus 1
PC v2014A
435
651.31Twin pregnancy with fetal loss and retention of one O31.23X2 Continuing pregnancy after intrauterine
fetus, delivered, with or without mention of
death of one fetus or more, third trimester,
antepartum condition
fetus 2
651.41Triplet pregnancy with fetal loss and retention of one O31.11X0 Continuing pregnancy after spontaneous
or more fetus(es), delivered, with or without mention
abortion of one fetus or more, first trimester,
of antepartum condition
not applicable or unspecified
651.51Quadruplet pregnancy with fetal loss and retention ofO31.11X0 Continuing pregnancy after spontaneous
one or more fetus(es), delivered, with or without
abortion of one fetus or more, first trimester,
mention of antepartum condition
not applicable or unspecified
651.51Other multiple pregnancy with fetal loss and
O31.11X0 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, first trimester,
without mention of antepartum condition
not applicable or unspecified
651.51Other multiple pregnancy with fetal loss and
O31.11X1 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, first trimester,
without mention of antepartum condition
fetus 1
651.51Other multiple pregnancy with fetal loss and
O31.11X2 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, first trimester,
without mention of antepartum condition
fetus 2
651.51Other multiple pregnancy with fetal loss and
O31.11X3 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, first trimester,
without mention of antepartum condition
fetus 3
651.51Other multiple pregnancy with fetal loss and
O31.11X4 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, first trimester,
without mention of antepartum condition
fetus 4
651.51Other multiple pregnancy with fetal loss and
O31.11X5 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, first trimester,
without mention of antepartum condition
fetus 5
651.51Other multiple pregnancy with fetal loss and
O31.11X9 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, first trimester,
without mention of antepartum condition
other fetus
651.51Other multiple pregnancy with fetal loss and
O31.12X0 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, second
without mention of antepartum condition
trimester, not applicable or unspecified
651.51Other multiple pregnancy with fetal loss and
O31.12X1 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, second
without mention of antepartum condition
trimester, fetus 1
651.51Other multiple pregnancy with fetal loss and
O31.12X2 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, second
without mention of antepartum condition
trimester, fetus 2
651.51Other multiple pregnancy with fetal loss and
retention of one or more fetus(es), delivered, with or
without mention of antepartum condition
651.51Other multiple pregnancy with fetal loss and
retention of one or more fetus(es), delivered, with or
without mention of antepartum condition
651.51Other multiple pregnancy with fetal loss and
retention of one or more fetus(es), delivered, with or
without mention of antepartum condition
651.51Other multiple pregnancy with fetal loss and
retention of one or more fetus(es), delivered, with or
without mention of antepartum condition
651.51Other multiple pregnancy with fetal loss and
retention of one or more fetus(es), delivered, with or
without mention of antepartum condition
PC v2014A
O31.12X3 Continuing pregnancy after spontaneous
abortion of one fetus or more, second
trimester, fetus 3
O31.12X4 Continuing pregnancy after spontaneous
abortion of one fetus or more, second
trimester, fetus 4
O31.12X5 Continuing pregnancy after spontaneous
abortion of one fetus or more, second
trimester, fetus 5
O31.12X9 Continuing pregnancy after spontaneous
abortion of one fetus or more, second
trimester, other fetus
O31.13X0 Continuing pregnancy after spontaneous
abortion of one fetus or more, third trimester,
not applicable or unspecified
436
651.51Other multiple pregnancy with fetal loss and
O31.13X1 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, third trimester,
without mention of antepartum condition
fetus 1
651.51Other multiple pregnancy with fetal loss and
O31.13X2 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, third trimester,
without mention of antepartum condition
fetus 2
651.51Other multiple pregnancy with fetal loss and
O31.13X3 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, third trimester,
without mention of antepartum condition
fetus 3
651.51Other multiple pregnancy with fetal loss and
O31.13X4 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, third trimester,
without mention of antepartum condition
fetus 4
651.51Other multiple pregnancy with fetal loss and
O31.13X5 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, third trimester,
without mention of antepartum condition
fetus 5
651.51Other multiple pregnancy with fetal loss and
O31.13X9 Continuing pregnancy after spontaneous
retention of one or more fetus(es), delivered, with or
abortion of one fetus or more, third trimester,
without mention of antepartum condition
other fetus
651.51Other multiple pregnancy with fetal loss and
O31.21X0 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, first trimester, not
without mention of antepartum condition
applicable or unspecified
651.51Other multiple pregnancy with fetal loss and
O31.21X1 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, first trimester,
without mention of antepartum condition
fetus 1
651.51Other multiple pregnancy with fetal loss and
O31.21X2 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, first trimester,
without mention of antepartum condition
fetus 2
651.51Other multiple pregnancy with fetal loss and
O31.21X3 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, first trimester,
without mention of antepartum condition
fetus 3
651.51Other multiple pregnancy with fetal loss and
O31.21X4 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, first trimester,
without mention of antepartum condition
fetus 4
651.51Other multiple pregnancy with fetal loss and
O31.21X5 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, first trimester,
without mention of antepartum condition
fetus 5
651.51Other multiple pregnancy with fetal loss and
O31.21X9 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, first trimester,
without mention of antepartum condition
other fetus
651.51Other multiple pregnancy with fetal loss and
O31.22X0 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, second
without mention of antepartum condition
trimester, not applicable or unspecified
651.51Other multiple pregnancy with fetal loss and
O31.22X1 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, second
without mention of antepartum condition
trimester, fetus 1
651.51Other multiple pregnancy with fetal loss and
O31.22X2 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, second
without mention of antepartum condition
trimester, fetus 2
651.51Other multiple pregnancy with fetal loss and
O31.22X3 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, second
without mention of antepartum condition
trimester, fetus 3
651.51Other multiple pregnancy with fetal loss and
O31.22X4 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, second
without mention of antepartum condition
trimester, fetus 4
651.51Other multiple pregnancy with fetal loss and
O31.22X5 Continuing pregnancy after intrauterine
PC v2014A
437
retention of one or more fetus(es), delivered, with or
death of one fetus or more, second
without mention of antepartum condition
trimester, fetus 5
651.51Other multiple pregnancy with fetal loss and
O31.22X9 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, second
without mention of antepartum condition
trimester, other fetus
651.51Other multiple pregnancy with fetal loss and
O31.23X0 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, third trimester,
without mention of antepartum condition
not applicable or unspecified
651.51Other multiple pregnancy with fetal loss and
O31.23X1 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, third trimester,
without mention of antepartum condition
fetus 1
651.51Other multiple pregnancy with fetal loss and
O31.23X2 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, third trimester,
without mention of antepartum condition
fetus 2
651.51Other multiple pregnancy with fetal loss and
O31.23X3 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, third trimester,
without mention of antepartum condition
fetus 3
651.51Other multiple pregnancy with fetal loss and
O31.23X4 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, third trimester,
without mention of antepartum condition
fetus 4
651.51Other multiple pregnancy with fetal loss and
O31.23X5 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, third trimester,
without mention of antepartum condition
fetus 5
651.51Other multiple pregnancy with fetal loss and
O31.23X9 Continuing pregnancy after intrauterine
retention of one or more fetus(es), delivered, with or
death of one fetus or more, third trimester,
without mention of antepartum condition
other fetus
651.71Multiple gestation following (elective) fetal
O31.31X0 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, first trimester,
antepartum condition
not applicable or unspecified
651.71Multiple gestation following (elective) fetal
O31.31X1 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, first trimester,
antepartum condition
fetus 1
651.71Multiple gestation following (elective) fetal
O31.31X2 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, first trimester,
antepartum condition
fetus 2
651.71Multiple gestation following (elective) fetal
O31.31X3 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, first trimester,
antepartum condition
fetus 3
651.71Multiple gestation following (elective) fetal
O31.31X4 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, first trimester,
antepartum condition
fetus 4
651.71Multiple gestation following (elective) fetal
O31.31X5 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, first trimester,
antepartum condition
fetus 5
651.71Multiple gestation following (elective) fetal
O31.31X9 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, first trimester,
antepartum condition
other fetus
651.71Multiple gestation following (elective) fetal
O31.32X0 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, second
antepartum condition
trimester, not applicable or unspecified
651.71Multiple gestation following (elective) fetal
O31.32X1 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, second
antepartum condition
trimester, fetus 1
651.71Multiple gestation following (elective) fetal
O31.32X2 Continuing pregnancy after elective fetal
PC v2014A
438
reduction,delivered, with or without mention of
antepartum condition
651.71Multiple gestation following (elective) fetal
reduction,delivered, with or without mention of
antepartum condition
reduction of one fetus or more, second
trimester, fetus 2
O31.32X3 Continuing pregnancy after elective fetal
reduction of one fetus or more, second
trimester, fetus 3
651.71Multiple gestation following (elective) fetal
O31.32X4 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, second
antepartum condition
trimester, fetus 4
651.71Multiple gestation following (elective) fetal
O31.32X5 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, second
antepartum condition
trimester, fetus 5
651.71Multiple gestation following (elective) fetal
O31.32X9 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, second
antepartum condition
trimester, other fetus
651.71Multiple gestation following (elective) fetal
O31.33X0 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, third
antepartum condition
trimester, not applicable or unspecified
651.71Multiple gestation following (elective) fetal
O31.33X1 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, third
antepartum condition
trimester, fetus 1
651.71Multiple gestation following (elective) fetal
O31.33X2 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, third
antepartum condition
trimester, fetus 2
651.71Multiple gestation following (elective) fetal
O31.33X3 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, third
antepartum condition
trimester, fetus 3
651.71Multiple gestation following (elective) fetal
O31.33X4 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, third
antepartum condition
trimester, fetus 4
651.71Multiple gestation following (elective) fetal
O31.33X5 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, third
antepartum condition
trimester, fetus 5
651.71Multiple gestation following (elective) fetal
O31.33X9 Continuing pregnancy after elective fetal
reduction,delivered, with or without mention of
reduction of one fetus or more, third
antepartum condition
trimester, other fetus
651.81Other specified multiple gestation, delivered, with or O30.801 Other specified multiple gestation,
without mention of antepartum condition
unspecified number of placenta and
unspecified number of amniotic sacs, first
trimester
651.81Other specified multiple gestation, delivered, with or O30.802 Other specified multiple gestation,
without mention of antepartum condition
unspecified number of placenta and
unspecified number of amniotic sacs,
second trimester
651.81Other specified multiple gestation, delivered, with or O30.803 Other specified multiple gestation,
without mention of antepartum condition
unspecified number of placenta and
unspecified number of amniotic sacs, third
trimester
651.81Other specified multiple gestation, delivered, with or O30.811 Other specified multiple gestation with two or
without mention of antepartum condition
more monochorionic fetuses, first trimester
651.81Other specified multiple gestation, delivered, with or O30.812 Other specified multiple gestation with two or
without mention of antepartum condition
more monochorionic fetuses, second
trimester
651.81Other specified multiple gestation, delivered, with or O30.813 Other specified multiple gestation with two or
without mention of antepartum condition
more monochorionic fetuses, third trimester
PC v2014A
439
651.81Other specified multiple gestation, delivered, with or O30.821
without mention of antepartum condition
651.81Other specified multiple gestation, delivered, with or O30.822
without mention of antepartum condition
Other specified multiple gestation with two or
more monoamniotic fetuses, first trimester
Other specified multiple gestation with two or
more monoamniotic fetuses, second
trimester
651.81Other specified multiple gestation, delivered, with or O30.823 Other specified multiple gestation with two or
without mention of antepartum condition
more monoamniotic fetuses, third trimester
651.81Other specified multiple gestation, delivered, with or O30.891 Other specified multiple gestation, unable to
without mention of antepartum condition
determine number of placenta and number
of amniotic sacs, first trimester
651.81Other specified multiple gestation, delivered, with or O30.892 Other specified multiple gestation, unable to
without mention of antepartum condition
determine number of placenta and number
of amniotic sacs, second trimester
651.81Other specified multiple gestation, delivered, with or O30.893 Other specified multiple gestation, unable to
without mention of antepartum condition
determine number of placenta and number
of amniotic sacs, third trimester
651.81Other specified multiple gestation, delivered, with or O31.8X10 Other complications specific to multiple
without mention of antepartum condition
gestation, first trimester, not applicable or
unspecified
651.81Other specified multiple gestation, delivered, with or O31.8X11 Other complications specific to multiple
without mention of antepartum condition
gestation, first trimester, fetus 1
651.81Other specified multiple gestation, delivered, with or O31.8X12 Other complications specific to multiple
without mention of antepartum condition
gestation, first trimester, fetus 2
651.81Other specified multiple gestation, delivered, with or O31.8X13 Other complications specific to multiple
without mention of antepartum condition
gestation, first trimester, fetus 3
651.81Other specified multiple gestation, delivered, with or O31.8X14 Other complications specific to multiple
without mention of antepartum condition
gestation, first trimester, fetus 4
651.81Other specified multiple gestation, delivered, with or O31.8X15 Other complications specific to multiple
without mention of antepartum condition
gestation, first trimester, fetus 5
651.81Other specified multiple gestation, delivered, with or O31.8X19 Other complications specific to multiple
without mention of antepartum condition
gestation, first trimester, other fetus
651.81Other specified multiple gestation, delivered, with or O31.8X20 Other complications specific to multiple
without mention of antepartum condition
gestation, second trimester, not applicable
or unspecified
651.81Other specified multiple gestation, delivered, with or O31.8X21 Other complications specific to multiple
without mention of antepartum condition
gestation, second trimester, fetus 1
651.81Other specified multiple gestation, delivered, with or O31.8X22 Other complications specific to multiple
without mention of antepartum condition
gestation, second trimester, fetus 2
651.81Other specified multiple gestation, delivered, with or O31.8X23 Other complications specific to multiple
without mention of antepartum condition
gestation, second trimester, fetus 3
651.81Other specified multiple gestation, delivered, with or O31.8X24 Other complications specific to multiple
without mention of antepartum condition
gestation, second trimester, fetus 4
651.81Other specified multiple gestation, delivered, with or O31.8X25 Other complications specific to multiple
without mention of antepartum condition
gestation, second trimester, fetus 5
651.81Other specified multiple gestation, delivered, with or O31.8X29 Other complications specific to multiple
without mention of antepartum condition
gestation, second trimester, other fetus
651.81Other specified multiple gestation, delivered, with or O31.8X30 Other complications specific to multiple
without mention of antepartum condition
gestation, third trimester, not applicable or
unspecified
651.81Other specified multiple gestation, delivered, with or O31.8X31 Other complications specific to multiple
without mention of antepartum condition
gestation, third trimester, fetus 1
651.81Other specified multiple gestation, delivered, with or O31.8X32 Other complications specific to multiple
without mention of antepartum condition
gestation, third trimester, fetus 2
651.81Other specified multiple gestation, delivered, with or O31.8X33 Other complications specific to multiple
without mention of antepartum condition
gestation, third trimester, fetus 3
PC v2014A
440
651.81Other specified multiple gestation, delivered, with or O31.8X34 Other complications specific to multiple
without mention of antepartum condition
gestation, third trimester, fetus 4
651.81Other specified multiple gestation, delivered, with or O31.8X35 Other complications specific to multiple
without mention of antepartum condition
gestation, third trimester, fetus 5
651.81Other specified multiple gestation, delivered, with or O31.8X39 Other complications specific to multiple
without mention of antepartum condition
gestation, third trimester, other fetus
651.91Unspecified multiple gestation, delivered, with or
O30.91 Multiple gestation, unspecified, first trimester
without mention of antepartum condition
651.91Unspecified multiple gestation, delivered, with or
O30.92 Multiple gestation, unspecified, second
without mention of antepartum condition
trimester
651.91Unspecified multiple gestation, delivered, with or
O30.93 Multiple gestation, unspecified, third
without mention of antepartum condition
trimester
652.01Unstable lie, delivered, with or without mention of
O32.0XX0Maternal care for unstable lie, not applicable
antepartum condition
or unspecified
652.01Unstable lie, delivered, with or without mention of
O32.0XX1Maternal care for unstable lie, fetus 1
antepartum condition
652.01Unstable lie, delivered, with or without mention of
O32.0XX2Maternal care for unstable lie, fetus 2
antepartum condition
652.01Unstable lie, delivered, with or without mention of
O32.0XX3Maternal care for unstable lie, fetus 3
antepartum condition
652.01Unstable lie, delivered, with or without mention of
O32.0XX4Maternal care for unstable lie, fetus 4
antepartum condition
652.01Unstable lie, delivered, with or without mention of
O32.0XX5Maternal care for unstable lie, fetus 5
antepartum condition
652.01Unstable lie, delivered, with or without mention of
O32.0XX9Maternal care for unstable lie, other fetus
antepartum condition
652.61Multiple gestation with malpresentation of one fetus O32.9XX0Maternal care for malpresentation of fetus,
or more, delivered,
unspecified, not applicable or unspecified
652.61Multiple gestation with malpresentation of one fetus
or more, delivered,
652.61Multiple gestation with malpresentation of one fetus
or more, delivered,
652.61Multiple gestation with malpresentation of one fetus
or more, delivered,
652.61Multiple gestation with malpresentation of one fetus
or more, delivered,
652.61Multiple gestation with malpresentation of one fetus
or more, delivered,
652.61Multiple gestation with malpresentation of one fetus
or more, delivered,
652.61Multiple gestation with malpresentation of one fetus
or more, delivered,
655.01Central nervous system malformation in fetus,
delivered, with or without mention of antepartum
condition
655.01Central nervous system malformation in fetus,
delivered, with or without mention of antepartum
condition
655.01Central nervous system malformation in fetus,
delivered, with or without mention of antepartum
condition
655.01Central nervous system malformation in fetus,
delivered, with or without mention of antepartum
condition
PC v2014A
O32.9XX1Maternal care for malpresentation of fetus,
unspecified, fetus 1
O32.9XX2Maternal care for malpresentation of fetus,
unspecified, fetus 2
O32.9XX3Maternal care for malpresentation of fetus,
unspecified, fetus 3
O32.9XX4Maternal care for malpresentation of fetus,
unspecified, fetus 4
O32.9XX5Maternal care for malpresentation of fetus,
unspecified, fetus 5
O32.9XX9Maternal care for malpresentation of fetus,
unspecified, other fetus
O66.6
Obstructed labor due to other multiple
fetuses
O35.0XX0Maternal care for (suspected) central
nervous system malformation in fetus, not
applicable or unspecified
O35.0XX1Maternal care for (suspected) central
nervous system malformation in fetus, fetus 1
O35.0XX2Maternal care for (suspected) central
nervous system malformation in fetus, fetus 2
O35.0XX3Maternal care for (suspected) central
nervous system malformation in fetus, fetus 3
441
655.01Central nervous system malformation in fetus,
delivered, with or without mention of antepartum
condition
655.01Central nervous system malformation in fetus,
delivered, with or without mention of antepartum
condition
655.01Central nervous system malformation in fetus,
delivered, with or without mention of antepartum
condition
655.11Chromosomal abnormality in fetus, affecting
management of mother, delivered, with or without
mention of antepartum condition
655.11Chromosomal abnormality in fetus, affecting
management of mother, delivered, with or without
mention of antepartum condition
655.11Chromosomal abnormality in fetus, affecting
management of mother, delivered, with or without
mention of antepartum condition
655.11Chromosomal abnormality in fetus, affecting
management of mother, delivered, with or without
mention of antepartum condition
655.11Chromosomal abnormality in fetus, affecting
management of mother, delivered, with or without
mention of antepartum condition
655.11Chromosomal abnormality in fetus, affecting
management of mother, delivered, with or without
mention of antepartum condition
O35.0XX4Maternal care for (suspected) central
nervous system malformation in fetus, fetus 4
O35.0XX5Maternal care for (suspected) central
nervous system malformation in fetus, fetus 5
O35.0XX9Maternal care for (suspected) central
nervous system malformation in fetus, other
fetus
O35.1XX0Maternal care for (suspected) chromosomal
abnormality in fetus, not applicable or
unspecified
O35.1XX1Maternal care for (suspected) chromosomal
abnormality in fetus, fetus 1
O35.1XX2Maternal care for (suspected) chromosomal
abnormality in fetus, fetus 2
O35.1XX3Maternal care for (suspected) chromosomal
abnormality in fetus, fetus 3
O35.1XX4Maternal care for (suspected) chromosomal
abnormality in fetus, fetus 4
O35.1XX5Maternal care for (suspected) chromosomal
abnormality in fetus, fetus 5
655.11Chromosomal abnormality in fetus, affecting
O35.1XX9Maternal care for (suspected) chromosomal
management of mother, delivered, with or without
abnormality in fetus, other fetus
mention of antepartum condition
655.31Suspected damage to fetus from viral disease in theO35.3XX0Maternal care for (suspected) damage to
mother, affecting management of mother, delivered,
fetus from viral disease in mother, not
with or without mention of antepartum condition
applicable or unspecified
655.31Suspected damage to fetus from viral disease in theO35.3XX1Maternal care for (suspected) damage to
mother, affecting management of mother, delivered,
fetus from viral disease in mother, fetus 1
with or without mention of antepartum condition
655.31Suspected damage to fetus from viral disease in theO35.3XX2Maternal care for (suspected) damage to
mother, affecting management of mother, delivered,
fetus from viral disease in mother, fetus 2
with or without mention of antepartum condition
655.31Suspected damage to fetus from viral disease in theO35.3XX3Maternal care for (suspected) damage to
mother, affecting management of mother, delivered,
fetus from viral disease in mother, fetus 3
with or without mention of antepartum condition
655.31Suspected damage to fetus from viral disease in theO35.3XX4Maternal care for (suspected) damage to
mother, affecting management of mother, delivered,
fetus from viral disease in mother, fetus 4
with or without mention of antepartum condition
655.31Suspected damage to fetus from viral disease in theO35.3XX5Maternal care for (suspected) damage to
mother, affecting management of mother, delivered,
fetus from viral disease in mother, fetus 5
with or without mention of antepartum condition
655.31Suspected damage to fetus from viral disease in theO35.3XX9Maternal care for (suspected) damage to
mother, affecting management of mother, delivered,
fetus from viral disease in mother, other fetus
with or without mention of antepartum condition
655.41Suspected damage to fetus from other disease in O35.4XX0Maternal care for (suspected) damage to
the mother, affecting management of mother,
fetus from alcohol, not applicable or
delivered, with or without mention of antepartum
unspecified
PC v2014A
442
condition
655.41Suspected damage to fetus from other disease in O35.4XX1Maternal care for (suspected) damage to
the mother, affecting management of mother,
fetus from alcohol, fetus 1
delivered, with or without mention of antepartum
condition
655.41Suspected damage to fetus from other disease in O35.4XX2Maternal care for (suspected) damage to
the mother, affecting management of mother,
fetus from alcohol, fetus 2
delivered, with or without mention of antepartum
condition
655.41Suspected damage to fetus from other disease in O35.4XX3Maternal care for (suspected) damage to
the mother, affecting management of mother,
fetus from alcohol, fetus 3
delivered, with or without mention of antepartum
condition
655.41Suspected damage to fetus from other disease in O35.4XX4Maternal care for (suspected) damage to
the mother, affecting management of mother,
fetus from alcohol, fetus 4
delivered, with or without mention of antepartum
condition
655.41Suspected damage to fetus from other disease in O35.4XX5Maternal care for (suspected) damage to
the mother, affecting management of mother,
fetus from alcohol, fetus 5
delivered, with or without mention of antepartum
condition
655.41Suspected damage to fetus from other disease in O35.4XX9Maternal care for (suspected) damage to
the mother, affecting management of mother,
fetus from alcohol, other fetus
delivered, with or without mention of antepartum
condition
655.51Suspected damage to fetus from drugs, affecting O35.5XX0Maternal care for (suspected) damage to
management of mother, delivered, with or without
fetus by drugs, not applicable or unspecified
mention of antepartum condition
655.51Suspected damage to fetus from drugs, affecting O35.5XX1Maternal care for (suspected) damage to
management of mother, delivered, with or without
fetus by drugs, fetus 1
mention of antepartum condition
655.51Suspected damage to fetus from drugs, affecting O35.5XX2Maternal care for (suspected) damage to
management of mother, delivered, with or without
fetus by drugs, fetus 2
mention of antepartum condition
655.51Suspected damage to fetus from drugs, affecting O35.5XX3Maternal care for (suspected) damage to
management of mother, delivered, with or without
fetus by drugs, fetus 3
mention of antepartum condition
655.51Suspected damage to fetus from drugs, affecting O35.5XX4Maternal care for (suspected) damage to
management of mother, delivered, with or without
fetus by drugs, fetus 4
mention of antepartum condition
655.51Suspected damage to fetus from drugs, affecting O35.5XX5Maternal care for (suspected) damage to
management of mother, delivered, with or without
fetus by drugs, fetus 5
mention of antepartum condition
655.51Suspected damage to fetus from drugs, affecting O35.5XX9Maternal care for (suspected) damage to
management of mother, delivered, with or without
fetus by drugs, other fetus
mention of antepartum condition
655.61Suspected damage to fetus from radiation, affecting O35.6XX0Maternal care for (suspected) damage to
management of mother, delivered,
fetus by radiation, not applicable or
unspecified
655.61Suspected damage to fetus from radiation, affecting O35.6XX1Maternal care for (suspected) damage to
management of mother, delivered,
fetus by radiation, fetus 1
655.61Suspected damage to fetus from radiation, affecting O35.6XX2Maternal care for (suspected) damage to
management of mother, delivered,
fetus by radiation, fetus 2
655.61Suspected damage to fetus from radiation, affecting O35.6XX3Maternal care for (suspected) damage to
management of mother, delivered,
fetus by radiation, fetus 3
PC v2014A
443
655.61Suspected damage to fetus from radiation, affecting O35.6XX4Maternal care for (suspected) damage to
management of mother, delivered,
fetus by radiation, fetus 4
655.61Suspected damage to fetus from radiation, affecting O35.6XX5Maternal care for (suspected) damage to
management of mother, delivered,
fetus by radiation, fetus 5
655.61Suspected damage to fetus from radiation, affecting O35.6XX9Maternal care for (suspected) damage to
management of mother, delivered,
fetus by radiation, other fetus
655.81Other known or suspected fetal abnormality, not
O35.8XX0Maternal care for other (suspected) fetal
elsewhere classified, affecting management of
abnormality and damage, not applicable or
mother, delivered, with or without mention of
unspecified
antepartum condition
655.81Other known or suspected fetal abnormality, not
O35.8XX1Maternal care for other (suspected) fetal
elsewhere classified, affecting management of
abnormality and damage, fetus 1
mother, delivered, with or without mention of
antepartum condition
655.81Other known or suspected fetal abnormality, not
O35.8XX2Maternal care for other (suspected) fetal
elsewhere classified, affecting management of
abnormality and damage, fetus 2
mother, delivered, with or without mention of
antepartum condition
655.81Other known or suspected fetal abnormality, not
O35.8XX3Maternal care for other (suspected) fetal
elsewhere classified, affecting management of
abnormality and damage, fetus 3
mother, delivered, with or without mention of
antepartum condition
655.81Other known or suspected fetal abnormality, not
O35.8XX4Maternal care for other (suspected) fetal
elsewhere classified, affecting management of
abnormality and damage, fetus 4
mother, delivered, with or without mention of
antepartum condition
655.81Other known or suspected fetal abnormality, not
O35.8XX5Maternal care for other (suspected) fetal
elsewhere classified, affecting management of
abnormality and damage, fetus 5
mother, delivered, with or without mention of
antepartum condition
655.81Other known or suspected fetal abnormality, not
O35.8XX9Maternal care for other (suspected) fetal
elsewhere classified, affecting management of
abnormality and damage, other fetus
mother, delivered, with or without mention of
antepartum condition
656.01Fetal-maternal hemorrhage, delivered, with or
O43.011 Fetomaternal placental transfusion
without mention of antepartum condition
syndrome, first trimester
656.01Fetal-maternal hemorrhage, delivered, with or
O43.012 Fetomaternal placental transfusion
without mention of antepartum condition
syndrome, second trimester
656.01Fetal-maternal hemorrhage, delivered, with or
O43.013 Fetomaternal placental transfusion
without mention of antepartum condition
syndrome, third trimester
656.01Fetal-maternal hemorrhage, delivered, with or
O43.021 Fetus-to-fetus placental transfusion
without mention of antepartum condition
syndrome, first trimester
656.01Fetal-maternal hemorrhage, delivered, with or
O43.022 Fetus-to-fetus placental transfusion
without mention of antepartum condition
syndrome, second trimester
656.01Fetal-maternal hemorrhage, delivered, with or
O43.023 Fetus-to-fetus placental transfusion
without mention of antepartum condition
syndrome, third trimester
656.11Rhesus isoimmunization, delivered, with or without O36.0110 Maternal care for anti-D [Rh] antibodies, first
mention of antepartum condition
trimester, not applicable or unspecified
656.11Rhesus isoimmunization, delivered, with or without O36.0111 Maternal care for anti-D [Rh] antibodies, first
mention of antepartum condition
trimester, fetus 1
656.11Rhesus isoimmunization, delivered, with or without O36.0112 Maternal care for anti-D [Rh] antibodies, first
mention of antepartum condition
trimester, fetus 2
656.11Rhesus isoimmunization, delivered, with or without O36.0113 Maternal care for anti-D [Rh] antibodies, first
mention of antepartum condition
trimester, fetus 3
656.11Rhesus isoimmunization, delivered, with or without O36.0114 Maternal care for anti-D [Rh] antibodies, first
PC v2014A
444
mention of antepartum condition
trimester, fetus 4
656.11Rhesus isoimmunization, delivered, with or without O36.0115 Maternal care for anti-D [Rh] antibodies, first
mention of antepartum condition
trimester, fetus 5
656.11Rhesus isoimmunization, delivered, with or without O36.0119 Maternal care for anti-D [Rh] antibodies, first
mention of antepartum condition
trimester, other fetus
656.11Rhesus isoimmunization, delivered, with or without O36.0120 Maternal care for anti-D [Rh] antibodies,
mention of antepartum condition
second trimester, not applicable or
unspecified
656.11Rhesus isoimmunization, delivered, with or without O36.0121 Maternal care for anti-D [Rh] antibodies,
mention of antepartum condition
second trimester, fetus 1
656.11Rhesus isoimmunization, delivered, with or without O36.0122 Maternal care for anti-D [Rh] antibodies,
mention of antepartum condition
second trimester, fetus 2
656.11Rhesus isoimmunization, delivered, with or without O36.0123 Maternal care for anti-D [Rh] antibodies,
mention of antepartum condition
second trimester, fetus 3
656.11Rhesus isoimmunization, delivered, with or without O36.0124 Maternal care for anti-D [Rh] antibodies,
mention of antepartum condition
second trimester, fetus 4
656.11Rhesus isoimmunization, delivered, with or without O36.0125 Maternal care for anti-D [Rh] antibodies,
mention of antepartum condition
second trimester, fetus 5
656.11Rhesus isoimmunization, delivered, with or without O36.0129 Maternal care for anti-D [Rh] antibodies,
mention of antepartum condition
second trimester, other fetus
656.11Rhesus isoimmunization, delivered, with or without O36.0130 Maternal care for anti-D [Rh] antibodies,
mention of antepartum condition
third trimester, not applicable or unspecified
656.11Rhesus isoimmunization, delivered, with or without O36.0131 Maternal care for anti-D [Rh] antibodies,
mention of antepartum condition
third trimester, fetus 1
656.11Rhesus isoimmunization, delivered, with or without O36.0132 Maternal care for anti-D [Rh] antibodies,
mention of antepartum condition
third trimester, fetus 2
656.11Rhesus isoimmunization, delivered, with or without O36.0133 Maternal care for anti-D [Rh] antibodies,
mention of antepartum condition
third trimester, fetus 3
656.11Rhesus isoimmunization, delivered, with or without O36.0134 Maternal care for anti-D [Rh] antibodies,
mention of antepartum condition
third trimester, fetus 4
656.11Rhesus isoimmunization, delivered, with or without O36.0135 Maternal care for anti-D [Rh] antibodies,
mention of antepartum condition
third trimester, fetus 5
656.11Rhesus isoimmunization, delivered, with or without O36.0139 Maternal care for anti-D [Rh] antibodies,
mention of antepartum condition
third trimester, other fetus
656.11Rhesus isoimmunization, delivered, with or without O36.0910 Maternal care for other rhesus
mention of antepartum condition
isoimmunization, first trimester, not
applicable or unspecified
656.11Rhesus isoimmunization, delivered, with or without O36.0911 Maternal care for other rhesus
mention of antepartum condition
isoimmunization, first trimester, fetus 1
656.11Rhesus isoimmunization, delivered, with or without O36.0912 Maternal care for other rhesus
mention of antepartum condition
isoimmunization, first trimester, fetus 2
656.11Rhesus isoimmunization, delivered, with or without O36.0913 Maternal care for other rhesus
mention of antepartum condition
isoimmunization, first trimester, fetus 3
656.11Rhesus isoimmunization, delivered, with or without O36.0914 Maternal care for other rhesus
mention of antepartum condition
isoimmunization, first trimester, fetus 4
656.11Rhesus isoimmunization, delivered, with or without O36.0915 Maternal care for other rhesus
mention of antepartum condition
isoimmunization, first trimester, fetus 5
656.11Rhesus isoimmunization, delivered, with or without O36.0919 Maternal care for other rhesus
mention of antepartum condition
isoimmunization, first trimester, other fetus
656.11Rhesus isoimmunization, delivered, with or without O36.0920 Maternal care for other rhesus
mention of antepartum condition
isoimmunization, second trimester, not
applicable or unspecified
656.11Rhesus isoimmunization, delivered, with or without O36.0921 Maternal care for other rhesus
mention of antepartum condition
isoimmunization, second trimester, fetus 1
PC v2014A
445
656.11Rhesus isoimmunization, delivered, with or without
mention of antepartum condition
656.11Rhesus isoimmunization, delivered, with or without
mention of antepartum condition
656.11Rhesus isoimmunization, delivered, with or without
mention of antepartum condition
656.11Rhesus isoimmunization, delivered, with or without
mention of antepartum condition
656.11Rhesus isoimmunization, delivered, with or without
mention of antepartum condition
656.11Rhesus isoimmunization, delivered, with or without
mention of antepartum condition
O36.0922 Maternal care for other rhesus
isoimmunization, second trimester, fetus 2
O36.0923 Maternal care for other rhesus
isoimmunization, second trimester, fetus 3
O36.0924 Maternal care for other rhesus
isoimmunization, second trimester, fetus 4
O36.0925 Maternal care for other rhesus
isoimmunization, second trimester, fetus 5
O36.0929 Maternal care for other rhesus
isoimmunization, second trimester, other
fetus
O36.0930 Maternal care for other rhesus
isoimmunization, third trimester, not
applicable or unspecified
O36.0931 Maternal care for other rhesus
isoimmunization, third trimester, fetus 1
O36.0932 Maternal care for other rhesus
isoimmunization, third trimester, fetus 2
O36.0933 Maternal care for other rhesus
isoimmunization, third trimester, fetus 3
O36.0934 Maternal care for other rhesus
isoimmunization, third trimester, fetus 4
O36.0935 Maternal care for other rhesus
isoimmunization, third trimester, fetus 5
O36.0939 Maternal care for other rhesus
isoimmunization, third trimester, other fetus
O36.1110 Maternal care for Anti-A sensitization, first
trimester, not applicable or unspecified
656.11Rhesus isoimmunization, delivered, with or without
mention of antepartum condition
656.11Rhesus isoimmunization, delivered, with or without
mention of antepartum condition
656.11Rhesus isoimmunization, delivered, with or without
mention of antepartum condition
656.11Rhesus isoimmunization, delivered, with or without
mention of antepartum condition
656.11Rhesus isoimmunization, delivered, with or without
mention of antepartum condition
656.11Rhesus isoimmunization, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified blood- O36.1111 Maternal care for Anti-A sensitization, first
group incompatibility, delivered, with or without
trimester, fetus 1
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodPC v2014A
O36.1112 Maternal care for Anti-A sensitization, first
trimester, fetus 2
O36.1113 Maternal care for Anti-A sensitization, first
trimester, fetus 3
O36.1114 Maternal care for Anti-A sensitization, first
trimester, fetus 4
O36.1115 Maternal care for Anti-A sensitization, first
trimester, fetus 5
O36.1119 Maternal care for Anti-A sensitization, first
trimester, other fetus
O36.1120 Maternal care for Anti-A sensitization,
second trimester, not applicable or
unspecified
O36.1121 Maternal care for Anti-A sensitization,
second trimester, fetus 1
O36.1122 Maternal care for Anti-A sensitization,
446
group incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
PC v2014A
second trimester, fetus 2
O36.1123 Maternal care for Anti-A sensitization,
second trimester, fetus 3
O36.1124 Maternal care for Anti-A sensitization,
second trimester, fetus 4
O36.1125 Maternal care for Anti-A sensitization,
second trimester, fetus 5
O36.1129 Maternal care for Anti-A sensitization,
second trimester, other fetus
O36.1130 Maternal care for Anti-A sensitization, third
trimester, not applicable or unspecified
O36.1131 Maternal care for Anti-A sensitization, third
trimester, fetus 2
O36.1132 Maternal care for Anti-A sensitization, third
trimester, fetus 3
O36.1133 Maternal care for Anti-A sensitization, third
trimester, fetus 4
O36.1134 Maternal care for Anti-A sensitization, third
trimester, fetus 5
O36.1139 Maternal care for Anti-A sensitization, third
trimester, other fetus
O36.1910 Maternal care for other isoimmunization, first
trimester, not applicable or unspecified
O36.1911 Maternal care for other isoimmunization, first
trimester, fetus 1
O36.1912 Maternal care for other isoimmunization, first
trimester, fetus 2
O36.1913 Maternal care for other isoimmunization, first
trimester, fetus 3
O36.1914 Maternal care for other isoimmunization, first
trimester, fetus 4
O36.1915 Maternal care for other isoimmunization, first
trimester, fetus 5
O36.1919 Maternal care for other isoimmunization, first
trimester, other fetus
O36.1920 Maternal care for other isoimmunization,
second trimester, not applicable or
447
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
656.21Isoimmunization from other and unspecified bloodgroup incompatibility, delivered, with or without
mention of antepartum condition
unspecified
O36.1921 Maternal care for other isoimmunization,
second trimester, fetus 1
O36.1922 Maternal care for other isoimmunization,
second trimester, fetus 2
O36.1923 Maternal care for other isoimmunization,
second trimester, fetus 3
O36.1924 Maternal care for other isoimmunization,
second trimester, fetus 4
O36.1925 Maternal care for other isoimmunization,
second trimester, fetus 5
O36.1929 Maternal care for other isoimmunization,
second trimester, other fetus
O36.1930 Maternal care for other isoimmunization,
third trimester, not applicable or unspecified
O36.1931 Maternal care for other isoimmunization,
third trimester, fetus 1
O36.1932 Maternal care for other isoimmunization,
third trimester, fetus 2
O36.1933 Maternal care for other isoimmunization,
third trimester, fetus 3
656.21Isoimmunization from other and unspecified blood- O36.1934 Maternal care for other isoimmunization,
group incompatibility, delivered, with or without
third trimester, fetus 4
mention of antepartum condition
656.21Isoimmunization from other and unspecified blood- O36.1935 Maternal care for other isoimmunization,
group incompatibility, delivered, with or without
third trimester, fetus 5
mention of antepartum condition
656.21Isoimmunization from other and unspecified blood- O36.1939 Maternal care for other isoimmunization,
group incompatibility, delivered, with or without
third trimester, other fetus
mention of antepartum condition
656.31Fetal distress, affecting management of mother,
O68
Labor and delivery complicated by
delivered, with or without mention of antepartum
abnormality of fetal acid-base balance
condition
656.41Intrauterine death, affecting management of mother, O36.1940 Maternal care for intrauterine death, not
delivered, with or without mention of antepartum
applicable or unspecified
condition
656.41Intrauterine death, affecting management of mother, O36.1941 Maternal care for intrauterine death, fetus 1
delivered, with or without mention of antepartum
condition
656.41Intrauterine death, affecting management of mother, O36.1942 Maternal care for intrauterine death, fetus 2
delivered, with or without mention of antepartum
condition
656.41Intrauterine death, affecting management of mother, O36.1943 Maternal care for intrauterine death, fetus 3
delivered, with or without mention of antepartum
PC v2014A
448
condition
656.41Intrauterine death, affecting management of mother, O36.1944 Maternal care for intrauterine death, fetus 4
delivered, with or without mention of antepartum
condition
656.41Intrauterine death, affecting management of mother, O36.1945 Maternal care for intrauterine death, fetus 5
delivered, with or without mention of antepartum
condition
656.41Intrauterine death, affecting management of mother, O36.4XX9Maternal care for intrauterine death, other
delivered, with or without mention of antepartum
fetus
condition
656.51Poor fetal growth, affecting management of mother, O36.5110 Maternal care for known or suspected
delivered, with or without mention of antepartum
placental insufficiency, first trimester, not
condition
applicable or unspecified
656.51Poor fetal growth, affecting management of mother, O36.5111 Maternal care for known or suspected
delivered, with or without mention of antepartum
placental insufficiency, first trimester, fetus 1
condition
656.51Poor fetal growth, affecting management of mother, O36.5112 Maternal care for known or suspected
delivered, with or without mention of antepartum
placental insufficiency, first trimester, fetus 2
condition
656.51Poor fetal growth, affecting management of mother, O36.5113 Maternal care for known or suspected
delivered, with or without mention of antepartum
placental insufficiency, first trimester, fetus 3
condition
656.51Poor fetal growth, affecting management of mother, O36.5114 Maternal care for known or suspected
delivered, with or without mention of antepartum
placental insufficiency, first trimester, fetus 4
condition
656.51Poor fetal growth, affecting management of mother, O36.5115 Maternal care for known or suspected
delivered, with or without mention of antepartum
placental insufficiency, first trimester, fetus 5
condition
656.51Poor fetal growth, affecting management of mother, O36.5119 Maternal care for known or suspected
delivered, with or without mention of antepartum
placental insufficiency, first trimester, other
condition
fetus
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
PC v2014A
O36.5120 Maternal care for known or suspected
placental insufficiency, second trimester, not
applicable or unspecified
O36.5121 Maternal care for known or suspected
placental insufficiency, second trimester,
fetus 1
O36.5122 Maternal care for known or suspected
placental insufficiency, second trimester,
fetus 2
O36.5123 Maternal care for known or suspected
placental insufficiency, second trimester,
fetus 3
O36.5124 Maternal care for known or suspected
placental insufficiency, second trimester,
fetus 4
O36.5125 Maternal care for known or suspected
placental insufficiency, second trimester,
fetus 5
O36.5129 Maternal care for known or suspected
placental insufficiency, second trimester,
other fetus
O36.5130 Maternal care for known or suspected
placental insufficiency, third trimester, not
449
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
applicable or unspecified
O36.5131 Maternal care for known or suspected
placental insufficiency, third trimester, fetus 1
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
O36.5913 Maternal care for other known or suspected
poor fetal growth, first trimester, fetus 3
PC v2014A
O36.5132 Maternal care for known or suspected
placental insufficiency, third trimester, fetus 2
O36.5133 Maternal care for known or suspected
placental insufficiency, third trimester, fetus 3
O36.5134 Maternal care for known or suspected
placental insufficiency, third trimester, fetus 4
O36.5135 Maternal care for known or suspected
placental insufficiency, third trimester, fetus 5
O36.5139 Maternal care for known or suspected
placental insufficiency, third trimester, other
fetus
O36.5910 Maternal care for other known or suspected
poor fetal growth, first trimester, not
applicable or unspecified
O36.5911 Maternal care for other known or suspected
poor fetal growth, first trimester, fetus 1
O36.5912 Maternal care for other known or suspected
poor fetal growth, first trimester, fetus 2
O36.5914 Maternal care for other known or suspected
poor fetal growth, first trimester, fetus 4
O36.5915 Maternal care for other known or suspected
poor fetal growth, first trimester, fetus 5
O36.5919 Maternal care for other known or suspected
poor fetal growth, first trimester, other fetus
O36.5920 Maternal care for other known or suspected
poor fetal growth, second trimester, not
applicable or unspecified
O36.5921 Maternal care for other known or suspected
poor fetal growth, second trimester, fetus 1
O36.5922 Maternal care for other known or suspected
poor fetal growth, second trimester, fetus 2
O36.5923 Maternal care for other known or suspected
poor fetal growth, second trimester, fetus 3
O36.5924 Maternal care for other known or suspected
poor fetal growth, second trimester, fetus 4
450
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
O36.5925 Maternal care for other known or suspected
poor fetal growth, second trimester, fetus 5
656.51Poor fetal growth, affecting management of mother,
delivered, with or without mention of antepartum
condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
O36.5939 Maternal care for other known or suspected
poor fetal growth, third trimester, other fetus
PC v2014A
O36.5929 Maternal care for other known or suspected
poor fetal growth, second trimester, other
fetus
O36.5930 Maternal care for other known or suspected
poor fetal growth, third trimester, not
applicable or unspecified
O36.5931 Maternal care for other known or suspected
poor fetal growth, third trimester, fetus 1
O36.5932 Maternal care for other known or suspected
poor fetal growth, third trimester, fetus 2
O36.5933 Maternal care for other known or suspected
poor fetal growth, third trimester, fetus 3
O36.5934 Maternal care for other known or suspected
poor fetal growth, third trimester, fetus 4
O36.5935 Maternal care for other known or suspected
poor fetal growth, third trimester, fetus 5
O40.1XX0Polyhydramnios, first trimester, not
applicable or unspecified
O40.1XX1Polyhydramnios, first trimester, fetus 1
O40.1XX2Polyhydramnios, first trimester, fetus 2
O40.1XX3Polyhydramnios, first trimester, fetus 3
O40.1XX4Polyhydramnios, first trimester, fetus 4
O40.1XX5Polyhydramnios, first trimester, fetus 5
O40.1XX9Polyhydramnios, first trimester, other fetus
O40.2XX0Polyhydramnios, second trimester, not
applicable or unspecified
O40.2XX1Polyhydramnios, second trimester, fetus 1
O40.2XX2Polyhydramnios, second trimester, fetus 2
O40.2XX3Polyhydramnios, second trimester, fetus 3
O40.2XX4Polyhydramnios, second trimester, fetus 4
O40.2XX5Polyhydramnios, second trimester, fetus 5
O40.2XX9Polyhydramnios, second trimester, other
451
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
657.01Polyhydramnios, delivered, with or without mention
of antepartum condition
658.01Oligohydramnios, delivered, with or without mention
of antepartum condition
658.01Oligohydramnios, delivered, with or without mention
of antepartum condition
658.01Oligohydramnios, delivered, with or without mention
of antepartum condition
658.01Oligohydramnios, delivered, with or without mention
of antepartum condition
658.01Oligohydramnios, delivered, with or without mention
of antepartum condition
fetus
O40.3XX0Polyhydramnios, third trimester, not
applicable or unspecified
O40.3XX1Polyhydramnios, third trimester, fetus 1
658.01Oligohydramnios, delivered, with or without mention
of antepartum condition
658.01Oligohydramnios, delivered, with or without mention
of antepartum condition
658.01Oligohydramnios, delivered, with or without mention
of antepartum condition
658.01Ol