CSHCS Diagnosis Codes
Transcript of CSHCS Diagnosis Codes
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
ICD-10 Code Description
Medical Review
Period
Code End
Date
Code Begin
Date
A1854 Tuberculous iridocyclitis 2
A507 Late congenital syphilis, unspecified 5
A925 Zika virus disease 2 10/1/2016
B20 Human immunodeficiency virus [HIV] disease 5
B259 Cytomegaloviral disease, unspecified 5
B393 Disseminated histoplasmosis capsulati 2
B399 Histoplasmosis, unspecified 2
B900 Sequelae of central nervous system tuberculosis 5
B902 Sequelae of tuberculosis of bones and joints 3
B909 Sequelae of respiratory and unspecified tuberculosis 3
B91 Sequelae of poliomyelitis 5
B941 Sequelae of viral encephalitis 5
B942 Sequelae of viral hepatitis 2
B948 Sequelae of other specified infectious and parasitic diseases 2
C029 Malignant neoplasm of tongue, unspecified 5
C039 Malignant neoplasm of gum, unspecified 5
C051 Malignant neoplasm of soft palate 5
C080 Malignant neoplasm of submandibular gland 5
C089 Malignant neoplasm of major salivary gland, unspecified 5
C118 Malignant neoplasm of overlapping sites of nasopharynx 5
C119 Malignant neoplasm of nasopharynx, unspecified 5
C169 Malignant neoplasm of stomach, unspecified 5
C179 Malignant neoplasm of small intestine, unspecified 5
C188 Malignant neoplasm of overlapping sites of colon 5
C189 Malignant neoplasm of colon, unspecified 5
C19 Malignant neoplasm of rectosigmoid junction 5
C210 Malignant neoplasm of anus, unspecified 5
C220 Liver cell carcinoma 5
C222 Hepatoblastoma 5
C223 Angiosarcoma of liver 5
C224 Other sarcomas of liver 5
C227 Other specified carcinomas of liver 5
C228 Malignant neoplasm of liver, primary, unspecified as to type 5
C229 Malignant neoplasm of liver, not specified as primary or secondary 5
C249 Malignant neoplasm of biliary tract, unspecified 5
C252 Malignant neoplasm of tail of pancreas 5
C254 Malignant neoplasm of endocrine pancreas 5
C259 Malignant neoplasm of pancreas, unspecified 5
C300 Malignant neoplasm of nasal cavity 5
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ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
C319 Malignant neoplasm of acessory sinus, unspecified 5
C329 Malignant neoplasm of larynx, unspecified 5
C3490 Malignant neoplasm of unspecified part of unspecified bronchus or lung 5
C380 Malignant neoplasm of heart 5
C383 Malignant neoplasm of mediastinum, part unspecified 5
C384 Malignant neoplasm of pleura 5
C4010 Malignant neoplasm of short bones of unspecified upper limb 5
C4020 Malignant neoplasm of long bones of unspecified lower limb 5
C4030 Malignant neoplasm of short bones of unspecified lower limb 5
C4080 Malignant neoplasm of overlapping sites of bone and articular cartilage of unspecified limb 5
C410 Malignant neoplasm of bones of skull and face 5
C411 Malignant neoplasm of mandible 5
C412 Malignant neoplasm of vertebral column 5
C413 Malignant neoplasm of ribs, sternum and clavicle 5
C414 Malignant neoplasm of pelvic bones, sacrum and coccyx 5
C419 Malignant neoplasm of bone and articular cartilage, unspecified 5
C4370 Malignant melanoma of unspecified lower limb, including hip 5
C439 Malignant melanoma of skin, unspecified 5
C44201 Unspecified malignant neoplasm of skin of unspecified ear and external auricular canal 5
C44291 Other specified malignant neoplasm of skin of unspecified ear and external auricular canal 5
C44300 Unspecified malignant neoplasm of skin of unspecified part of face 5
C44301 Unspecified malignant neoplasm of skin of nose 5
C44309 Unspecified malignant neoplasm of skin of other parts of face 5
C44390 Other specified malignant neoplasm of skin of unspecified parts of face 5
C44391 Other specified malignant neoplasm of skin of nose 5
C44399 Other specified malignant neoplasm of skin of other parts of face 5
C4490 Unspecified malignant neoplasm of skin, unspecified 5
C4491 Basal cell carcinoma of skin, unspecified 5
C4492 Squamous cell carcinoma of skin, unspecified 5
C4499 Other specified malignant neoplasm of skin, unspecified 5
C457 Mesothelioma of other sites 5
C459 Mesothelioma, unspecified 2
C470 Malignant neoplasm of peripheral nerves of head, face and neck 5
C4710 Malignant neoplasm of peripheral nerves of unspecified upper limb, including shoulder 5
C4720 Malignant neoplasm of peripheral nerves of unspecified lower limb, including hip 5
C473 Malignant neoplasm of peripheral nerves of thorax 5
C474 Malignant neoplasm of peripheral nerves of abdomen 5
C475 Malignant neoplasm of peripheral nerves of pelvis 5
C476 Malignant neoplasm of peripheral nerves of trunk, unspecified 5
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ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
C478 Malignant neoplasm of overlapping sites of peripheral nerves and autonomic nervous system 5
C479 Malignant neoplasm of peripheral nerves and autonomic nervous system, unspecified 5
C480 Malignant neoplasm of retroperitoneum 5C490 Malignant neoplasm of connective and soft tissue of head, face and neck 5
C4910
Malignant neoplasm of connective and soft tissue of unspecified upper limb, including
shoulder 5
C4920 Malignant neoplasm of connective and soft tissue of unspecified lower limb, including hip 5
C493 Malignant neoplasm of connective and soft tissue of thorax 5
C494 Malignant neoplasm of connective and soft tissue of abdomen 5
C495 Malignant neoplasm of connective and soft tissue of pelvis 5
C496 Malignant neoplasm of connective and soft tissue of trunk, unspecified 5
C498 Malignant neoplasm of overlapping sites of connective and soft tissue 5
C499 Malignant neoplasm of connective and soft tissue, unspecified 5
C50919 Malignant neoplasm of unspecified site of unspecified female breast 5
C519 Malignant neoplasm of vulva, unspecified 5
C52 Malignant neoplasm of vagina 5
C538 Malignant neoplasm of overlapping sites of cervix uteri 5
C539 Malignant neoplasm of cervix uteri, unspecified 5
C569 Malignant neoplasm of unspecified ovary 5
C574 Malignant neoplasm of uterine adnexa, unspecified 5
C58 Malignant neoplasm of placenta 5
C6290 Malignant neoplasm of unspecified testis, unspecified whether descended or undescended 5
C639 Malignant neoplasm of male genital organ, unspecified 5
C649 Malignant neoplasm of unspecified kidney, except renal pelvis 5
C679 Malignant neoplasm of bladder, unspecified 5
C6920 Malignant neoplasm of unspecified retina 5
C6960 Malignant neoplasm of unspecified orbit 5
C6980 Malignant neoplasm of overlapping sites of unspecified eye and adnexa 5
C6990 Malignant neoplasm of unspecified site of unspecified eye 5
C701 Malignant neoplasm of spinal meninges 5
C710 Malignant neoplasm of cerebrum, except lobes and ventricles 5
C717 Malignant neoplasm of brain stem 5
C718 Malignant neoplasm of overlapping sites of brain 5
C719 Malignant neoplasm of brain, unspecified 5
C720 Malignant neoplasm of spinal cord 5
C7230 Malignant neoplasm of unspecified optic nerve 5
C7250 Malignant neoplasm of unspecified cranial nerve 5
C7259 Malignant neoplasm of other cranial nerves 5
C729 Malignant neoplasm of central nervous system, unspecified 5
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ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
C73 Malignant neoplasm of thyroid gland 5
C7400 Malignant neoplasm of cortex of unspecified adrenal gland 5
C7410 Malignant neoplasm of medulla of unspecified adrenal gland 5
C7490 Malignant neoplasm of unspecified part of unspecified adrenal gland 5
C751 Malignant neoplasm of pituitary gland 5
C752 Malignant neoplasm of craniopharyngeal duct 5
C753 Malignant neoplasm of pineal gland 5
C755 Malignant neoplasm of aortic body and other paraganglia 5
C760 Malignant neoplasm of head, face and neck 5
C761 Malignant neoplasm of thorax 5
C762 Malignant neoplasm of abdomen 5
C763 Malignant neoplasm of pelvis 5
C7640 Malignant neoplasm of unspecified upper limb 5
C7650 Malignant neoplasm of unspecified lower limb 5
C768 Malignant neoplasm of other specified ill-defined sites 5
C775 Secondary and unspecified malignant neoplasm of intrapelvic lymph nodes 5
C778 Secondary and unspecified malignant neoplasm of lymph nodes of multiple regions 5
C779 Secondary and unspecified malignant neoplasm of lymph node, unspecified 5
C7800 Secondary malignant neoplasm of unspecified lung 5
C787 Secondary malignant neoplasm of liver and intrahepatic bile duct 5
C7931 Secondary malignant neoplasm of brain 5
C7989 Secondary malignant neoplasm of other specified sites 5
C799 Secondary malignant neoplasm of unspecified site 5
C7A090 Malignant carcinoid tumor of the bronchus and lung 5
C7A095 Malignant carcinoid tumor of the midgut NOS 5
C800 Disseminated malignant neoplasm, unspecified 5
C801 Malignant (primary) neoplasm, unspecified 2
C8100 Nodular lymphocyte predominant Hodgkin lymphoma, unspecified site 5
C8109 Nodular lymphocyte predominant Hodgkin lymphoma, extranodal and solid organ sites 5
C8110 Nodular sclerosis classical Hodgkin lymphoma, unspecified site 5
C8121 Mixed cellular classical Hodgkin lymphoma, lymph nodes of head, face, and neck 5
C8130 Lymphocyte depleted classical Hodgkin lymphoma, unspecified site 5
C8140 Lymphocyte-rich classical Hodgkin lymphoma, unspecified site 5
C8190 Hodgkin lymphoma, unspecified, unspecified site 5
C8200 Follicular lymphoma grade I, unspecified site 5
C8210 Follicular lymphoma grade II, unspecified site 5
C8220 Follicular lymphoma grade III, unspecified, unspecified site 5
C8230 Follicular lymphoma grade IIIa, unspecified site 5
C8240 Follicular lymphoma grade IIIb, unspecified site 5
C8250 Diffuse follicle center lymphoma, unspecified site 5
C8260 Cutaneous follicle center lymphoma, unspecified site 5
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ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
C8280 Other types of follicular lymphoma, unspecified site 5
C8290 Follicular lymphoma, unspecified, unspecified site 5
C8300 Small cell B-cell lymphoma, unspecified site 5
C8330 Diffuse large B-cell lymphoma, unspecified site 5
C8350 Lymphoblastic (diffuse) lymphoma, unspecified site 5
C8351 Lymphoblastic (diffuse) lymphoma, lymph nodes of head, face, and neck 5
C8352 Lymphoblastic (diffuse) lymphoma, intrathoracic lymph nodes 5
C8370 Burkitt lymphoma, unspecified site 5
C8378 Burkitt lymphoma, lymph nodes of multiple sites 5
C8380 Other non-follicular lymphoma, unspecified site 5
C8390 Non-follicular (diffuse) lymphoma, unspecified, unspecified site 5
C8400 Mycosis fungoides, unspecified site 5
C8408 Mycosis fungoides, lymph nodes of multiple sites 5
C8410 Sezary disease, unspecified site 5
C8440 Peripheral T-cell lymphoma, not classified, unspecified site 5
C8448 Peripheral T-cell lymphoma, not classified, lymph nodes of multiple sites 5
C8460 Anaplastic large cell lymphoma, ALK-positive, unspecified site 5
C8470 Anaplastic large cell lymphoma, ALK-negative, unspecified site 5
C8490 Mature T/NK-cell lymphomas, unspecified, unspecified site 5
C84A0 Cutaneous T-cell lymphoma, unspecified, unspecified site 5
C84Z0 Other mature T/NK-cell lymphomas, unspecified site 5
C8510 Unspecified B-cell lymphoma, unspecified site 5
C8520 Mediastinal (thymic) large B-cell lymphoma, unspecified site 5
C8580 Other specified types of non-Hodgkin lymphoma, unspecified site 5
C8590 Non-Hodgkin lymphoma, unspecified, unspecified site 5
C860 Extranodal NK/T-cell lymphoma, nasal type 5
C861 Hepatosplenic T-cell lymphoma 5
C862 Enteropathy-type (intestinal) T-cell lymphoma 5
C863 Subcutaneous panniculitis-like T-cell lymphoma 5
C864 Blastic NK-cell lymphoma 5
C865 Angioimmunoblastic T-cell lymphoma 5
C866 Primary cutaneous CD30-positive T-cell proliferations 5
C882 Heavy chain disease 5
C883 Immunoproliferative small intestinal disease 5
C884
Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-
lymphoma] 5
C888 Other malignant immunoproliferative diseases 2
C889 Malignant immunoproliferative disease, unspecified 5
C9000 Multiple myeloma not having achieved remission 5
C9001 Multiple myeloma in remission 5
C9002 Multiple myeloma in relapse 5
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ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
C9010 Plasma cell leukemia not having achieved remission 5
C9011 Plasma cell leukemia in remission 5
C9012 Plasma cell leukemia in relapse 5
C9020 Extramedullary plasmacytoma not having achieved remission 5
C9021 Extramedullary plasmacytoma in remission 5
C9022 Extramedullary plasmacytoma in relapse 5
C9030 Solitary plasmacytoma not having achieved remission 5
C9031 Solitary plasmacytoma in remission 5
C9032 Solitary plasmacytoma in relapse 5
C9100 Acute lymphoblastic leukemia not having achieved remission 5
C9101 Acute lymphoblastic leukemia, in remission 5
C9102 Acute lymphoblastic leukemia, in relapse 5
C9110 Chronic lymphocytic leukemia of B-cell type not having achieved remission 5
C9111 Chronic lymphocytic leukemia of B-cell type in remission 5
C9112 Chronic lymphocytic leukemia of B-cell type in relapse 5
C9130 Prolymphocytic leucemia of B-cell tympe not having achieved remission 5
C9131 Prolymphocytic leukemia of B-cell type, in remission 5
C9132 Prolymphocytic leukemia of B-cell type, in relapse 5
C9140 Hairy cell leukemia, not having achieved remission 5
C9141 Hairy cell leukemia, in remission 5
C9142 Hairy cell leukemia, in relapse 5
C9190 Lymphoid leukemia, unspecified not having achieved remission 5
C9191 Lymphoid leukemia, unspecified, in remission 5
C9192 Lymphoid leukemia, uspecified, in relapse 5
C91Z0 Other lymphoid leukemia not having achieved remission 5
C9200 Acute myeloblastic leukemia, not having achieved remission 5
C9201 Acute myeloblastic leukemia, in remission 5
C9202 Acute myeloblastic leukemia, in relapse 5
C9210 Chronic myeloid leukemia, BCR/ABL-positive, not having achieved remission 5
C9211 Chronic myeloid leukemia, BCR/ABL-positive, in remission 5
C9212 Chronic myeloid leukemia, BCR/ABL-positive in relapse 5
C9220 Atypical chronic myeloid leukemia BCR/ABL-negative, not having achieved remission 5
C9221 Atypical chronic myeloid leukemia BCR/ABL-negative, in remission 5
C9222 Atypical chronic myeloid leukemia BCR/ABL-negative, in relapse 5
C9230 Myeloid sarcoma, not having achieved remission 5
C9240 Acute promyelocytic leukemia, not having achieved remission 5
C9241 Acute promyelocytic leukemia, in remission 5
C9242 Acute promyelocytic leukemia, in relapse 5
C9250 Acute myelomonocytic leukemia, not having achieved remission 5
C9251 Acute myelomonocytic leukemia, in remission 5
C9252 Acute myelomonocytic leukemia, in relapse 5
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ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
C9260 Acute myeloid leukemia with 11q23-abnormality not having achieved remission 5
C9261 Acute myeloid leukemia with 11q23-abnormality in remission 5
C9262 Acute myeloid leukemia with 11q23-abnormality in relapse 5
C9290 Myeloid leukemia, unspecified, not having achieved remission 5
C9291 Myeloid leukemia, unspecified in remission 5
C9292 Myeloid leukemia, unspecified in relapse 5
C92A0 Acute myeloid leukemia with multilineage dysplasia, not having achieved remission 5
C92A1 Acute myeloid leukemia with multilineage dysplasia, in remission 5
C92A2 Acute myeloid leukemia with multilineage dysplasia, in relapse 5
C92Z0 Other myeloid leukemia not having achieved remission 5
C92Z1 Other myeloid leukemia, in remission 5
C9300 Acute monoblastic/monocytic leukemia, not having achieved remission 5
C9301 Acute monoblastic/monocytic leukemia, in remission 5
C9302 Acute monoblastic/monocytic leukemia, in relapse 5
C9390 Monocytic leukemia, unspecified, not having achieved remission 5
C9391 Monocytic leukemia, unspecified, in remission 5
C9392 Monocytic leukemia, unspecified, in relapse 5
C9400 Acute erythroid leukemia, not having achieved remission 5
C9401 Acute erythroid leukemia, in remission 5
C9402 Acute erythroid leukemia, in relapse 5
C9420 Acute megakaryoblastic leukemia not having achieved remission 5
C9421 Acute megakaryoblastic leukemia, in remission 5
C9422 Acute megakaryoblastic leukemia, in relapse 5
C9430 Mast cell leukemia not having achieved remission 5
C9431 Mast cell leukemia, in remission 5
C9432 Mast cell leukemia, in relapse 5
C9440 Acute panmyelosis with myelofibrosis not having achieved remission 2
C9441 Acute panmyelosis with myelofibrosis, in remission 2
C9442 Acute panmyelosis with myelofibrosis, in relapse 2
C946 Myelodysplastic disease, not classified 2
C9480 Other specified leukemias not having achieved remission 5
C9481 Other specified leukemias, in remission 5
C9482 Other specified leukemias, in relapse 5
C9500 Acute leukemia of unspecified cell type not having achieved remission 5
C9501 Acute leukemia of unspecified cell type, in remission 5
C9502 Acute leukemia of unspecified cell type, in relapse 5
C9510 Chronic leukemia of unspecified cell type, not having achieved remission 5
C9511 Chronic leukemia of unspecified cell type, in remission 5
C9512 Chronic leukemia of unspecified cell type, in relapse 5
C9590 Leukemia, unspecified not having achieved remission 5
C9591 Leukemia, unspecified, in remission 5
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ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
C9592 Leukemiaunspecified, in relapse 5
C960 Multifocal and multisystemic (disseminated) Langerhans-cell histiocytosis 5
C962 Malignant mast cell tumor 5 9/30/2017
C9620 Malignant mast cell neoplasm, unspecified 5 10/1/2017
C9622 Mast cell sarcoma 5 10/1/2017
C9629 Other malignant mast cell neoplasm 5 10/1/2017
C964 Sarcoma of dendritic cells (accessory cells) 5
C965 Multifocal and unisystemic Langerhans-cell histiocytosis 3
C966 Unifocal Langerhans-cell histiocytosis 3
C969 Malignant neoplasm of lymphoid, hematopoietic and related tissue, unspecified 5
C96A Histiocytic sarcoma 5
C96Z Other specified malignant neoplasms of lymphoid, hematopoietic and related tissue 5
D0000 Carcinoma in situ of oral cavity, unspecified site 5
D019 Carcinoma in situ of digestive oragan, unspecified 5
D024 Carcinoma in situ of respiratory system, unspecified 5
D039 Melanoma in situ, unspecified 5
D049 Carcinoma in situ of skin, unspecified 5
D0590 Unspecified type of carcinoma in situ of unspecified breast 5
D0730 Carcinoma in situ of unspecified female genital organs 5
D0760 Carcinoma in situ of unspecified male genital organs 5
D099 Carcinoma in situ, unspecified 5
D1030 Benign neoplasm of unspecified part of mouth 2
D107 Benign neoplasm of the hypopharynx, unspecified 2
D109 Benign neoplasm of pharynx, unspecified 2
D119 Benign neoplasm of major salivary gland, unspecified 2
D126 Benign neoplasm of colon, unspecified 2
D1330 Benign neoplasm of unspecified part of small intestine 2
D139 Benign neoplasm of ill-defined sites within the digestive system 2
D140 Benign neoplasm of middle ear, nasal cavity and accessory sinuses 2
D141 Benign neoplasm of larynx 2
D142 Benign neoplasm of trachea 2
D144 Benign neoplasm of respiratory system, unspecified 2
D169 Benign neoplasm of bone and articular cartilage, unspecified 2
D1800 Hemangioma unspecified sites 2
D1801 Hemangioma of skin and subcutaneous tissue 2
D1802 Hemangioma of intracranial structures 2
D1803 Hemangioma of intra-abdominal structures 2
D1809 Hemangioma of other sites 2
D181 Lymphangioma, any site 2
D215 Benign neoplasm of connective and other soft tissue of pelvis 2
D219 Benign neoplasm of connective and other soft tissue, unspecified 2
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ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
D309 Benign neoplasm of urinary organ, unspecified 2
D3120 Benign neoplasm of unspecified retina 2
D3140 Benign neoplasm of unspecified ciliary body 2
D3160 Benign neoplasm of unspecified site of unspecified orbit 2
D3190 Benign neoplasm of unspecified part of unspecified eye 2
D320 Benign neoplasm of cerebral meninges 2
D321 Benign neoplasm of spinal meninges 2
D329 Benign neoplasm of meninges, unspecified 2
D330 Benign neoplasm of brain, supratentorial 2
D331 Benign neoplasm of brain, infratentorial 2
D332 Benign neoplasm of brain, unspecified 2
D333 Benign neoplasm of cranial nerves 2
D334 Benign neoplasm of spinal cord 2
D337 Benign neoplasm of other specified parts of central nervous system 2
D339 Benign neoplasm of central nervous system, unspecified 2
D3500 Benign neoplasm of unspecified adrenal gland 2
D352 Benign neoplasm of pituitary gland 2
D353 Benign neoplasm of craniopharyngeal duct 2
D354 Benign neoplasm of pineal gland 2
D359 Benign neoplasm of endocrine gland, unspecified 2
D3610 Benign neoplasm of peripheral nerves and autonomic nervous system, unspecified 2
D433 Neoplasm of uncertain behavior of cranial nerves 2
D438 Neoplasm of uncertain behavior of other specified parts of central nervous system 2
D439 Neoplasm of uncertain behavior of central nervous system, unspecified 2
D440 Neoplasm of uncertain behavior of thyroid gland 2
D4410 Neoplasm of uncertain behavior of unspecified adrenal gland 2
D442 Neoplasm of uncertain behavior of parathyroid gland 2
D443 Neoplasm of uncertain behavior of pituitary gland 3
D444 Neoplasm of uncertain behavior of craniopharyngeal duct 3
D445 Neoplasm of uncertain behavior of pineal gland 3
D446 Neoplasm of uncertain behavior of carotid body 2
D447 Neoplasm of uncertain behavior of aortic body and other paraganglia 2
D449 Neoplasm of uncertain behavior of unspecified endocrine gland 2
D45 Polycythemia vera 2
D469 Myelodysplastic syndrome, unspecified 2
D4702 Systemic mastocytosis 5 10/1/2017D473 Essential (hemorrhagic) thrombocythemia 2
D47Z1 Post-transplant lymphoproliferative disorder (PTLD) 2
D47Z9
Other specified neoplasms of uncertain behavior of lymphoid, hematopoietic and related
tissue 2
D481 Neoplasm of uncertain behavior of connective and other soft tissue 2
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ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
D487 Neoplasm of uncertain behavior of other specified sites 2
D489 Neoplasm of uncertain behavior, unspecified 1
D4989 Neoplasm of unspecified behavior of other specified sites 2
D499 Neoplasm of unspecified behavior of unspecified site 2
D519 Vitamin B12 deficiency anemia, unspecified 2
D550 Anemia due to glucose-6-phosphate dehydrogenase [G6PD] deficiency 3
D551 Anemia due to other disorders of glutathione metabolism 3
D558 Other anemias due to enzyme disorders 5
D559 Anemia due to enzyme disorder, unspecified 5
D560 Alpha thalassemia 5
D561 Beta thalassemia 5
D568 Other thalassemias 5
D571 Sickle-cell disease without crisis 5
D5720 Sickle-cell/Hb-C disease without crisis 5
D5740 Sickle-cell thalassemia without crisis 5
D57419 Sickle-cell thalassemia with crisis, unspecified 5
D5780 Other sickle-cell disorders without crisis 5
D580 Hereditary spherocytosis 3
D581 Hereditary elliptocytosis 3
D582 Other hemoglobinopathies 2
D590 Drug-induced autoimmune hemolytic anemia 2
D591 Other autoimmune hemolytic anemias 2
D593 Hemolytic-uremic syndrome 2
D594 Other nonautoimmune hemolytic anemias 2
D595 Paroxysmal nocturnal hemoglobinuria 2
D600 Chronic acquired pure red cell aplasia 5
D608 Other acquired pure red cell aplasias 5
D609 Acquired pure red cell aplasia, unspecified 5
D6101 Constitutional (pure) red blood cell aplasia 5
D6109 Other constitutional aplastic anemia 5
D611 Drug-induced aplastic anemia 5
D612 Aplastic anemia due to other external agents 5
D613 Idiopathic aplastic anemia 5
D61818 Other pancytopenia 5
D6189 Other specified aplastic anemias and other bone marrow failure syndromes 5
D619 Aplastic anemia, unspecified 2
D631 Anemia in chronic kidney disease 3
D643 Other sideroblastic anemias 3
D65 Disseminated intravascular coagulation [defibrination syndrome] 3
D66 Hereditary factor VIII deficiency 5
D67 Hereditary factor IX deficiency 5
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ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
D680 Von Willebrand's disease 5
D681 Hereditary factor XI deficiency 5
D682 Hereditary deficiency of other clotting factors 5
D6832 Hemorrhagic disorder due to extrinsic circulating anticoagulants 3
D684 Acquired coagulation factor deficiency 3
D6851 Activated protein C resistance 5
D6852 Prothrombin gene mutation 5
D6859 Other primary thrombophilia 5
D6861 Antiphospholipid syndrome 5
D6862 Lupus anticoagulant syndrome 5
D688 Other specified coagulation defects 3
D689 Coagulation defect, unspecified 3
D693 Immune thrombocytopenic purpura 2
D6941 Evans syndrome 2
D6942 Congenital and hereditary thrombocytopenia purpura 2
D6949 Other primary thrombocytopenia 2
D699 Hemorrhagic condition, unspecified 2
D700 Congenital agranulocytosis 2
D704 Cyclic neutropenia 2
D708 Other neutropenia 2
D709 Neutropenia, unspecified 2
D71 Functional disorders of polymorphonuclear neutrophils 3
D761 Hemophagocytic lymphohistiocytosis 2
D762 Hemophagocytic syndrome, infection associated 2
D800 Hereditary hypogammaglobulinemia 3
D801 Nonfamilial hypogammaglobulinemia 3
D802 Selective deficiency of immunoglobulin A [IgA] 3
D803 Selective deficiency of immunoglobulin G [IgG] subclasses 3
D804 Selective deficiency of immunoglobulin M [IgM] 3
D805 Immunodeficiency with increased immunoglobulin M [IgM] 3
D806 Antibody deficiency with near-normal immunoglobulins or with hyperimmunoglobulinemia 2
D807 Transient hypogammaglobulinemia of infancy 2
D808 Other immunodeficiencies with predominantly antibody defects 2
D809 Immunodeficiency with predominantly antibody defects, unspecified 2
D810 Severe combined immunodeficiency [SCID] with reticular dysgenesis 5
D811 Severe combined immunodeficiency [SCID] with low T- and B-cell numbers 5
D812 Severe combined immunodeficiency [SCID] with low or normal B-cell numbers 5
D813 Adenosine deaminase [ADA] deficiency 3
D815 Purine nucleoside phosphorylase [PNP] deficiency 3
D816 Major histocompatibility complex class I deficiency 5
D817 Major histocompatibility complex class II deficiency 5
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ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
D81810 Biotinidase deficiency 3
D8189 Other combined immunodeficiencies 5
D819 Combined immunodeficiency, unspecified 5
D820 Wiskott-Aldrich syndrome 5
D821 Di George's syndrome 5
D824 Hyperimmunoglobulin E syndrome 2
D830
Common variable immunodeficiency with predominant abnormalities of B-cell numbers and
function 3
D831 Common variable immunodeficiency with predominant immunoregulatory T-cell disorders 2
D832 Common variable immunodeficiency with autoantibodies to B- or T-cells 3
D838 Other common variable immunodeficiencies 3
D839 Common variable immunodeficiency, unspecified 2
D848 Other specified immunodeficiencies 2
D849 Immunodeficiency, unspecified 2
D869 Sarcoidosis, unspecified 3
D89811 Chronic graft-versus-host disease 5
D89813 Graft-versus-host disease, unspecified 5
D8982 Autoimmune lymphoproliferative syndrome [ALPS] 2
D8989 Other specified disorders involving the immune mechanism, not elsewhere classified 2
D899 Disorder involving the immune mechanism, unspecified 2
E009 Congenital iodine-deficiency syndrome, unspecified 5
E030 Congenital hypothyroidism with diffuse goiter 5
E031 Congenital hypothyroidism without goiter 5
E039 Hypothyroidism, unspecified 3
E0510 Thyrotoxicosis with toxic single thyroid nodule without thyrotoxic crisis or storm 3
E0520 Thyrotoxicosis with toxic multinodular goiter without thyrotoxic crisis or storm 3
E0590 Thyrotoxicosis, unspecified without thyrotoxic crisis or storm 3
E063 Autoimmune thyroiditis 2
E0840 Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified 3
E0849 Diabetes mellitus due to underlying condition with other diabetic neurological complication 3
E08610 Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy 2
E088 Diabetes mellitus due to underlying condition with unspecified complications 2
E1021 Type 1 diabetes mellitus with diabetic nephropathy 5
E1022 Type 1 diabetes mellitus with diabetic chronic kidney disease 5
E1029 Type 1 diabetes mellitus with other diabetic kidney complication 5
E1039 Type 1 diabetes mellitus with other diabetic ophthalmic complication 5
E1040 Type 1 diabetes mellitus with diabetic neuropathy, unspecified 3
E1043 Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy 5
E1049 Type 1 diabetes mellitus with other diabetic neurological complication 3
E1059 Type 1 diabetes mellitus with other circulatory complications 5
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ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
E1069 Type 1 diabetes mellitus with other specified complication 5
E108 Type 1 diabetes mellitus with unspecified complications 2
E109 Type 1 diabetes mellitus without complications 5
E1140 Type 2 diabetes mellitus with diabetic neuropathy, unspecified 3
E118 Type 2 diabetes mellitus with unspecified complications 2
E161 Other hypoglycemia 2
E200 Idiopathic hypoparathyroidism 3
E201 Pseudohypoparathyroidism 3
E208 Other hypoparathyroidism 3
E209 Hypoparathyroidism, unspecified 3
E210 Primary hyperparathyroidism 5
E211 Secondary hyperparathyroidism, not elsewhere classified 2
E213 Hyperparathyroidism, unspecified 1
E215 Disorder of parathyroid gland, unspecified 2
E220 Acromegaly and pituitary gigantism 5
E221 Hyperprolactinemia 3
E228 Other hyperfunction of pituitary gland 3
E229 Hyperfunction of pituitary gland, unspecified 3
E230 Hypopituitarism 3
E232 Diabetes insipidus 5
E233 Hypothalamic dysfunction, not elsewhere classified 3
E236 Other disorders of pituitary gland 3
E237 Disorder of pituitary gland, unspecified 3
E240 Pituitary-dependent Cushing's disease 3
E248 Other Cushing's syndrome 3
E249 Cushing's syndrome, unspecified 3
E250 Congenital adrenogenital disorders associated with enzyme deficiency 5
E258 Other adrenogenital disorders 5
E259 Adrenogenital disorder, unspecified 5
E2609 Other primary hyperaldosteronism 3
E2681 Bartter's Syndrome 2
E269 Hyperaldosteronism, unspecified 3
E271 Primary adrenocortical insufficiency 3
E2740 Unspecified adrenocortical insufficiency 3
E2749 Other adrenocortical insufficiency 3
E275 Adrenomedullary hyperfunction 3
E2839 Other primary ovarian failure 3
E299 Testicular dysfunction, unspecified 3
E301 Precocious puberty 2
E309 Disorder of puberty, unspecified 3
E310 Autoimmune polyglandular failure 3
13
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
E311 Polyglandular hyperfunction 3
E3120 Multiple endocrine neoplasia [MEN] syndrome, unspecified 3
E3121 Multiple endocrine neoplasia [MEN] type I 3
E3122 Multiple endocrine neoplasia [MEN] type IIA 3
E3123 Multiple endocrine neoplasia [MEN] type IIB 3
E318 Other polyglandular dysfunction 3
E319 Polyglandular dysfunction, unspecified 3
E340 Carcinoid syndrome 3
E343 Short stature due to endocrine disorder 3
E3450 Androgen insensitivity syndrome, unspecified 2
E348 Other specified endocrine disorders 2
E349 Endocrine disorder, unspecified 3
E43 Unspecified severe protein-calorie malnutrition 2
E440 Moderate protein-calorie malnutrition 2
E46 Unspecified protein-calorie malnutrition 2
E618 Deficiency of other specified nutrient elements 3
E619 Deficiency of nutrient element, unspecified 1
E638 Other specified nutritional deficiencies 3
E639 Nutritional deficiency, unspecified 1
E640 Sequelae of protein-calorie malnutrition 2
E643 Sequelae of rickets 3
E648 Sequelae of other nutritional deficiencies 3
E649 Sequelae of unspecified nutritional deficiency 1
E662 Morbid (severe) obesity with alveolar hypoventilation 2
E700 Classical phenylketonuria 5
E701 Other hyperphenylalaninemias 5
E7020 Disorder of tyrosine metabolism, unspecified 5
E7021 Tyrosinemia 5
E7029 Other disorders of tyrosine metabolism 5
E7030 Albinism, unspecified 5
E70319 Ocular albinism, unspecified 5
E70329 Oculocutaneous albinism, unspecified 5
E7039 Other specified albinism 5
E705 Disorders of tryptophan metabolism 5
E708 Other disorders of aromatic amino-acid metabolism 5
E709 Disorder of aromatic amino-acid metabolism, unspecified 5
E710 Maple-syrup-urine disease 5
E71110 Isovaleric acidemia 5
E71111 3-methylglutaconic aciduria 5
E71118 Other branched-chain organic acidurias 5
E71120 Methylmalonic acidemia 5
14
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
E71121 Propionic acidemia 5
E71128 Other disorders of propionate metabolism 5
E7119 Other disorders of branched-chain amino-acid metabolism 5
E712 Disorder of branched-chain amino-acid metabolism, unspecified 5
E7130 Disorder of fatty-acid metabolism, unspecified 3
E71310 Long chain/very long chain acyl CoA dehydrogenase deficiency 5
E71311 Medium chain acyl CoA dehydrogenase deficiency 5
E71312 Short chain acyl CoA dehydrogenase deficiency 5
E71313 Glutaric aciduria type II 5
E71314 Muscle carnitine palmitoyltransferase deficiency 5
E71318 Other disorders of fatty-acid oxidation 5
E7132 Disorders of ketone metabolism 5
E7139 Other disorders of fatty-acid metabolism 3
E7141 Primary carnitine deficiency 3
E7142 Carnitine deficiency due to inborn errors of metabolism 5
E7150 Peroxisomal disorder, unspecified 5
E71510 Zellweger syndrome 5
E71511 Neonatal adrenoleukodystrophy 5
E71518 Other disorders of peroxisome biogenesis 5
E71520 Childhood cerebral X-linked adrenoleukodystrophy 5
E71521 Adolescent X-linked adrenoleukodystrophy 5
E71522 Adrenomyeloneuropathy 5
E71528 Other X-linked adrenoleukodystrophy 5
E71529 X-linked adrenoleukodystrophy, unspecified type 5
E7153 Other group 2 peroxisomal disorders 5
E71540 Rhizomelic chondrodysplasia punctata 5
E71541 Zellweger-like syndrome 5
E71542 Other group 3 peroxisomal disorders 5
E71548 Other peroxisomal disorders 5
E7200 Disorders of amino-acid transport, unspecified 3
E7201 Cystinuria 3
E7202 Hartnup's disease 3
E7203 Lowe's syndrome 5
E7204 Cystinosis 3
E7209 Other disorders of amino-acid transport 3
E7210 Disorders of sulfur-bearing amino-acid metabolism, unspecified 5
E7211 Homocystinuria 5
E7212 Methylenetetrahydrofolate reductase deficiency 5
E7219 Other disorders of sulfur-bearing amino-acid metabolism 5
E7220 Disorder of urea cycle metabolism, unspecified 5
E7221 Argininemia 5
15
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
E7222 Arginosuccinic aciduria 5
E7223 Citrullinemia 5
E7229 Other disorders of urea cycle metabolism 5
E723 Disorders of lysine and hydroxylysine metabolism 5
E724 Disorders of ornithine metabolism 5
E7250 Disorder of glycine metabolism, unspecified 5
E7251 Non-ketotic hyperglycinemia 5
E7253 Hyperoxaluria 3
E7259 Other disorders of glycine metabolism 5
E728 Other specified disorders of amino-acid metabolism 5 9/30/2018
E7281 Disorders of gamma aminobutyric acid metabolism 5 10/1/2018
E7289 Other specified disorders of amino-acid metabolism 5 10/1/2018
E729 Disorder of amino-acid metabolism, unspecified 3
E7400 Glycogen storage disease, unspecified 5
E7401 von Gierke disease 5
E7402 Pompe disease 5
E7403 Cori disease 5
E7404 McArdle disease 5
E7409 Other glycogen storage disease 5
E7420 Disorders of galactose metabolism, unspecified 5
E7421 Galactosemia 5
E7429 Other disorders of galactose metabolism 5
E744 Disorders of pyruvate metabolism and gluconeogenesis 3
E748 Other specified disorders of carbohydrate metabolism 3
E749 Disorder of carbohydrate metabolism, unspecified 3
E7500 GM2 gangliosidosis, unspecified 5
E7501 Sandhoff disease 5
E7502 Tay-Sachs disease 5
E7509 Other GM2 gangliosidosis 5
E7510 Unspecified gangliosidosis 5
E7511 Mucolipidosis IV 5
E7519 Other gangliosidosis 5
E7521 Fabry (-Anderson) disease 5
E7522 Gaucher disease 5
E75240 Niemann-Pick disease type A 5
E75241 Niemann-Pick disease type B 5
E75242 Niemann-Pick disease type C 5
E75243 Niemann-Pick disease type D 5
E75248 Other Niemann-Pick disease 5
E75249 Niemann-Pick disease, unspecified 5
E753 Sphingolipidosis, unspecified 5
16
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
E754 Neuronal ceroid lipofuscinosis 5
E755 Other lipid storage disorders 3
E756 Lipid storage disorder, unspecified 3
E7601 Hurler's syndrome 5
E7602 Hurler-Scheie syndrome 5
E7603 Scheie's syndrome 5
E761 Mucopolysaccharidosis, type II 5
E76210 Morquio A mucopolysaccharidoses 5
E76211 Morquio B mucopolysaccharidoses 5
E76219 Morquio mucopolysaccharidoses, unspecified 5
E7622 Sanfilippo mucopolysaccharidoses 5
E7629 Other mucopolysaccharidoses 5
E763 Mucopolysaccharidosis, unspecified 5
E768 Other disorders of glucosaminoglycan metabolism 5
E769 Glucosaminoglycan metabolism disorder, unspecified 5
E770 Defects in post-translational modification of lysosomal enzymes 5
E771 Defects in glycoprotein degradation 3
E778 Other disorders of glycoprotein metabolism 5
E779 Disorder of glycoprotein metabolism, unspecified 5
E780 Pure hypercholesterolemia 3 9/30/2016
E7800 Pure hypercholesterolemia unspecified 3 10/1/2016
E781 Pure hyperglyceridemia 3
E782 Mixed hyperlipidemia 3
E784 Other hyperlipidemia 3 9/30/2018
E7841 Elevated Lipoprotein(a) 3 10/1/2018
E7849 Other hyperlipidemia 3 10/1/2018
E785 Hyperlipidemia, unspecified 3
E786 Lipoprotein deficiency 3
E7870 Disorder of bile acid and cholesterol metabolism, unspecified 3
E7871 Barth syndrome 3
E7879 Other disorders of bile acid and cholesterol metabolism 3
E7881 Lipoid dermatoarthritis 3
E7889 Other lipoprotein metabolism disorders 3
E789 Disorder of lipoprotein metabolism, unspecified 3
E791 Lesch-Nyhan syndrome 3
E792 Myoadenylate deaminase deficiency 3
E798 Other disorders of purine and pyrimidine metabolism 3
E799 Disorder of purine and pyrimidine metabolism, unspecified 3
E800 Hereditary erythropoietic porphyria 5
E801 Porphyria cutanea tarda 5
E8020 Unspecified porphyria 5
17
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
E8021 Acute intermittent (hepatic) porphyria 5
E8029 Other porphyria 5
E803 Defects of catalase and peroxidase 3
E8300 Disorder of copper metabolism, unspecified 5
E8301 Wilson's disease 5
E8309 Other disorders of copper metabolism 5
E83110 Hereditary Hemochromatosis 2 10/1/2017
E832 Disorders of zinc metabolism 3
E8330 Disorder of phosphorus metabolism, unspecified 3
E8331 Familial hypophosphatemia 3
E8332 Hereditary vitamin D-dependent rickets (type 1) (type 2) 3
E8339 Other disorders of phosphorus metabolism 3
E8350 Unspecified disorder of calcium metabolism 2
E8351 Hypocalcemia 2
E8352 Hypercalcemia 2
E8359 Other disorders of calcium metabolism 3
E8389 Other disorders of mineral metabolism 3
E839 Disorder of mineral metabolism, unspecified 3
E849 Cystic fibrosis, unspecified 5
E850 Non-neuropathic heredofamilial amyloidosis 3
E859 Amyloidosis, unspecified 3
E8801 Alpha-1-antitrypsin deficiency 3
E882 Lipomatosis, not elsewhere classified 3
E8840 Mitochondrial metabolism disorder, unspecified 5
E8841 MELAS Syndrome 5
E8842 MERRF Syndrome 5
E8889 Other specified metabolic disorders 3
E889 Metabolic disorder, unspecified 2
E892 Postprocedural hypoparathyroidism 3
E896 Postprocedural adrenocortical (-medullary) hypofunction 3
F842 Rett's syndrome 5
G009 Bacterial meningitis, unspecified 2
G032 Benign recurrent meningitis [Mollaret] 2
G039 Meningitis, unspecified 2
G0400 Acute disseminated encephalitis and encephalomyelitis (ADEM), unspecified 2
G041 Tropical spastic paraplegia 5
G0430 Acute necrotizing hemorrhagic encephalopathy, unspecified 2
G0490 Encephalitis and encephalomyelitis, unspecified 2
G0491 Myelitis, unspecified 2
G09 Sequelae of inflammatory diseases of central nervous system 3
G10 Huntington's disease 5
18
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
G111 Early-onset cerebellar ataxia 5
G112 Late-onset cerebellar ataxia 3
G113 Cerebellar ataxia with defective DNA repair 3
G114 Hereditary spastic paraplegia 3
G118 Other hereditary ataxias 3
G120 Infantile spinal muscular atrophy, type I [Werdnig-Hoffman] 5
G121 Other inherited spinal muscular atrophy 3
G1220 Motor neuron disease, unspecified 2
G1221 Amyotrophic lateral sclerosis 5
G1223 Primary lateral sclerosis 2 10/1/2017
G1224 Familial motor neuron disease 2 10/1/2017
G1225 Progressive spinal muscle atrophy 2 10/1/2017
G1229 Other motor neuron disease 2
G128 Other spinal muscular atrophies and related syndromes 5
G129 Spinal muscular atrophy, unspecified 5
G130 Paraneoplastic neuromyopathy and neuropathy 3
G14 Postpolio syndrome 5
G230 Hallervorden-Spatz disease 3
G231 Progressive supranuclear ophthalmoplegia [Steele-Richardson-Olszewski] 3
G232 Striatonigral degeneration 3
G238 Other specified degenerative diseases of basal ganglia 3
G239 Degenerative disease of basal ganglia, unspecified 3
G241 Genetic torsion dystonia 3
G242 Idiopathic nonfamilial dystonia 3
G244 Idiopathic orofacial dystonia 2
G248 Other dystonia 2
G249 Dystonia, unspecified 2
G253 Myoclonus 2
G2589 Other specified extrapyramidal and movement disorders 3
G259 Extrapyramidal and movement disorder, unspecified 3
G3181 Alpers disease 5
G3182 Leigh's disease 5
G3189 Other specified degenerative diseases of nervous system 3
G319 Degenerative disease of nervous system, unspecified 3
G3289 Other specified degenerative disorders of nervous system in diseases classified elsewhere 3
G35 Multiple sclerosis 5
G360 Neuromyelitis optica [Devic] 2
G361 Acute and subacute hemorrhagic leukoencephalitis [Hurst] 3
G368 Other specified acute disseminated demyelination 3
G369 Acute disseminated demyelination, unspecified 3
19
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
G371 Central demyelination of corpus callosum 3
G372 Central pontine myelinolysis 3
G373 Acute transverse myelitis in demyelinating disease of central nervous system 3
G374 Subacute necrotizing myelitis of central nervous system 2
G378 Other specified demyelinating diseases of central nervous system 3
G379 Demyelinating disease of central nervous system, unspecified 3
G40009
Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures
of localized onset, not intractable, without status epilepticus 3
G40019
Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures
of localized onset, intractable, without status epilepticus 5
G40109
Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple
partial seizures, not intractable, without status epilepticus 3
G40119
Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple
partial seizures, intractable, without status epilepticus 5G40209 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with 3G40219 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with 5
G40309 Generalized idiopathic epilepsy and epileptic syndromes, not intractable, without status 2
G40319 Generalized idiopathic epilepsy and epileptic syndromes, intractable, without status epilepticus 5
G40409 Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus 3
G40419 Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus 5
G40822 Epileptic spasms, not intractable, without status epilepticus 2
G40824 Epileptic spasms, intractable, without status epilepticus 5
G43A1 Cyclical vomiting, intractable 2
G459 Transient cerebral ischemic attack, unspecified 2
G4730 Sleep apnea, unspecified 2
G4731 Primary central sleep apnea 2
G4733 Obstructive sleep apnea 2
G4735 Congenital central alveolar hypoventilation 5
G508 Other disorders of trigeminal nerve 3
G509 Disorder of trigeminal nerve, unspecified 2
G510 Bell's palsy 2
G512 Melkersson's syndrome 3
G514 Facial myokymia 3
G518 Other disorders of facial nerve 3
G519 Disorder of facial nerve, unspecified 2
G527 Disorders of multiple cranial nerves 3
G529 Cranial nerve disorder, unspecified 2
G53 Cranial nerve disorders in diseases classified elsewhere 2
20
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
G540 Brachial plexus disorders 3
G600 Hereditary motor and sensory neuropathy 3
G601 Refsum's disease 5
G602 Neuropathy in association with hereditary ataxia 3
G609 Hereditary and Idiopathic Neuropathy, Unspecified 3 10/1/2017
G610 Guillain-Barre syndrome 2
G6181 Chronic inflammatory demyelinating polyneuritis 3
G629 Polyneuropathy, unspecified 2
G63 Polyneuropathy in diseases classified elsewhere 3
G7000 Myasthenia gravis without (acute) exacerbation 5
G7001 Myasthenia gravis with (acute) exacerbation 5
G702 Congenital and developmental myasthenia 5
G7089 Other specified myoneural disorders 5
G709 Myoneural disorder, unspecified 2
G710 Muscular dystrophy 5 9/30/2018
G7100 Muscular dystrophy, unspecified 5 10/1/2018
G7101 Duchenne or Becker muscular dystrophy 5 10/1/2018
G7102 Facioscapulohumeral muscular dystrophy 5 10/1/2018
G7109 Other specified muscular dystrophies 5 10/1/2018
G7111 Myotonic muscular dystrophy 5
G7112 Myotonia congenita 5
G7119 Other specified myotonic disorders 5
G712 Congenital myopathies 5
G718 Other primary disorders of muscles 2
G723 Periodic paralysis 5
G729 Myopathy, unspecified 2
G800 Spastic quadriplegic cerebral palsy 5
G801 Spastic diplegic cerebral palsy 5
G802 Spastic hemiplegic cerebral palsy 5
G803 Athetoid cerebral palsy 3
G804 Ataxic cerebral palsy 3
G808 Other cerebral palsy 5
G809 Cerebral palsy, unspecified 3
G8190 Hemiplegia, unspecified affecting unspecified side 3
G8220 Paraplegia, unspecified 5
G8250 Quadriplegia, unspecified 3
G8330 Monoplegia, unspecified affecting unspecified side 3
G834 Cauda equina syndrome 3
G8381 Brown-Sequard syndrome 2
G8382 Anterior cord syndrome 2
G8383 Posterior cord syndrome 2
21
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
G8389 Other specified paralytic syndromes 2
G839 Paralytic syndrome, unspecified 2
G901 Familial dysautonomia [Riley-Day] 2
G903 Multi-system degeneration of the autonomic nervous system 3
G910 Communicating hydrocephalus 3
G911 Obstructive hydrocephalus 3
G913 Post-traumatic hydrocephalus, unspecified 3
G914 Hydrocephalus in diseases classified elsewhere 3
G918 Other hydrocephalus 3
G919 Hydrocephalus, unspecified 3
G930 Cerebral cysts 3
G931 Anoxic brain damage, not elsewhere classified 2
G935 Compression of brain 2
G9389 Other specified disorders of brain 5
G939 Disorder of brain, unspecified 2
G94 Other disorders of brain in diseases classified elsewhere 3
G950 Syringomyelia and syringobulbia 3
G9511 Acute infarction of spinal cord (embolic) (nonembolic) 2
G9519 Other vascular myelopathies 2
G9520 Unspecified cord compression 3
G9529 Other cord compression 3
G9581 Conus medullaris syndrome 2
G9589 Other specified diseases of spinal cord 2
G959 Disease of spinal cord, unspecified 3
G960 Cerebrospinal fluid leak 2
G9619 Other disorders of meninges, not elsewhere classified 2
G968 Other specified disorders of central nervous system 3
G969 Disorder of central nervous system, unspecified 2
G9781 Other intraoperative complications of nervous system 2
G9782 Other postprocedural complications and disorders of nervous system 3
G988 Other disorders of nervous system 2
G992 Myelopathy in diseases classified elsewhere 2
G998 Other specified disorders of nervous system in diseases classified elsewhere 3
H0260 Xanthelasma of unspecified eye, unspecified eyelid 2
H15849 Scleral ectasia, unspecified eye 2
H1589 Other disorders of sclera 2
H159 Unspecified disorder of sclera 2
H16019 Central corneal ulcer, unspecified eye 2
H16079 Perforated corneal ulcer, unspecified eye 2
H16239 Neurotrophic keratoconjunctivitis, unspecified eye 2
H16309 Unspecified interstitial keratitis, unspecified eye 2
22
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
H16409 Unspecified corneal neovascularization, unspecified eye 2
H16429 Pannus (corneal), unspecified eye 2
H1710 Central corneal opacity, unspecified eye 2
H17829 Peripheral opacity of cornea, unspecified eye 2
H1789 Other corneal scars and opacities 2
H179 Unspecified corneal scar and opacity 2
H1840 Unspecified corneal degeneration 2
H18449 Keratomalacia, unspecified eye 2
H1852 Epithelial (juvenile) corneal dystrophy 3
H1853 Granular corneal dystrophy 3
H1859 Other hereditary corneal dystrophies 2
H18609 Keratoconus, unspecified, unspecified eye 2
H18719 Corneal ectasia, unspecified eye 2
H18799 Other corneal deformities, unspecified eye 3
H18839 Recurrent erosion of cornea, unspecified eye 2
H18899 Other specified disorders of cornea, unspecified eye 2
H189 Unspecified disorder of cornea 2
H209 Unspecified iridocyclitis 2
H211X9 Other vascular disorders of iris and ciliary body, unspecified eye 2
H21259 Iridoschisis, unspecified eye 2
H21309 Idiopathic cysts of iris, ciliary body or anterior chamber, unspecified eye 2
H2140 Pupillary membranes, unspecified eye 2
H21539 Iridodialysis, unspecified eye 2
H21549 Posterior synechiae (iris), unspecified eye 2
H2189 Other specified disorders of iris and ciliary body 2
H219 Unspecified disorder of iris and ciliary body 2
H22 Disorders of iris and ciliary body in diseases classified elsewhere 2
H26009 Unspecified infantile and juvenile cataract, unspecified eye 2
H26019 Infantile and juvenile cortical, lamellar, or zonular cataract, unspecified eye 2
H26059 Posterior subcapsular polar infantile and juvenile cataract, unspecified eye 2
H26069 Combined forms of infantile and juvenile cataract, unspecified eye 2
H2609 Other infantile and juvenile cataract 2
H26109 Unspecified traumatic cataract, unspecified eye 2
H26129 Partially resolved traumatic cataract, unspecified eye 2
H26139 Total traumatic cataract, unspecified eye 2
H26219 Cataract with neovascularization, unspecified eye 2
H26229 Cataract secondary to ocular disorders (degenerative) (inflammatory), unspecified eye 2
H2630 Drug-induced cataract, unspecified eye 2
H2640 Unspecified secondary cataract 2
H268 Other specified cataract 2
H269 Unspecified cataract 2
23
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
H2700 Aphakia, unspecified eye 3
H2710 Unspecified dislocation of lens 2
H27119 Subluxation of lens, unspecified eye 2
H278 Other specified disorders of lens 2
H279 Unspecified disorder of lens 2
H28 Cataract in diseases classified elsewhere 2
H30149 Acute posterior multifocal placoid pigment epitheliopathy, unspecified eye 2
H3020 Posterior cyclitis, unspecified eye 2
H30819 Harada's disease, unspecified eye 2
H30899 Other chorioretinal inflammations, unspecified eye 2
H3090 Unspecified chorioretinal inflammation, unspecified eye 2
H31119 Age-related choroidal atrophy, unspecified eye 2
H3121 Choroideremia 2
H3129 Other hereditary choroidal dystrophy 2
H33009 Unspecified retinal detachment with retinal break, unspecified eye 2
H33109 Unspecified retinoschisis, unspecified eye 2
H33199 Other retinoschisis and retinal cysts, unspecified eye 2
H3320 Serous retinal detachment, unspecified eye 2
H3340 Traction detachment of retina, unspecified eye 2
H338 Other retinal detachments 2
H349 Unspecified retinal vascular occlusion 2
H35019 Changes in retinal vascular appearance, unspecified eye 2
H35029 Exudative retinopathy, unspecified eye 2
H35059 Retinal neovascularization, unspecified, unspecified eye 2
H35069 Retinal vasculitis, unspecified eye 2
H35109 Retinopathy of prematurity, unspecified, unspecified eye 2
H35169 Retinopathy of prematurity, stage 5, unspecified eye 2
H35179 Retrolental fibroplasia, unspecified eye 2
H3520 Other non-diabetic proliferative retinopathy, unspecified eye 2
H3540 Unspecified peripheral retinal degeneration 2
H35419 Lattice degeneration of retina, unspecified eye 2
H35429 Microcystoid degeneration of retina, unspecified eye 2
H35459 Secondary pigmentary degeneration, unspecified eye 2
H35469 Secondary vitreoretinal degeneration, unspecified eye 2
H3550 Unspecified hereditary retinal dystrophy 2
H3551 Vitreoretinal dystrophy 2
H3552 Pigmentary retinal dystrophy 5
H3553 Other dystrophies primarily involving the sensory retina 2
H3554 Dystrophies primarily involving the retinal pigment epithelium 2
H3560 Retinal hemorrhage, unspecified eye 2
H35739 Hemorrhagic detachment of retinal pigment epithelium, unspecified eye 2
24
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
H3582 Retinal ischemia 2
H36 Retinal disorders in diseases classified elsewhere 2
H40009 Preglaucoma, unspecified , unspecified eye 2
H4010x0 Unspecified open-angle glaucoma, stage unspecified 2
H401190 Primary open-angle glaucoma unspecified eye, stage unspecified 2 10/1/2016
H4011x0 Primary open-angle glaucoma, stage unspecified 2 9/30/2016
H401290 Low-tension glaucoma, unspecified eye, stage unspecified 2
H4020x0 Unspecified primary angle-closure glaucoma, stage unspecified 2
H4030x0 Glaucoma secondary to eye trauma, unspecified eye, stage unspecified 2
H4040x0 Glaucoma secondary to eye inflammation, unspecified eye, stage unspecified 2
H4050x0 Glaucoma secondary to other eye disorders, unspecified eye, stage unspecified 2
H4089 Other specified glaucoma 2
H409 Unspecified glaucoma 2
H42 Glaucoma in diseases classified elsewhere 3
H4310 Vitreous hemorrhage, unspecified eye 2
H44009 Unspecified purulent endophthalmitis, unspecified eye 2
H44119 Panuveitis, unspecified eye 2
H44139 Sympathetic uveitis, unspecified eye 2
H442A9 Degenerative myopia with choroidal neovascularization, unspecified eye 2 10/1/2017
H442C9 Degenerative myopia with retinal detachment, unspecified eye 2 10/1/2017
H449 Unspecified disorder of globe 2
H47019 Ischemic optic neuropathy, unspecified eye 2
H47029 Hemorrhage in optic nerve sheath, unspecified eye 2
H47039 Optic nerve hypoplasia, unspecified eye 2
H47099 Other disorders of optic nerve, not elsewhere classified, unspecified eye 2
H4720 Unspecified optic atrophy 2
H47219 Primary optic atrophy, unspecified eye 2
H4722 Hereditary optic atrophy 2
H47239 Glaucomatous optic atrophy, unspecified eye 2
H47299 Other optic atrophy, unspecified eye 2
H47319 Coloboma of optic disc, unspecified eye 2
H47329 Drusen of optic disc, unspecified eye 2
H4742 Disorders of optic chiasm in (due to) neoplasm 2
H47529 Disorders of visual pathways in (due to) neoplasm, unspecified side 2
H47619 Cortical blindness, unspecified side of brain 2
H479 Unspecified disorder of visual pathways 2
H4900 Third [oculomotor] nerve palsy, unspecified eye 2
H4910 Fourth [trochlear] nerve palsy, unspecified eye 2
H4920 Sixth [abducent] nerve palsy, unspecified eye 2
H4940 Progressive external ophthalmoplegia, unspecified eye 2
H49889 Other paralytic strabismus, unspecified eye 2
25
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
H499 Unspecified paralytic strabismus 2
H5000 Unspecified esotropia 2
H5005 Alternating esotropia 2
H5006 Alternating esotropia with A pattern 2
H5007 Alternating esotropia with V pattern 2
H5010 Unspecified exotropia 2
H5015 Alternating exotropia 2
H5017 Alternating exotropia with V pattern 2
H5021 Vertical strabismus, right eye 2
H5030 Unspecified intermittent heterotropia 2
H5034 Intermittent alternating exotropia 2
H5042 Monofixation syndrome 2
H5043 Accommodative component in esotropia 2
H5051 Esophoria 2
H5060 Mechanical strabismus, unspecified 2
H5069 Other mechanical strabismus 2
H50811 Duane's syndrome, right eye 3
H509 Unspecified strabismus 2
H5111 Convergence insufficiency 2
H518 Other specified disorders of binocular movement 2
H519 Unspecified disorder of binocular movement 2
H5501 Congenital nystagmus 2
H61309 Acquired stenosis of external ear canal, unspecified, unspecified ear 2
H61399 Other acquired stenosis of external ear canal, unspecified ear 2
H6520 Chronic serous otitis media, unspecified ear 2
H6530 Chronic mucoid otitis media, unspecified ear 2
H65499 Other chronic nonsuppurative otitis media, unspecified ear 2
H6610 Chronic tubotympanic suppurative otitis media, unspecified 2
H6620 Chronic atticoantral suppurative otitis media, unspecified ear 2
H663X9 Other chronic suppurative otitis media, unspecified ear 2
H68109 Unspecified obstruction of Eustachian tube, unspecified ear 2
H6980 Other specified disorders of Eustachian tube, unspecified ear 2
H7010 Chronic mastoiditis, unspecified ear 2
H70229 Chronic petrositis, unspecified ear 2
H70899 Other mastoiditis and related conditions, unspecified ear 2
H7190 Unspecified cholesteatoma, unspecified ear 2
H7310 Chronic myringitis, unspecified ear 2
H7390 Unspecified disorder of tympanic membrane, unspecified ear 2
H7409 Tympanosclerosis, unspecified ear 2
H7419 Adhesive middle ear disease, unspecified ear 2
H74319 Ankylosis of ear ossicles, unspecified ear 2
26
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
H748X9 Other specified disorders of middle ear and mastoid, unspecified ear 2
H7490 Unspecified disorder of middle ear and mastoid, unspecified ear 2
H7500 Mastoiditis in infectious and parasitic diseases classified elsewhere, unspecified ear 2
H7580
Other specified disorders of middle ear and mastoid in diseases classified elsewhere,
unspecified ear 2
H818X9 Other disorders of vestibular function, unspecified ear 2
H829 Vertiginous syndromes in diseases classified elsewhere, unspecified ear 2
H8319 Labyrinthine fistula, unspecified ear 2
H838X9 Other specified diseases of inner ear, unspecified ear 2
H902 Conductive hearing loss, unspecified 2
H905 Unspecified sensorineural hearing loss 5
H908 Mixed conductive and sensorineural hearing loss, unspecified 1
H93219 Auditory recruitment, unspecified ear 2
H9390 Unspecified disorder of ear, unspecified ear 2
H9500 Recurrent cholesteatoma of postmastoidectomy cavity, unspecified ear 2
H95119 Chronic inflammation of postmastoidectomy cavity, unspecified ear 2
H95139 Mucosal cyst of postmastoidectomy cavity, unspecified ear 2
H95199 Other disorders following mastoidectomy, unspecified ear 2
I018 Other acute rheumatic heart disease 3
I019 Acute rheumatic heart disease, unspecified 3
I020 Rheumatic chorea with heart involvement 3
I029 Rheumatic chorea without heart involvement 3
I050 Rheumatic mitral stenosis 3
I051 Rheumatic mitral insufficiency 3
I052 Rheumatic mitral stenosis with insufficiency 3
I058 Other rheumatic mitral valve diseases 3
I059 Rheumatic mitral valve disease, unspecified 3
I061 Rheumatic aortic insufficiency 3
I070 Rheumatic tricuspid stenosis 3
I071 Rheumatic tricuspid insufficiency 3
I072 Rheumatic tricuspid stenosis and insufficiency 3
I078 Other rheumatic tricuspid valve diseases 3
I079 Rheumatic tricuspid valve disease, unspecified 3
I080 Rheumatic disorders of both mitral and aortic valves 3
I089 Rheumatic multiple valve disease, unspecified 3
I10 Essential (primary) hypertension 2
I110 Hypertensive heart disease with heart failure 3
I119 Hypertensive heart disease without heart failure 2
I120
Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal
disease 3
27
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
I129
Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or
unspecified chronic kidney disease 3
I1310
Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through
stage 4 chronic kidney disease, or unspecified chronic kidney disease 3
I1311
Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic
kidney disease, or end stage renal disease 3
I132
Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic
kidney disease, or end stage renal disease 3
I150 Renovascular hypertension 2
I151 Hypertension secondary to other renal disorders 2
I152 Hypertension secondary to endocrine disorders 2
I158 Other secondary hypertension 2
I159 Secondary hypertension, unspecified 2
I213 ST elevation (STEMI) myocardial infarction of unspecified site 2
I219 Acute myocardial infarction, unspecified 2 10/1/2017
I21A9 Other myocardial infarction type 2 10/1/2017
I229 Subsequent ST elevation (STEMI) myocardial infarction of unspecified site 2
I2541 Coronary artery aneurysm 2
I255 Ischemic cardiomyopathy 2
I256 Silent myocardial ischemia 2
I2589 Other forms of chronic ischemic heart disease 2
I259 Chronic ischemic heart disease, unspecified 2
I270 Primary pulmonary hypertension 2
I272 Other secondary pulmonary hypertension 2 9/30/2017
I2720 Pulmonary hypertension, unspecified 2 10/1/2017
I2721 Secondary pulmonary arterial hypertension 2 10/1/2017
I2781 Cor pulmonale (chronic) 2
I2782 Chronic pulmonary embolism 2
I2783 Eisenmenger's syndrome 2 10/1/2017
I2789 Other specified pulmonary heart diseases 2
I279 Pulmonary heart disease, unspecified 2
I288 Other diseases of pulmonary vessels 2
I289 Disease of pulmonary vessels, unspecified 2
I311 Chronic constrictive pericarditis 2
I313 Pericardial effusion (noninflammatory) 2
I318 Other specified diseases of pericardium 2
I319 Disease of pericardium, unspecified 2
I330 Acute and subacute infective endocarditis 2
I339 Acute and subacute endocarditis, unspecified 2
I340 Nonrheumatic mitral (valve) insufficiency 3
I341 Nonrheumatic mitral (valve) prolapse 3
28
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
I342 Nonrheumatic mitral (valve) stenosis 3
I348 Other nonrheumatic mitral valve disorders 3
I349 Nonrheumatic mitral valve disorder, unspecified 3
I350 Nonrheumatic aortic (valve) stenosis 3
I351 Nonrheumatic aortic (valve) insufficiency 3
I352 Nonrheumatic aortic (valve) stenosis with insufficiency 3
I358 Other nonrheumatic aortic valve disorders 3
I359 Nonrheumatic aortic valve disorder, unspecified 3
I360 Nonrheumatic tricuspid (valve) stenosis 3
I361 Nonrheumatic tricuspid (valve) insufficiency 3
I362 Nonrheumatic tricuspid (valve) stenosis with insufficiency 3
I368 Other nonrheumatic tricuspid valve disorders 3
I369 Nonrheumatic tricuspid valve disorder, unspecified 3
I370 Nonrheumatic pulmonary valve stenosis 3
I371 Nonrheumatic pulmonary valve insufficiency 3
I372 Nonrheumatic pulmonary valve stenosis with insufficiency 3
I378 Other nonrheumatic pulmonary valve disorders 3
I379 Nonrheumatic pulmonary valve disorder, unspecified 3
I38 Endocarditis, valve unspecified 3
I400 Infective myocarditis 2
I401 Isolated myocarditis 2
I408 Other acute myocarditis 2
I409 Acute myocarditis, unspecified 2
I420 Dilated cardiomyopathy 3
I421 Obstructive hypertrophic cardiomyopathy 3
I422 Other hypertrophic cardiomyopathy 3
I423 Endomyocardial (eosinophilic) disease 3
I424 Endocardial fibroelastosis 3
I425 Other restrictive cardiomyopathy 3
I427 Cardiomyopathy due to drug and external agent 3
I428 Other cardiomyopathies 3
I429 Cardiomyopathy, unspecified 3
I43 Cardiomyopathy in diseases classified elsewhere 3
I440 Atrioventricular block, first degree 3
I441 Atrioventricular block, second degree 3
I442 Atrioventricular block, complete 3
I4430 Unspecified atrioventricular block 3
I4439 Other atrioventricular block 3
I450 Right fascicular block 3
I4510 Unspecified right bundle-branch block 3
I4519 Other right bundle-branch block 3
29
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
I454 Nonspecific intraventricular block 3
I455 Other specified heart block 3
I456 Pre-excitation syndrome 3
I4589 Other specified conduction disorders 3
I459 Conduction disorder, unspecified 2
I471 Supraventricular tachycardia 3
I480 Paroxysmal atrial fibrillation 3
I481 Persistent atrial fibrillation 3
I482 Chronic atrial fibrillation 3
I483 Typical atrial flutter 3
I484 Atypical atrial flutter 3
I4891 Unspecified atrial fibrillation 3
I4892 Unspecified atrial flutter 3
I492 Junctional premature depolarization 3
I501 Left ventricular failure 2
I5020 Unspecified systolic (congestive) heart failure 2
I5030 Unspecified diastolic (congestive) heart failure 2
I5040 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure 2
I50810 Right heart failure, unspecified 2 10/1/2017
I5082 Biventricular heart failure 2 10/1/2017
I5083 High output heart failure 2 10/1/2017
I5084 End stage heart failure 2 10/1/2017
I5089 Other heart failure 2 10/1/2017
I509 Heart failure, unspecified 2
I514 Myocarditis, unspecified 2
I515 Myocardial degeneration 2
I517 Cardiomegaly 2
I519 Heart disease, unspecified 2
I52 Other heart disorders in diseases classified elsewhere 2
I609 Nontraumatic subarachnoid hemorrhage, unspecified 2
I619 Nontraumatic intracerebral hemorrhage, unspecified 2
I6200 Nontraumatic subdural hemorrhage, unspecified 2
I669 Occlusion and stenosis of unspecified cerebral artery 2
I671 Cerebral aneurysm, nonruptured 2
I675 Moyamoya disease 5
I677 Cerebral arteritis, not elsewhere classified 2
I67841 Reversible cerebrovascular vasoconstriction syndrome 2
I67848 Other cerebrovascular vasospasm and vasoconstriction 2
I6789 Other cerebrovascular disease 2
I6900 Unspecified sequelae of nontraumatic subarachnoid hemorrhage 2
30
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
I69059
Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting
unspecified side 2
I69098 Other sequelae following nontraumatic subarachnoid hemorrhage 2
I6910 Unspecified sequelae of nontraumatic intracerebral hemorrhage 2
I69159
Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting
unspecified side 5
I69198 Other sequelae of nontraumatic intracerebral hemorrhage 5
I6920 Unspecified sequelae of other nontraumatic intracranial hemorrhage 2
I69259
Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting
unspecified side 5
I69298 Other sequelae of other nontraumatic intracranial hemorrhage 5
I6930 Unspecified sequelae of cerebral infarction 2
I69359 Hemiplegia and hemiparesis following cerebral infarction affecting unspecified side 5
I69398 Other sequelae of cerebral infarction 5
I6980 Unspecified sequelae of other cerebrovascular disease 2
I69859 Hemiplegia and hemiparesis following other cerebrovascular disease affecting unspecified side 5
I69898 Other sequelae of other cerebrovascular disease 5
I6990 Unspecified sequelae of unspecified cerebrovascular disease 2
I6991 Cognitive deficits following unspecified cerebrovascular disease 2 9/30/2016
I69919 Unspecified symptoms and signs involving cognitive functions following unspecified cerebrovascular disease2 10/1/2016
I69920 Aphasia following unspecified cerebrovascular disease 2
I69959
Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting
unspecified side 5
I69998 Other sequelae following unspecified cerebrovascular disease 5
I728 Aneurysm of other specified arteries 2
I739 Peripheral vascular disease, unspecified 2
I748 Embolism and thrombosis of other arteries 2
I749 Embolism and thrombosis of unspecified artery 2
I776 Arteritis, unspecified 3
I780 Hereditary hemorrhagic telangiectasia 3
I823 Embolism and thrombosis of renal vein 2
I82891 Chronic embolism and thrombosis of other specified veins 2
I8291 Chronic embolism and thrombosis of unspecified vein 2
I890 Lymphedema, not elsewhere classified 3
I96 Gangrene, not elsewhere classified 2
J3800 Paralysis of vocal cords and larynx, unspecified 2
J3801 Paralysis of vocal cords and larynx, unilateral 3
J381 Polyp of vocal cord and larynx 2
J386 Stenosis of larynx 2
J42 Unspecified chronic bronchitis 2
31
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
J439 Emphysema, unspecified 3
J4540 Moderate persistent asthma, uncomplicated 3
J4550 Severe persistent asthma, uncomplicated 3
J45998 Other asthma 2
J479 Bronchiectasis, uncomplicated 2
J8403 Idiopathic pulmonary hemosiderosis 3
J8409 Other alveolar and parieto-alveolar conditions 3
J8410 Pulmonary fibrosis, unspecified 3
J84111 Idiopathic interstitial pneumonia, not otherwise specified 3
J84112 Idiopathic pulmonary fibrosis 3
J84113 Idiopathic non-specific interstitial pneumonitis 3
J84114 Acute interstitial pneumonitis 3
J84115 Respiratory bronchiolitis interstitial lung disease 3
J84116 Cryptogenic organizing pneumonia 2
J8417 Other interstitial pulmonary diseases with fibrosis in diseases classified elsewhere 3
J8489 Other specified interstitial pulmonary diseases 3
J853 Abscess of mediastinum 2
J860 Pyothorax with fistula 2
J869 Pyothorax without fistula 2
J9500 Unspecified tracheostomy complication 2
J951 Acute pulmonary insufficiency following thoracic surgery 2
J952 Acute pulmonary insufficiency following nonthoracic surgery 2
J953 Chronic pulmonary insufficiency following surgery 2
J95821 Acute postprocedural respiratory failure 2
J95822 Acute and chronic postprocedural respiratory failure 2
J982 Interstitial emphysema 3
J984 Other disorders of lung 2
J989 Respiratory disorder, unspecified 2
K000 Anodontia 3
K004 Disturbances in tooth formation 3
K005 Hereditary disturbances in tooth structure, not elsewhere classified 3
K0389 Other specified diseases of hard tissues of teeth 3
K222 Esophageal obstruction 2
K5000 Crohn's disease of small intestine without complications 3
K50019 Crohn's disease of small intestine with unspecified complications 3
K5010 Crohn's disease of large intestine without complications 3
K50119 Crohn's disease of large intestine with unspecified complications 3
K5080 Crohn's disease of both small and large intestine without complications 3
K50819 Crohn's disease of both small and large intestine with unspecified complications 3
K5090 Crohn's disease, unspecified, without complications 3
K50919 Crohn's disease, unspecified, with unspecified complications 3
32
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
K5100 Ulcerative (chronic) pancolitis without complications 5
K5190 Ulcerative colitis, unspecified, without complications 3
K51919 Ulcerative colitis, unspecified with unspecified complications 3
K522 Allergic and dietetic gastroenteritis and colitis 2 9/30/2016
K5221 Allergic & Dietetic Gastroenteritis and Colitis 2 10/1/2017
K5229 Other allergic dietetic gastroenteritis colitis 2 10/1/2016
K5281 Eosinophilic gastritis or gastroenteritis 2
K5282 Eosinophilic colitis 2
K529 Noninfective gastroenteritis and colitis, unspecified 2
K550 Acute vascular disorders of intestine 2 9/30/2016
K551 Chronic vascular disorders of intestine 2 10/1/2016
K592 Neurogenic bowel, not elsewhere classified 1
K717 Toxic liver disease with fibrosis and cirrhosis of liver 3
K7290 Hepatitic failure, unspecified without coma 3
K7291 Hepatitic failure, unspecified with coma 3
K730 Chronic persistent hepatitis, not elsewhere classified 3
K731 Chronic lobular hepatitis, not elsewhere classified 3
K732 Chronic active hepatitis, not elsewhere classified 3
K738 Other chronic hepatitis, not elsewhere classified 3
K739 Chronic hepatitis, unspecified 2
K740 Hepatic fibrosis 3
K745 Biliary cirrhosis, unspecified 3
K7460 Unspecified cirrhosis of liver 3
K7469 Other cirrhosis of liver 3
K754 Autoimmune hepatitis 3
K766 Portal hypertension 3
K835 Biliary cyst 2
K838 Other specified diseases of biliary tract 2
K861 Other chronic pancreatitis 2
K868 Other specified diseases of pancreas 2 9/30/2016
K8681 Exocrine pancreatic insufficiency 2 10/1/2016
K8689 Other specified diseases of pancreas 2 10/1/2016
K87 Disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere 2
K900 Celiac disease 3
K902 Blind loop syndrome, not elsewhere classified 2
K903 Pancreatic steatorrhea 3
K904 Malabsorption due to intolerance, not elsewhere classified 2 9/30/2016
K9049 Malabsorption due to intolerance not elswhere classified 2 10/1/2016
K9089 Other intestinal malabsorption 2
K909 Intestinal malabsorption, unspecified 3
K912 Postsurgical malabsorption, not elsewhere classified 3
33
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
L109 Pemphigus, unspecified 5
L400 Psoriasis vulgaris 3
L404 Guttate psoriasis 3
L4050 Arthropathic psoriasis, unspecified 5
L4059 Other psoriatic arthropathy 5
L408 Other psoriasis 3
L409 Psoriasis, unspecified 3
L511 Stevens-Johnson syndrome 2
L512 Toxic epidermal necrolysis [Lyell] 2
L518 Other erythema multiforme 3
L599 Disorder of the skin and subcutaneous tissue related to radiation, unspecified 2
L905 Scar conditions and fibrosis of skin 2
L930 Discoid lupus erythematosus 3
L931 Subacute cutaneous lupus erythematosus 3
L932 Other local lupus erythematosus 3
L940 Localized scleroderma 5
M009 Pyogenic arthritis, unspecified 2
M01X0 Direct infection of unspecified joint in infectious and parasitic diseases classified elsewhere 2
M029 Reactive arthropathy, unspecified 2
M041 Periodic fever syndromes 3 10/1/2016
M0520 Rheumatoid vasculitis with rheumatoid arthritis of unspecified site 3
M0530 Rheumatoid heart disease with rheumatoid arthritis of unspecified site 3
M0540 Rheumatoid myopathy with rheumatoid arthritis of unspecified site 3
M0550 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified site 3
M0560 Rheumatoid arthritis of unspecified site with involvement of other organs and systems 3
M0570
Rheumatoid arthritis with rheumatoid factor of unspecified site without organ or systems
involvement 3
M0580 Other rheumatoid arthritis with rheumatoid factor of unspecified site 3
M059 Rheumatoid arthritis with rheumatoid factor, unspecified 3
M0600 Rheumatoid arthritis without rheumatoid factor, unspecified site 3
M061 Adult-onset Still's disease 3
M0620 Rheumatoid bursitis, unspecified site 3
M0630 Rheumatoid nodule, unspecified site 3
M064 Inflammatory polyarthropathy 2
M0680 Other specified rheumatoid arthritis, unspecified site 3
M069 Rheumatoid arthritis, unspecified 3
M0760 Enteropathic arthropathies, unspecified site 2
M0800 Unspecified juvenile rheumatoid arthritis of unspecified site 3
M081 Juvenile ankylosing spondylitis 5
M0820 Juvenile rheumatoid arthritis with systemic onset, unspecified site 3
34
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
M083 Juvenile rheumatoid polyarthritis (seronegative) 3
M0840 Pauciarticular juvenile rheumatoid arthritis, unspecified site 3
M0880 Other juvenile arthritis, unspecified site 3
M0890 Juvenile arthritis, unspecified, unspecified site 3
M1280 Other specific arthropathies, not elsewhere classified, unspecified site 2
M1460 Charcot's joint, unspecified site 2
M1480 Arthropathies in other specified diseases classified elsewhere, unspecified site 2
M151 Heberden's nodes (with arthropathy) 2
M152 Bouchard's nodes (with arthropathy) 3
M1990 Unspecified osteoarthritis, unspecified site 2
M1A10x0 Lead-induced chronic gout, unspecified site, without tophus (tophi) 2
M1A10x1 Lead-induced chronic gout, unspecified site, with tophus (tophi) 2
M2100 Valgus deformity, not elsewhere classified, unspecified site 3
M21059 Valgus deformity, not elsewhere classified, unspecified hip 2
M21069 Valgus deformity, not elsewhere classified, unspecified knee 2
M21129 Varus deformity, not elsewhere classified, unspecified elbow 2
M21159 Varus deformity, not elsewhere classified, unspecified 2
M21169 Varus deformity, not elsewhere classified, unspecified knee 2
M2120 Flexion deformity, unspecified site 3
M21379 Foot drop, unspecified foot 2
M21519 Acquired clawhand, unspecified hand 2
M21539 Acquired clawfoot, unspecified foot 2
M21549 Acquired clubfoot, unspecified foot 2
M216X9 Other acquired deformities of unspecified foot 2
M2170 Unequal limb length (acquired), unspecified site 3
M2180 Other specified acquired deformities of unspecified limb 2
M21859 Other specified acquired deformities of unspecified thigh 2
M21869 Other specified acquired deformities of unspecified lower leg 2
M2190 Unspecified acquired deformity of unspecified limb 3
M21939 Unspecified acquired deformity of unspecified forearm 2
M21959 Unspecified acquired deformity of unspecified thigh 2
M21969 Unspecified acquired deformity of unspecified lower leg 2
M2410 Other articular cartilage disorders, unspecified site 2
M2430 Pathological dislocation of unspecified joint, not elsewhere classified 2
M2440 Recurrent dislocation, unspecified joint 2
M2450 Contracture, unspecified joint 2
M24659 Ankylosis, unspecified hip 2
M2480 Other specific joint derangements of unspecified joint, not elsewhere classified 2
M24859 Other specific joint derangements of unspecified hip, not elsewhere classified 3
M2510 Fistula, unspecified joint 2
M2518 Fistula, vertebrae 2
35
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
M2520 Flail joint, unspecified joint 2
M2530 Other instability, unspecified joint 2
M2580 Other specified joint disorders, unspecified joint 2
M25859 Other specified joint disorders, unspecified hip 2
M25869 Other specified joint disorders, unspecified knee 2
M259 Joint disorder, unspecified 2
M2600 Unspecified anomaly of jaw size 3
M2610 Unspecified anomaly of jaw-cranial base relationship 3
M2620 Unspecified anomaly of dental arch relationship 3
M26212 Malocclusion, Angle's class II 3
M26213 Malocclusion, Angle's class III 3
M26219 Malocclusion, Angle's class, unspecified 3
M264 Malocclusion, unspecified 3
M2650 Dentofacial functional abnormalities, unspecified 2
M2659 Other dentofacial functional abnormalities 2
M2660 Temporomandibular joint disorder, unspecified 2 9/30/2016
M26609 Unspecified temporomandibular joint disorder unspecfied side 2 10/1/2016
M2662 Arthralgia of temporomandibular joint 2 9/30/2016
M2669 Other specified disorders of temporomandibular joint 2
M2689 Other dentofacial anomalies 3
M269 Dentofacial anomaly, unspecified 3
M300 Polyarteritis nodosa 5
M301 Polyarteritis with lung involvement [Churg-Strauss] 5
M302 Juvenile polyarteritis 3
M303 Mucocutaneous lymph node syndrome [Kawasaki] 2
M311 Thrombotic microangiopathy 5
M3130 Wegener's granulomatosis without renal involvement 5
M3131 Wegener's granulomatosis with renal involvement 5
M314 Aortic arch syndrome [Takayasu] 5
M329 Systemic lupus erythematosus, unspecified 5
M3300 Juvenile dermatopolymyositis, organ involvement unspecified 5
M3303 Juvenile dermatomyositis without myopathy 5 10/1/2017
M3310 Other dermatopolymyositis, organ involvement unspecified 5
M3313 Other dermatomyositis without myopathy 5 10/1/2017
M3320 Polymyositis, organ involvement unspecified 5
M3390 Dermatopolymyositis, unspecified, organ involvement unspecified 5
M3393 Dermatopolymyositis, unspecified without myopathy 5 10/1/2017
M340 Progressive systemic sclerosis 5
M341 CR(E)ST syndrome 5
M3481 Systemic sclerosis with lung involvement 5
M349 Systemic sclerosis, unspecified 5
36
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
M3500 Sicca syndrome (Sjogren), unspecified 5
M351 Other overlap syndromes 3
M352 Behcet's disease 2
M354 Diffuse (eosinophilic) fasciitis 2
M355 Multifocal fibrosclerosis 3
M358 Other specified systemic involvement of connective tissue 3
M359 Systemic involvement of connective tissue, unspecified 2
M360 Dermato(poly)myositis in neoplastic disease 5
M361 Arthropathy in neoplastic disease 2
M362 Hemophilic arthropathy 2
M363 Arthropathy in other blood disorder 2
M368 Systemic disorders of connective tissue in other diseases classified elsewhere 2
M4000 Postural kyphosis, site unspecified 2
M4010 Other secondary kyphosis, site unspecified 3
M40209 Unspecified kyphosis, site unspecified 2
M40299 Other kyphosis, site unspecified 2
M4100 Infantile idiopathic scoliosis, site unspecified 2
M41119 Juvenile idiopathic scoliosis, site unspecified 2
M41129 Adolescent idiopathic scoliosis, site unspecified 2
M4120 Other idiopathic scoliosis, site unspecified 2
M4130 Thoracogenic scoliosis, site unspecified 2
M4140 Neuromuscular scoliosis, site unspecified 3
M4150 Other secondary scoliosis, site unspecified 3
M4180 Other forms of scoliosis, site unspecified 2
M419 Scoliosis, unspecified 2
M4200 Juvenile osteochondrosis of spine, site unspecified 2
M429 Spinal osteochondrosis, unspecified 2
M435X9 Other recurrent vertebral dislocation, site unspecified 2
M438X9 Other specified deforming dorsopathies, site unspecified 3
M439 Deforming dorsopathy, unspecified 2
M459 Ankylosing spondylitis of unspecified sites in spine 5
M4690 Unspecified inflammatory spondylopathy, site unspecified 2
M4699 Unspecified inflammatory spondylopathy, multiple sites in spine 2
M4720 Other spondylosis with radiculopathy, site unspecified 2
M47819 Spondylosis without myelopathy or radiculopathy, site unspecified 2
M47892 Other spondylosis, cervical region 2
M47897 Other spondylosis, lumbosacral region 2
M47899 Other spondylosis, site unspecified 2
M479 Spondylosis, unspecified 2
M4800 Spinal stenosis, site unspecified 2
M4840xS Fatigue fracture of vertebra, site unspecified, sequela of fracture 2
37
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
M4850xS Collapsed vertebra, not elsewhere classified, site unspecified, sequela of fracture 2
M488X9 Other specified spondylopathies, site unspecified 5
M489 Spondylopathy, unspecified 2
M5106 Intervertebral disc disorders with myelopathy, lumbar region 2
M5127 Other intervertebral disc displacement, lumbosacral region 2
M519 Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder 2
M532X9 Spinal instabilities, site unspecified 2
M5381 Other specified dorsopathies, occipito-atlanto-axial region 2
M6110 Myositis ossificans progressiva, unspecified site 5
M6220 Nontraumatic ischemic infarction of muscle, unspecified site 2
M623 Immobility syndrome (paraplegic) 2
M6250 Muscle wasting and atrophy, not elsewhere classified, unspecified site 2
M6289 Other specified disorders of muscle 2
M6700 Short Achilles tendon (acquired), unspecified ankle 2
M8080xK
Other osteoporosis with current pathological fracture, unspecified site, subsequent encounter
for fracture with nonunion 2
M8430xK Stress fracture, unspecified site, subsequent encounter for fracture with nonunion 2
M8430xS Stress fracture, unspecified site, sequela 2
M8438xK Stress fracture, other site, subsequent encounter for fracture with nonunion 2
M8440xK Pathological fracture, unspecified site, subsequent encounter for fracture with nonunion 2
M8440xS Pathological fracture, unspecified site, sequela 2
M84550S Pathological fracture in neoplastic disease, pelvis, sequela 2
M8458xS Pathological fracture in neoplastic disease, vertebrae, sequela 2
M8460xK
Pathological fracture in other disease, unspecified site, subsequent encounter for fracture with
nonunion 2
M84669S Pathological fracture in other disease, unspecified tibia and fibula, sequela 2
M84673S Pathological fracture in other disease, unspecified ankle, sequela 2
M84676S Pathological fracture in other disease, unspecified foot, sequela 2
M8560 Other cyst of bone, unspecified site 2
M8630 Chronic multifocal osteomyelitis, unspecified site 2
M8640 Chronic osteomyelitis with draining sinus, unspecified site 2
M8650 Other chronic hematogenous osteomyelitis, unspecified site 2
M8660 Other chronic osteomyelitis, unspecified site 2
M868X9 Other osteomyelitis, unspecified sites 2
M8700 Idiopathic aseptic necrosis of unspecified bone 2
M8710 Osteonecrosis due to drugs, unspecified bone 2
M8720 Osteonecrosis due to previous trauma, unspecified bone 2
M8730 Other secondary osteonecrosis, unspecified bone 2
M8780 Other osteonecrosis, unspecified bone 2
M879 Osteonecrosis, unspecified 2
M9058 Osteonecrosis in diseases classified elsewhere, other site 2
38
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
M910 Juvenile osteochondrosis of pelvis 2
M9110 Juvenile osteochondrosis of head of femur [Legg-Calve-Perthes], unspecified leg 2
M9120 Coxa plana, unspecified hip 2
M9130 Pseudocoxalgia, unspecified hip 2
M9140 Coxa magna, unspecified hip 2
M9180 Other juvenile osteochondrosis of hip and pelvis, unspecified leg 2
M9190 Juvenile osteochondrosis of hip and pelvis, unspecified, unspecified leg 2
M9200 Juvenile osteochondrosis of humerus, unspecified arm 2
M9210 Juvenile osteochondrosis of radius and ulna, unspecified arm 2
M92209 Unspecified juvenile osteochondrosis, unspecified hand 2
M92219 Osteochondrosis (juvenile) of carpal lunate [Kienbock], unspecified hand 2
M92229 Osteochondrosis (juvenile) of metacarpal heads [Mauclaire], unspecified hand 2
M92299 Other juvenile osteochondrosis, unspecified hand 2
M9230 Other juvenile osteochondrosis, unspecified upper limb 2
M9240 Juvenile osteochondrosis of patella, unspecified knee 2
M9250 Juvenile osteochondrosis of tibia and fibula, unspecified leg 2
M9260 Juvenile osteochondrosis of tarsus, unspecified ankle 2
M9270 Juvenile osteochondrosis of metatarsus, unspecified foot 2
M93003 Unspecified slipped upper femoral epiphysis (nontraumatic), unspecified hip 2
M93013 Acute slipped upper femoral epiphysis (nontraumatic), unspecified hip 2
M93023 Chronic slipped upper femoral epiphysis (nontraumatic), unspecified hip 2
M93033 Acute on chronic slipped upper femoral epiphysis (nontraumatic), unspecified hip 2
M9320 Osteochondritis dissecans of unspecified site 2
M9328 Osteochondritis dissecans other site 2
M9329 Osteochondritis dissecans multiple sites 2
M9390 Osteochondropathy, unspecified of unspecified site 2
M950 Acquired deformity of nose 2
M959 Acquired deformity of musculoskeletal system, unspecified 2
M963 Postlaminectomy kyphosis 2
M9920 Subluxation stenosis of neural canal of head region 2
M9921 Subluxation stenosis of neural canal of cervical region 2
M9923 Subluxation stenosis of neural canal of lumbar region 2
M9930 Osseous stenosis of neural canal of head region 2
M9931 Osseous stenosis of neural canal of cervical region 2
M9933 Osseous stenosis of neural canal of lumbar region 2
M9940 Connective tissue stenosis of neural canal of head region 2
M9941 Connective tissue stenosis of neural canal of cervical region 2
M9943 Connective tissue stenosis of neural canal of lumbar region 2
M9950 Intervertebral disc stenosis of neural canal of head region 2
M9951 Intervertebral disc stenosis of neural canal of cervical region 2
M9953 Intervertebral disc stenosis of neural canal of lumbar region 2
39
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
M9960 Osseous and subluxation stenosis of intervertebral foramina of head region 2
M9961 Osseous and subluxation stenosis of intervertebral foramina of cervical region 2
M9963 Osseous and subluxation stenosis of intervertebral foramina of lumbar region 2
M9970 Connective tissue and disc stenosis of intervertebral foramina of head region 2
M9971 Connective tissue and disc stenosis of intervertebral foramina of cervical region 2
M9973 Connective tissue and disc stenosis of intervertebral foramina of lumbar region 2
M999 Biomechanical lesion, unspecified 2
N019 Rapidly progressive nephritic syndrome with unspecified morphologic changes 3
N020 Recurrent and persistent hematuria with minor glomerular abnormality 3
N025 Recurrent and persistent hematuria with diffuse mesangiocapillary glomerulonephritis 3
N026 Recurrent and persistent hematuria with dense deposit disease 3
N038 Chronic nephritic syndrome with other morphologic changes 3
N039 Chronic nephritic syndrome with unspecified morphologic changes 3
N040 Nephrotic syndrome with minor glomerular abnormality 3
N043 Nephrotic syndrome with diffuse mesangial proliferative glomerulonephritis 3
N044 Nephrotic syndrome with diffuse endocapillary proliferative glomerulonephritis 3
N045 Nephrotic syndrome with diffuse mesangiocapillary glomerulonephritis 3
N046 Nephrotic syndrome with dense deposit disease 3
N048 Nephrotic syndrome with other morphologic changes 3
N049 Nephrotic syndrome with unspecified morphologic changes 3
N052 Unspecified nephritic syndrome with diffuse membranous glomerulonephritis 3
N055 Unspecified nephritic syndrome with diffuse mesangiocapillary glomerulonephritis 3
N059 Unspecified nephritic syndrome with unspecified morphologic changes 3
N079 Hereditary nephropathy, not elsewhere classified with unspecified morphologic lesions 3
N08 Glomerular disorders in diseases classified elsewhere 3
N131 Hydronephrosis with ureteral stricture, not elsewhere classified 2
N132 Hydronephrosis with renal and ureteral calculous obstruction 2
N1330 Unspecified hydronephrosis 2
N1339 Other hydronephrosis 2
N134 Hydroureter 2
N1370 Vesicoureteral-reflux, unspecified 2
N13729 Vesicoureteral-reflux with reflux nephropathy without hydroureter, unspecified 3
N13731 Vesicoureteral-reflux with reflux nephropathy with hydroureter, unilateral 2
N13732 Vesicoureteral-reflux with reflux nephropathy with hydroureter, bilateral 2
N13739 Vesicoureteral-reflux with reflux nephropathy with hydroureter, unspecified 3
N138 Other obstructive and reflux uropathy 2
N139 Obstructive and reflux uropathy, unspecified 3
N159 Renal tubulo-interstitial disease, unspecified 3
N171 Acute kidney failure with acute cortical necrosis 2
N178 Other acute kidney failure 2
N179 Acute kidney failure, unspecified 2
40
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
N181 Chronic kidney disease, stage 1 5
N182 Chronic kidney disease, stage 2 (mild) 5
N183 Chronic kidney disease, stage 3 (moderate) 5
N184 Chronic kidney disease, stage 4 (severe) 5
N185 Chronic kidney disease, stage 5 5
N186 End stage renal disease 5
N189 Chronic kidney disease, unspecified 5
N19 Unspecified kidney failure 2
N250 Renal osteodystrophy 3
N251 Nephrogenic diabetes insipidus 2
N2589 Other disorders resulting from impaired renal tubular function 2
N262 Page kidney 2
N280 Ischemia and infarction of kidney 3
N2889 Other specified disorders of kidney and ureter 2
N289 Disorder of kidney and ureter, unspecified 2
N29 Other disorders of kidney and ureter in diseases classified elsewhere 2
N319 Neuromuscular dysfunction of bladder, unspecified 3
N320 Bladder-neck obstruction 3
N329 Bladder disorder, unspecified 2
N990 Postprocedural (acute) (chronic) kidney failure 2
N9981 Other intraoperative complications of genitourinary system 2
N9989 Other postprocedural complications and disorders of genitourinary system 2
P0701 Extremely low birth weight newborn, less than 500 grams 1
P0702 Extremely low birth weight newborn, 500-749 grams 1
P0703 Extremely low birth weight newborn, 750-999 grams 1
P114 Birth injury to other cranial nerves 2
P115 Birth injury to spine and spinal cord 5
P140 Erb's paralysis due to birth injury 3
P141 Klumpke's paralysis due to birth injury 3
P142 Phrenic nerve paralysis due to birth injury 2
P143 Other brachial plexus birth injuries 3
P148 Birth injuries to other parts of peripheral nervous system 2
P149 Birth injury to peripheral nervous system, unspecified 2
P220 Respiratory distress syndrome of newborn 1
P270 Wilson-Mikity syndrome 2
P271 Bronchopulmonary dysplasia originating in the perinatal period 2
P278 Other chronic respiratory diseases originating in the perinatal period 2
P279 Unspecified chronic respiratory disease originating in the perinatal period 2
P284 Other apnea of newborn 1
P293 Persistent fetal circulation 1 9/30/2017
P2930 Pulmonary hypertension of newborn 1 10/1/2017
41
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
P2938 Other persistent fetal circulation 1 10/1/2017
P350 Congenital rubella syndrome 5
P351 Congenital cytomegalovirus infection 2
P352 Congenital herpesviral [herpes simplex] infection 2
P353 Congenital viral hepatitis 2
P359 Congenital viral disease, unspecified 2
P370 Congenital tuberculosis 2
P371 Congenital toxoplasmosis 2
P372 Neonatal (disseminated) listeriosis 2
P373 Congenital falciparum malaria 2
P374 Other congenital malaria 2
P378 Other specified congenital infectious and parasitic diseases 2
P379 Congenital infectious or parasitic disease, unspecified 2
P399 Infection specific to the perinatal period, unspecified 1
P5221 Intraventricular (nontraumatic) hemorrhage, grade 3, of newborn 1
P5222 Intraventricular (nontraumatic) hemorrhage, grade 4, of newborn 1
P591 Inspissated bile syndrome 2
P5920 Neonatal jaundice from unspecified hepatocellular damage 2
P60 Disseminated intravascular coagulation of newborn 2
P704 Other neonatal hypoglycemia 2
P771 Stage 1 necrotizing enterocolitis in newborn 2
P772 Stage 2 necrotizing enterocolitis in newborn 2
P773 Stage 3 necrotizing enterocolitis in newborn 2
P779 Necrotizing enterocolitis in newborn, unspecified 2
P8388 Other specified conditions of integument specific to newborn 1 10/1/2017
P84 Other problems with newborn 2
P9160 Hypoxic ischemic encephalopathy [HIE], unspecified 1
P9163 Severe hypoxic ischemic encephalopathy [HIE] 2
P940 Transient neonatal myasthenia gravis 2
Q019 Encephalocele, unspecified 5
Q039 Congenital hydrocephalus, unspecified 3
Q040 Congenital malformations of corpus callosum 3
Q042 Holoprosencephaly 3
Q043 Other reduction deformities of brain 3
Q044 Septo-optic dysplasia of brain 2
Q045 Megalencephaly 2
Q046 Congenital cerebral cysts 2
Q048 Other specified congenital malformations of brain 2
Q049 Congenital malformation of brain, unspecified 3
Q050 Cervical spina bifida with hydrocephalus 5
Q051 Thoracic spina bifida with hydrocephalus 5
42
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
Q052 Lumbar spina bifida with hydrocephalus 5
Q053 Sacral spina bifida with hydrocephalus 5
Q054 Unspecified spina bifida with hydrocephalus 5
Q055 Cervical spina bifida without hydrocephalus 5
Q056 Thoracic spina bifida without hydrocephalus 5
Q057 Lumbar spina bifida without hydrocephalus 5
Q058 Sacral spina bifida without hydrocephalus 5
Q059 Spina bifida, unspecified 5
Q060 Amyelia 3
Q061 Hypoplasia and dysplasia of spinal cord 3
Q062 Diastematomyelia 2
Q063 Other congenital cauda equina malformations 3
Q064 Hydromyelia 2
Q069 Congenital malformation of spinal cord, unspecified 3
Q0701 Arnold-Chiari syndrome with spina bifida 5
Q0702 Arnold-Chiari syndrome with hydrocephalus 5
Q0703 Arnold-Chiari syndrome with spina bifida and hydrocephalus 5
Q078 Other specified congenital malformations of nervous system 2
Q079 Congenital malformation of nervous system, unspecified 3
Q100 Congenital ptosis 3
Q103 Other congenital malformations of eyelid 2
Q107 Congenital malformation of orbit 2
Q110 Cystic eyeball 3
Q111 Other anophthalmos 3
Q112 Microphthalmos 3
Q113 Macrophthalmos 2
Q120 Congenital cataract 2
Q121 Congenital displaced lens 3
Q122 Coloboma of lens 3
Q123 Congenital aphakia 3
Q124 Spherophakia 3
Q128 Other congenital lens malformations 3
Q129 Congenital lens malformation, unspecified 3
Q130 Coloboma of iris 3
Q131 Absence of iris 3
Q132 Other congenital malformations of iris 3
Q133 Congenital corneal opacity 2
Q134 Other congenital corneal malformations 2
Q1381 Rieger's anomaly 3
Q139 Congenital malformation of anterior segment of eye, unspecified 2
Q140 Congenital malformation of vitreous humor 2
43
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
Q141 Congenital malformation of retina 2
Q142 Congenital malformation of optic disc 2
Q143 Congenital malformation of choroid 2
Q148 Other congenital malformations of posterior segment of eye 2
Q149 Congenital malformation of posterior segment of eye, unspecified 2
Q150 Congenital glaucoma 2
Q158 Other specified congenital malformations of eye 2
Q159 Congenital malformation of eye, unspecified 3
Q160 Congenital absence of (ear) auricle 5
Q161 Congenital absence, atresia and stricture of auditory canal (external) 5
Q162 Absence of eustachian tube 2
Q163 Congenital malformation of ear ossicles 2
Q164 Other congenital malformations of middle ear 2
Q165 Congenital malformation of inner ear 2
Q169 Congenital malformation of ear causing impairment of hearing, unspecified 3
Q172 Microtia 5
Q178 Other specified congenital malformations of ear 2
Q180 Sinus, fistula and cyst of branchial cleft 2
Q185 Microstomia 2
Q188 Other specified congenital malformations of face and neck 2
Q189 Congenital malformation of face and neck, unspecified 3
Q200 Common arterial trunk 5
Q201 Double outlet right ventricle 5
Q202 Double outlet left ventricle 5
Q203 Discordant ventriculoarterial connection 5
Q204 Double inlet ventricle 5
Q205 Discordant atrioventricular connection 5
Q208 Other congenital malformations of cardiac chambers and connections 5
Q209 Congenital malformation of cardiac chambers and connections, unspecified 5
Q210 Ventricular septal defect 3
Q211 Atrial septal defect 5
Q212 Atrioventricular septal defect 5
Q213 Tetralogy of Fallot 5
Q218 Other congenital malformations of cardiac septa 5
Q219 Congenital malformation of cardiac septum, unspecified 5
Q220 Pulmonary valve atresia 5
Q221 Congenital pulmonary valve stenosis 5
Q222 Congenital pulmonary valve insufficiency 5
Q223 Other congenital malformations of pulmonary valve 5
Q224 Congenital tricuspid stenosis 5
Q225 Ebstein's anomaly 5
44
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
Q226 Hypoplastic right heart syndrome 5
Q228 Other congenital malformations of tricuspid valve 5
Q229 Congenital malformation of tricuspid valve, unspecified 5
Q230 Congenital stenosis of aortic valve 5
Q231 Congenital insufficiency of aortic valve 5
Q232 Congenital mitral stenosis 5
Q233 Congenital mitral insufficiency 5
Q234 Hypoplastic left heart syndrome 5
Q238 Other congenital malformations of aortic and mitral valves 5
Q239 Congenital malformation of aortic and mitral valves, unspecified 5
Q242 Cor triatriatum 5
Q243 Pulmonary infundibular stenosis 5
Q244 Congenital subaortic stenosis 5
Q245 Malformation of coronary vessels 5
Q246 Congenital heart block 5
Q248 Other specified congenital malformations of heart 5
Q249 Congenital malformation of heart, unspecified 5
Q250 Patent ductus arteriosus 3
Q251 Coarctation of aorta 5
Q252 Atresia of aorta 5 9/30/2016
Q2521 Interruption of aortic arch 5 10/1/2016
Q2529 Other atresia of aorta 5 10/1/2016
Q253 Supravalvular aortic stenosis 5
Q254 Other congenital malformations of aorta 5 9/30/2016
Q2549 Other congenital malformations of aorta 5 10/1/2016
Q255 Atresia of pulmonary artery 5
Q256 Stenosis of pulmonary artery 5
Q2571 Coarctation of pulmonary artery 5
Q2572 Congenital pulmonary arteriovenous malformation 5
Q2579 Other congenital malformations of pulmonary artery 5
Q258 Other congenital malformations of other great arteries 5
Q259 Congenital malformation of great arteries, unspecified 5
Q260 Congenital stenosis of vena cava 5
Q261 Persistent left superior vena cava 5
Q262 Total anomalous pulmonary venous connection 5
Q264 Anomalous pulmonary venous connection, unspecified 5
Q265 Anomalous portal venous connection 2
Q266 Portal vein-hepatic artery fistula 2
Q271 Congenital renal artery stenosis 2
Q272 Other congenital malformations of renal artery 2
Q2730 Arteriovenous malformation, site unspecified 2
45
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
Q2731 Arteriovenous malformation of vessel of upper limb 2
Q2732 Arteriovenous malformation of vessel of lower limb 2
Q274 Congenital phlebectasia 2
Q278 Other specified congenital malformations of peripheral vascular system 2
Q279 Congenital malformation of peripheral vascular system, unspecified 2
Q280 Arteriovenous malformation of precerebral vessels 2
Q281 Other malformations of precerebral vessels 2
Q282 Arteriovenous malformation of cerebral vessels 2
Q283 Other malformations of cerebral vessels 2
Q288 Other specified congenital malformations of circulatory system 2
Q300 Choanal atresia 2
Q310 Web of larynx 2
Q319 Congenital malformation of larynx, unspecified 2
Q321 Other congenital malformations of trachea 2
Q323 Congenital stenosis of bronchus 2
Q324 Other congenital malformations of bronchus 2
Q330 Congenital cystic lung 3
Q332 Sequestration of lung 3
Q333 Agenesis of lung 3
Q334 Congenital bronchiectasis 3
Q335 Ectopic tissue in lung 3
Q336 Congenital hypoplasia and dysplasia of lung 3
Q338 Other congenital malformations of lung 3
Q339 Congenital malformation of lung, unspecified 2
Q340 Anomaly of pleura 2
Q341 Congenital cyst of mediastinum 2
Q349 Congenital malformation of respiratory system, unspecified 3
Q359 Cleft palate, unspecified 5
Q360 Cleft lip, bilateral 5
Q361 Cleft lip, median 5
Q369 Cleft lip, unilateral 5
Q378 Unspecified cleft palate with bilateral cleft lip 5
Q379 Unspecified cleft palate with unilateral cleft lip 5
Q383 Other congenital malformations of tongue 2
Q386 Other congenital malformations of mouth 2
Q388 Other congenital malformations of pharynx 3
Q390 Atresia of esophagus without fistula 5
Q391 Atresia of esophagus with tracheo-esophageal fistula 5
Q392 Congenital tracheo-esophageal fistula without atresia 5
Q393 Congenital stenosis and stricture of esophagus 5
Q394 Esophageal web 5
46
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
Q399 Congenital malformation of esophagus, unspecified 2
Q419 Congenital absence, atresia and stenosis of small intestine, part unspecified 2
Q429 Congenital absence, atresia and stenosis of large intestine, part unspecified 2
Q431 Hirschsprung's disease 5
Q432 Other congenital functional disorders of colon 5
Q439 Congenital malformation of intestine, unspecified 2
Q441 Other congenital malformations of gallbladder 2
Q442 Atresia of bile ducts 5
Q443 Congenital stenosis and stricture of bile ducts 5
Q444 Choledochal cyst 2
Q445 Other congenital malformations of bile ducts 2
Q447 Other congenital malformations of liver 2
Q458 Other specified congenital malformations of digestive system 2
Q506 Other congenital malformations of fallopian tube and broad ligament 2
Q528 Other specified congenital malformations of female genitalia 2
Q529 Congenital malformation of female genitalia, unspecified 2
Q539 Undescended testicle, unspecified 1
Q548 Other hypospadias 3
Q549 Hypospadias, unspecified 3
Q5520 Unspecified congenital malformations of testis and scrotum 2
Q5529 Other congenital malformations of testis and scrotum 2
Q5569 Other congenital malformation of penis 2
Q559 Congenital malformation of male genital organ, unspecified 2
Q560 Hermaphroditism, not elsewhere classified 3
Q563 Pseudohermaphroditism, unspecified 3
Q564 Indeterminate sex, unspecified 3
Q602 Renal agenesis, unspecified 5
Q605 Renal hypoplasia, unspecified 5
Q6100 Congenital renal cyst, unspecified 3
Q6101 Congenital single renal cyst 2
Q6119 Other polycystic kidney, infantile type 5
Q612 Polycystic kidney, adult type 5
Q613 Polycystic kidney, unspecified 5
Q614 Renal dysplasia 5
Q615 Medullary cystic kidney 5
Q618 Other cystic kidney diseases 5
Q619 Cystic kidney disease, unspecified 3
Q6239 Other obstructive defects of renal pelvis and ureter 2
Q640 Epispadias 3
Q6410 Exstrophy of urinary bladder, unspecified 5
Q6412 Cloacal extrophy of urinary bladder 5
47
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
Q644 Malformation of urachus 2
Q645 Congenital absence of bladder and urethra 2
Q646 Congenital diverticulum of bladder 2
Q6470 Unspecified congenital malformation of bladder and urethra 2
Q6479 Other congenital malformations of bladder and urethra 2
Q648 Other specified congenital malformations of urinary system 2
Q649 Congenital malformation of urinary system, unspecified 2
Q6500 Congenital dislocation of unspecified hip, unilateral 2
Q651 Congenital dislocation of hip, bilateral 2
Q652 Congenital dislocation of hip, unspecified 2
Q6530 Congenital partial dislocation of unspecified hip, unilateral 2
Q654 Congenital partial dislocation of hip, bilateral 2
Q655 Congenital partial dislocation of hip, unspecified 2
Q6589 Other specified congenital deformities of hip 2
Q660 Congenital talipes equinovarus 2
Q661 Congenital talipes calcaneovarus 2
Q663 Other congenital varus deformities of feet 2
Q664 Congenital talipes calcaneovalgus 2
Q666 Other congenital valgus deformities of feet 2
Q667 Congenital pes cavus 2
Q6689 Other specified congenital deformities of feet 2
Q669 Congenital deformity of feet, unspecified 2
Q670 Congenital facial asymmetry 3
Q674 Other congenital deformities of skull, face and jaw 3
Q675 Congenital deformity of spine 3
Q676 Pectus excavatum 2
Q678 Other congenital deformities of chest 3
Q680 Congenital deformity of sternocleidomastoid muscle 2
Q681 Congenital deformity of finger(s) and hand 3
Q682 Congenital deformity of knee 2
Q688 Other specified congenital musculoskeletal deformities 2
Q690 Accessory finger(s) 2
Q691 Accessory thumb(s) 2
Q692 Accessory toe(s) 2
Q699 Polydactyly, unspecified 2
Q7000 Fused fingers, unspecified hand 2
Q7010 Webbed fingers, unspecified hand 2
Q7020 Fused toes, unspecified foot 2
Q7030 Webbed toes, unspecified foot 2
Q704 Polysyndactyly, unspecified 2
Q709 Syndactyly, unspecified 2
48
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
Q7100 Congenital complete absence of unspecified upper limb 5
Q7110 Congenital absence of unspecified upper arm and forearm with hand present 5
Q7130 Congenital absence of unspecified hand and finger 5
Q7140 Longitudinal reduction defect of unspecified radius 3
Q7150 Longitudinal reduction defect of unspecified ulna 5
Q7160 Lobster-claw hand, unspecified hand 5
Q71819 Congenital shortening of unspecified upper limb 5
Q71899 Other reduction defects of unspecified upper limb 5
Q7190 Unspecified reduction defect of unspecified upper limb 5
Q7200 Congenital complete absence of unspecified lower limb 5
Q7210 Congenital absence of unspecified thigh and lower leg with foot present 5
Q7220 Congenital absence of both lower leg and foot, unspecified lower limb 5
Q7230 Congenital absence of unspecified foot and toe(s) 5
Q7240 Longitudinal reduction defect of unspecified femur 5
Q7250 Longitudinal reduction defect of unspecified tibia 5
Q7260 Longitudinal reduction defect of unspecified fibula 5
Q7270 Split foot, unspecified lower limb 5
Q72819 Congenital shortening of unspecified lower limb 5
Q72899 Other reduction defects of unspecified lower limb 5
Q7290 Unspecified reduction defect of unspecified lower limb 5
Q730 Congenital absence of unspecified limb(s) 2
Q731 Phocomelia, unspecified limb(s) 2
Q738 Other reduction defects of unspecified limb(s) 2
Q740 Other congenital malformations of upper limb(s), including shoulder girdle 3
Q742 Other congenital malformations of lower limb(s), including pelvic girdle 3
Q743 Arthrogryposis multiplex congenita 3
Q749 Unspecified congenital malformation of limb(s) 2
Q750 Craniosynostosis 5
Q758 Other specified congenital malformations of skull and face bones 5
Q759 Congenital malformation of skull and face bones, unspecified 5
Q760 Spina bifida occulta 3
Q761 Klippel-Feil syndrome 5
Q762 Congenital spondylolisthesis 3
Q76419 Congenital kyphosis, unspecified region 3
Q7649 Other congenital malformations of spine, not associated with scoliosis 3
Q770 Achondrogenesis 5
Q771 Thanatophoric short stature 5
Q773 Chondrodysplasia punctata 3
Q774 Achondroplasia 5
Q776 Chondroectodermal dysplasia 5
Q778 Other osteochondrodysplasia with defects of growth of tubular bones and spine 5
49
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
Q779 Osteochondrodysplasia with defects of growth of tubular bones and spine, unspecified 5
Q780 Osteogenesis imperfecta 5
Q781 Polyostotic fibrous dysplasia 3
Q782 Osteopetrosis 5
Q783 Progressive diaphyseal dysplasia 5
Q784 Enchondromatosis 5
Q786 Multiple congenital exostoses 3
Q788 Other specified osteochondrodysplasias 3
Q789 Osteochondrodysplasia, unspecified 3
Q790 Congenital diaphragmatic hernia 2
Q791 Other congenital malformations of diaphragm 2
Q792 Exomphalos 1
Q793 Gastroschisis 1
Q794 Prune belly syndrome 2
Q7959 Other congenital malformations of abdominal wall 2
Q796 Ehlers-Danlos syndrome 2 10/1/2016
Q798 Other congenital malformations of musculoskeletal system 2
Q799 Congenital malformation of musculoskeletal system, unspecified 2
Q819 Epidermolysis bullosa, unspecified 2
Q820 Hereditary lymphedema 3
Q821 Xeroderma pigmentosum 3
Q822 Mastocytosis 3
Q823 Incontinentia pigmenti 3
Q824 Ectodermal dysplasia (anhidrotic) 3
Q828 Other specified congenital malformations of skin 2
Q829 Congenital malformation of skin, unspecified 2
Q848 Other specified congenital malformations of integument 2
Q8500 Neurofibromatosis, unspecified 5
Q8501 Neurofibromatosis, type 1 5
Q8502 Neurofibromatosis, type 2 5
Q8503 Schwannomatosis 5
Q851 Tuberous sclerosis 5
Q858 Other phakomatoses, not elsewhere classified 3
Q859 Phakomatosis, unspecified 3
Q870 Congenital malformation syndromes predominantly affecting facial appearance 5
Q871 Congenital malformation syndromes predominantly associated with short stature 3
Q873 Congenital malformation syndromes involving early overgrowth 2
Q8740 Marfan's syndrome, unspecified 3
Q8781 Alport syndrome 3
Q897 Multiple congenital malformations, not elsewhere classified 3
Q898 Other specified congenital malformations 3
50
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
Q899 Congenital malformation, unspecified 2
Q969 Turner's syndrome, unspecified 3
R0681 Apnea, not elsewhere classified 1
R0689 Other abnormalities of breathing 2
R1310 Dysphagia, unspecified 1
R1319 Other dysphagia 1
R17 Unspecified jaundice 2
R4701 Aphasia 2
R4702 Dysphasia 2
R75 Inconclusive laboratory evidence of human immunodeficiency virus [HIV] 2
S0100xS Unspecified open wound of scalp, sequela 2
S01109S Unspecified open wound of unspecified eyelid and periocular area, sequela 2
S0120xS Unspecified open wound of nose, sequela 2
S01309S Unspecified open wound of unspecified ear, sequela 2
S01409S Unspecified open wound of unspecified cheek and temporomandibular area, sequela 2
S01501S Unspecified open wound of lip, sequela 2
S01502S Unspecified open wound of oral cavity, sequela 2
S0180xS Unspecified open wound of other part of head, sequela 2
S0190xS Unspecified open wound of unspecified part of head, sequela 2
S020xxS Fracture of vault of skull, sequela 2
S02109S Fracture base of skull unspecified side sequela 2 10/1/2016
S0210xS Unspecified fracture of base of skull, sequela 2 9/30/2016
S02113S Unspecified occipital condyle fracture, sequela 2
S02118S Other fracture of occiput, sequela 2
S022xxS Fracture of nasal bones, sequela 2
S0230XS Fracture of orbital floor unspecified side sequela 2 10/1/2016
S023xxS Fracture of orbital floor, sequela 2 9/30/2016
S02400S Malar fracture unspecified, sequela 2
S02401S Maxillary fracture, unspecified, sequela 2
S02402S Zygomatic fracture, unspecified, sequela 2
S025xxS Fracture of tooth (traumatic), sequela 2
S02609S Fracture of mandible, unspecified, sequela 2
S0280XS Fractures other specified skull facial bones unspecified side sequela 2 10/1/2016
S028xxS Fractures of other specified skull and facial bones, sequela 2 9/30/2016
S0291xK Unspecified fracture of skull, subsequent encounter for fracture with nonunion 2
S0291xS Unspecified fracture of skull, sequela 2
S0292xK Unspecified fracture of facial bones, subsequent encounter for fracture with nonunion 2
S0292xS Unspecified fracture of facial bones, sequela 2
S032xxS Dislocation of tooth, sequela 2
S04019S Injury of optic nerve, unspecified eye, sequela 2
S0402xS Injury of optic chiasm, sequela 2
51
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
S04039S Injury of optic tract and pathways, unspecified eye, sequela 2
S04049S Injury of visual cortex, unspecified eye, sequela 2
S0410xS Injury of oculomotor nerve, unspecified side, sequela 2
S0420xS Injury of trochlear nerve, unspecified side, sequela 2
S0430xS Injury of trigeminal nerve, unspecified side, sequela 2
S0440xS Injury of abducent nerve, unspecified side, sequela 2
S0450xS Injury of facial nerve, unspecified side, sequela 2
S0460xS Injury of acoustic nerve, unspecified side, sequela 2
S0470xS Injury of accessory nerve, unspecified side, sequela 2
S04819S Injury of olfactory [1st ] nerve, unspecified side, sequela 2
S04899S Injury of other cranial nerves, unspecified side, sequela 2
S049xxS Injury of unspecified cranial nerve, sequela 2
S0590xS Unspecified injury of unspecified eye and orbit, sequela 2
S064X0A Epidural hemorrhage without loss of consciousness, initial encounter 2
S065X0A Traumatic subdural hemorrhage without loss of consciousness, initial encounter 2
S065X7A
Traumatic subdural hemorrhage with loss of consciousness of any duration with death due to
brain injury before regaining consciousness, initial encounter 2
S065X9A
Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, initial
encounter 2
S066X0A Traumatic subarachnoid hemorrhage without loss of consciousness, initial encounter 2
S066X9A
Traumatic subarachnoid hemorrhage with loss of consciousness of unspecified duration, initial
encounter 2
S069X0S Unspecified intracranial injury without loss of consciousness, sequela 2
S069X9S Unspecified intracranial injury with loss of consciousness of unspecified duration, sequela 2
S070xxS Crushing injury of face, sequela 2
S071xxS Crushing injury of skull, sequela 2
S078xxS Crushing injury of other parts of head, sequela 2
S080xxS Avulsion of scalp, sequela 2
S08119S Complete traumatic amputation of unspecified ear, sequela 2
S08129S Partial traumatic amputation of unspecified ear, sequela 2
S08811S Complete traumatic amputation of nose, sequela 2
S08812S Partial traumatic amputation of nose, sequela 2
S0889xS Traumatic amputation of other parts of head, sequela 2
S0910xS Unspecified injury of muscle and tendon of head, sequela 2
S0920xS Traumatic rupture of unspecified ear drum, sequela 2
S09309S Unspecified injury of unspecified middle and inner ear, sequela 2
S0990xS Unspecified injury of head, sequela 2
S0991xS Unspecified injury of ear, sequela 2
S0992xS Unspecified injury of nose, sequela 2
S0993xS Unspecified injury of face, sequela 2
S11019S Unspecified open wound of larynx, sequela 2
52
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
S11029S Unspecified open wound of trachea, sequela 2
S11039S Unspecified open wound of vocal cord, sequela 2
S1110xS Unspecified open wound of thyroid gland, sequela 2
S1120xS Unspecified open wound of pharynx and cervical esophagus, sequela 2
S1180xS Unspecified open wound of other specified part of neck, sequela 2
S1190xS Unspecified open wound of unspecified part of neck, sequela 2
S128xxS Fracture of other parts of neck, sequela 2
S129xxA Fracture of neck, unspecified, initial encounter 5
S129xxS Fracture of neck, unspecified, sequela 2
S140xxS Concussion and edema of cervical spinal cord, sequela 2
S14109S Unspecified injury at unspecified level of cervical spinal cord, sequela 2
S14115A Complete lesion at C5 level of cervical spinal cord, initial encounter 5
S14116A Complete lesion at C6 level of cervical spinal cord, initial encounter 1
S14117A Complete lesion at C7 level of cervical spinal cord, initial encounter 1
S14119S Complete lesion at unspecified level of cervical spinal cord, sequela 2
S14121A Central cord syndrome at C1 level of cervical spinal cord, initial encounter 5
S14122A Central cord syndrome at C2 level of cervical spinal cord, initial encounter 5
S14123A Central cord syndrome at C3 level of cervical spinal cord, initial encounter 5
S14124A Central cord syndrome at C4 level of cervical spinal cord, initial encounter 5
S14129S Central cord syndrome at unspecified level of cervical spinal cord, sequela 2
S14139S Anterior cord syndrome at unspecified level of cervical spinal cord, sequela 2
S14149S Brown-Sequard syndrome at unspecified level of cervical spinal cord, sequela 2
S14159S Other incomplete lesion at unspecified level of cervical spinal cord, sequela 2
S143xxS Injury of brachial plexus, sequela 2
S149xxS Injury of unspecified nerves of neck, sequela 2
S15001S Unspecified injury of right carotid artery, sequela 2
S15002S Unspecified injury of left carotid artery, sequela 2
S15009S Unspecified injury of unspecified carotid artery, sequela 2
S15101S Unspecified injury of right vertebral artery, sequela 2
S15102S Unspecified injury of left vertebral artery, sequela 2
S15109S Unspecified injury of unspecified vertebral artery, sequela 2
S15199S Other specified injury of unspecified vertebral artery, sequela 2
S15201S Unspecified injury of right external jugular vein, sequela 2
S15202S Unspecified injury of left external jugular vein, sequela 2
S15209S Unspecified injury of unspecified external jugular vein, sequela 2
S15301S Unspecified injury of right internal jugular vein, sequela 2
S15302S Unspecified injury of left internal jugular vein, sequela 2
S15309S Unspecified injury of unspecified internal jugular vein, sequela 2
S159xxS Injury of unspecified blood vessel at neck level, sequela 2
S169xxS Unspecified injury of muscle, fascia and tendon at neck level, sequela 2
S179xxS Crushing injury of neck, part unspecified, sequela 2
53
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
S1980xS Other specified injuries of unspecified part of neck, sequela 2
S199xxS Unspecified injury of neck, sequela 2
S21009S Unspecified open wound of unspecified breast, sequela 2
S21109S
Unspecified open wound of unspecified front wall of thorax without penetration into thoracic
cavity, sequela 2
S21209S
Unspecified open wound of unspecified back wall of thorax without penetration into thoracic
cavity, sequela 2
S21309S
Unspecified open wound of unspecified front wall of thorax with penetration into thoracic
cavity, sequela 2
S21409S
Unspecified open wound of unspecified back wall of thorax with penetration into thoracic
cavity, sequela 2
S2190xS Unspecified open wound of unspecified part of thorax, sequela 2
S22009A Unspecified fracture of unspecified thoracic vertebra, initial encounter for closed fracture 5
S22009B Unspecified fracture of unspecified thoracic vertebra, initial encounter for open fracture 5
S22009K
Unspecified fracture of unspecified thoracic vertebra, subsequent encounter for fracture with
nonunion 2
S22009S Unspecified fracture of unspecified thoracic vertebra, sequela 2
S2220xS Unspecified fracture of sternum, sequela 2
S2221xS Fracture of manubrium, sequela 2
S2222xS Fracture of body of sternum, sequela 2
S2223xS Sternal manubrial dissociation, sequela 2
S2224xS Fracture of xiphoid process, sequela 2
S2249xS Multiple fractures of ribs, unspecified side, sequela 2
S225xxS Flail chest, sequela 2
S229xxK Fracture of bony thorax, part unspecified, subsequent encounter for fracture with nonunion 2
S229xxS Fracture of bony thorax, part unspecified, sequela 2
S240xxS Concussion and edema of thoracic spinal cord, sequela 2
S24103A Unspecified injury at T7-T10 level of thoracic spinal cord, initial encounter 5
S24104A Unspecified injury at T11-T12 level of thoracic spinal cord, initial encounter 5
S24109S Unspecified injury at unspecified level of thoracic spinal cord, sequela 2
S24111A Complete lesion at T1 level of thoracic spinal cord, initial encounter 5
S24112A Complete lesion at T2-T6 level of thoracic spinal cord, initial encounter 5
S24119S Complete lesion at unspecified level of thoracic spinal cord, sequela 2
S24139S Anterior cord syndrome at unspecified level of thoracic spinal cord, sequela 2
S24149S Brown-Sequard syndrome at unspecified level of thoracic spinal cord, sequela 2
S24159S Other incomplete lesion at unspecified level of thoracic spinal cord, sequela 2
S25809S Unspecified injury of other blood vessels of thorax, unspecified side, sequela 2
S2690xS Unspecified injury of heart, unspecified with or without hemopericardium, sequela 2
S279xxS Injury of unspecified intrathorarcic organ, sequela 2
S280xxS Crushed chest, sequela 2
54
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
S281xxS Traumatic amputation (partial) of part of thorax, except breast, sequela 2
S28219S Complete traumatic amputation of unspecified breast, sequela 2
S28229S Partial traumatic amputation of unspecified breast, sequela 2
S29001S Unspecified injury of muscle and tendon of front wall of thorax, sequela 2
S29002S Unspecified injury of muscle and tendon of back wall of thorax, sequela 2
S29009S Unspecified injury of muscle and tendon of unspecified wall of thorax, sequela 2
S29029S Laceration of muscle and tendon of unspecified wall of thorax, sequela 2
S29099S Other injury of muscle and tendon of unspecified wall of thorax, sequela 2
S298xxS Other specified injuries of thorax, sequela 2
S299xxS Unspecified injury of thorax, sequela 2
S31000S Unspecified open wound of lower back and pelvis without penetration into retroperitoneum, 2
S31001S
Unspecified open wound of lower back and pelvis with penetration into retroperitoneum,
sequela 2
S31102S
Unspecified open wound of abdominal wall, epigastric region without penetration into
peritoneal cavity, sequela 2
S31105S
Unspecified open wound of abdominal wall, periumbilic region without penetration into
peritoneal cavity, sequela 2
S31109S
Unspecified open wound of abdominal wall, unspecified quadrant without penetration into
peritoneal cavity, sequela 2
S3120xS Unspecified open wound of penis, sequela 2
S3130xS Unspecified open wound of scrotum and testes, sequela 2
S3140xS Unspecified open wound of vagina and vulva, sequela 2
S31602S
Unspecified open wound of abdominal wall, epigastric region with penetration into peritoneal
cavity, sequela 2
S31605S
Unspecified open wound of abdominal wall, periumbilic region with penetration into
peritoneal cavity, sequela 2
S31609S
Unspecified open wound of abdominal wall, unspecified quadrant with penetration into
peritoneal cavity, sequela 2
S31801S Laceration without foreign body of unspecified buttock, sequela 2
S31809S Unspecified open wound of unspecified buttock, sequela 2
S31839S Unspecified open wound of anus, sequela 2
S32000S Wedge compression fracture of unspecified lumbar vertebra, sequela 2
S32009K
Unspecified fracture of unspecified lumbar vertebra, subsequent encounter for fracture with
nonunion 2
S32009S Unspecified fracture of unspecified lumbar vertebra, sequela 2
S3210xK Unspecified fracture of sacrum, subsequent encounter for fracture with nonunion 2
S3210xS Unspecified fracture of sacrum, sequela 2
S322xxK Fracture of coccyx, subsequent encounter for fracture with nonunion 2
S322xxS Fracture of coccyx, sequela 2
S32309K Unspecified fracture of unspecified ilium, subsequent encounter for fracture with nonunion 2
55
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
S32309S Unspecified fracture of unspecified ilium, sequela 2
S32409K
Unspecified fracture of unspecified acetabulum, subsequent encounter for fracture with
nonunion 2
S32409S Unspecified fracture of unspecified acetabulum, sequela 2
S32509S Unspecified fracture of unspecified pubis, sequela 2
S32519S Fracture of superior rim of unspecified pubis, sequela 2
S32609S Unspecified fracture of unspecified ischium, sequela 2
S32810S Multiple fractures of pelvis with stable disruption of pelvic ring, sequela 2
S32811S Multiple fractures of pelvis with unstable disruption of pelvic ring, sequela 2
S3282xS Multiple fractures of pelvis without disruption of pelvic ring, sequela 2
S3289xS Fracture of other parts of pelvis, sequela 2
S329xxS Fracture of unspecified parts of lumbosacral spine and pelvis, sequela 2
S3401xS Concussion and edema of lumbar spinal cord, sequela 2
S3402xS Concussion and edema of sacral spinal cord, sequela 2
S34109A Unspecified injury to unspecified level of lumbar spinal cord, initial encounter 2
S34109S Unspecified injury to unspecified level of lumbar spinal cord, sequela 2
S34119A Complete lesion of unspecified level of lumbar spinal cord, initial encounter 5
S34129A Incomplete lesion of unspecified level of lumbar spinal cord, initial encounter 5
S34139S Unspecified injury to sacral spinal cord, sequela 2
S358X9S Unspecified injury of other blood vessels at abdomen, lower back and pelvis level, sequela 2
S3600xS Unspecified injury of spleen, sequela 2
S36112S Contusion of liver, sequela 2
S36113S Laceration of liver, unspecified degree, sequela 2
S36118S Other injury of liver, sequela 2
S36119S Unspecified injury of liver, sequela 2
S36129S Unspecified injury of gallbladder, sequela 2
S3613xS Injury of bile duct, sequela 2
S36209S Unspecified injury of unspecified part of pancreas, sequela 2
S3630xS Unspecified injury of stomach, sequela 2
S36400S Unspecified injury of duodenum, sequela 2
S36409S Unspecified injury of unspecified part of small intestine, sequela 2
S36509S Unspecified injury of unspecified part of colon, sequela 2
S3660xS Unspecified injury of rectum, sequela 2
S3681xS Injury of peritoneum, sequela 2
S3690xS Unspecified injury of unspecified intra-abdominal organ, sequela 2
S37009S Unspecified injury of unspecified kidney, sequela 2
S38001S Crushing injury of unspecified external genital organs, male, sequela 2
S38002S Crushing injury of unspecified external genital organs, female, sequela 2S381xxS Crushing injury of abdomen, lower back, and pelvis, sequela 2
S39001S Unspecified injury of muscle, fascia and tendon of abdomen, sequela 2
S39002S Unspecified injury of muscle, fascia and tendon of lower back, sequela 2
56
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
S39003S Unspecified injury of muscle, fascia and tendon of pelvis, sequela 2
S3991xS Unspecified injury of abdomen, sequela 2
S3992xS Unspecified injury of lower back, sequela 2
S3993xS Unspecified injury of pelvis, sequela 2
S3994xS Unspecified injury of external genitals, sequela 2S41009S Unspecified open wound of unspecified shoulder, sequela 2
S41109S Unspecified open wound of unspecified upper arm, sequela 2
S42009S Fracture of unspecified part of unspecified clavicle, sequela 2
S42109S Fracture of unspecified part of scapula, unspecified shoulder, sequela 2
S42209S Unspecified fracture of upper end of unspecified humerus, sequela 2
S42309S Unspecified fracture of shaft of humerus, unspecified arm, sequela 2
S42409S Unspecified fracture of lower end of unspecified humerus, sequela 2
S4290xS Fracture of unspecified shoulder girdle, part unspecified, sequela 2
S4490xS Injury of unspecified nerve at shoulder and upper arm level, unspecified arm, sequela 2
S45109S Unspecified injury of brachial artery, unspecified side, sequela 2
S45209S Unspecified injury of axillary or brachial vein, unspecified side, sequela 2
S45909S
Unspecified injury of unspecified blood vessel at shoulder and upper arm level, unspecified
arm, sequela 2
S46009S
Unspecified injury of muscle(s) and tendon(s) of the rotator cuff of unspecified shoulder,
sequela 2
S46109S
Unspecified injury of muscle, fascia and tendon of long head of biceps, unspecified arm,
sequela 2
S46229S Laceration of muscle, fascia and tendon of other parts of biceps, unspecified arm, sequela 2
S46309S Unspecified injury of muscle, fascia and tendon of triceps, unspecified arm, sequela 2
S46909S
Unspecified injury of unspecified muscle, fascia and tendon at shoulder and upper arm level,
unspecified arm, sequela 2
S479xxS Crushing injury of shoulder and upper arm, unspecified arm, sequela 2
S48019S Complete traumatic amputation at unspecified shoulder joint, sequela 2
S48029S Partial traumatic amputation at unspecified shoulder joint, sequela 2
S48119A
Complete traumatic amputation at level between unspecified shoulder and elbow, initial
encounter 5
S48129A
Partial traumatic amputation at level between unspecified shoulder and elbow, initial
encounter 5S48911A Complete traumatic amputation of right shoulder and upper arm, level unspecified, initial 5
S48912A Complete traumatic amputation of left shoulder and upper arm, level unspecified, initial 1
S48919A
Complete traumatic amputation of unspecified shoulder and upper arm, level unspecified,
initial encounter 5
S48929A
Partial traumatic amputation of unspecified shoulder and upper arm, level unspecified, initial
encounter 5
S49009S Unspecified physeal fracture of upper end of humerus, unspecified arm, sequela 2
S49109S Unspecified physeal fracture of lower end of humerus, unspecified arm, sequela 2
57
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
S4990xS Unspecified injury of shoulder and upper arm, unspecified arm, sequela 2
S51009S Unspecified open wound of unspecified elbow, sequela 2
S51809S Unspecified open wound of unspecified forearm, sequela 2
S52009S Unspecified fracture of upper end of unspecified ulna, sequela 2
S52209S Unspecified fracture of shaft of unspecified ulna, sequela 2S52309S Unspecified fracture of shaft of unspecified radius, sequela 2
S52509S Unspecified fracture of the lower end of unspecified radius, sequela 2
S52609S Unspecified fracture of lower end of unspecified ulna, sequela 2
S5290xS Unspecified fracture of unspecified forearm, sequela 2
S5490xS Injury of unspecified nerve at forearm level, unspecified arm, sequela 2
S55909S Unspecified injury of unspecified blood vessel at forearm level, unspecified arm, sequela 2
S56009S
Unspecified injury of flexor muscle, fascia and tendon of unspecified thumb at forearm level,
sequela 2
S56109S
Unspecified injury of flexor muscle, fascia and tendon of unspecified finger at forearm level,
sequela 2
S56909S
Unspecified injury of unspecified muscles, fascia and tendons at forearm level, unspecified
arm, sequela 2
S58119A
Complete traumatic amputation at level between elbow and wrist, unspecified arm, initial
encounter 5
S58129A
Partial traumatic amputation at level between elbow and wrist, unspecified arm, initial
encounter 1
S58919A Complete traumatic amputation of unspecified forearm, level unspecified, initial encounter 1
S58929A Partial traumatic amputation of unspecified forearm, level unspecified, initial encounter 1
S59009S Unspecified physeal fracture of lower end of ulna, unspecified arm, sequela 2
S59109S Unspecified physeal fracture of upper end of radius, unspecified arm, sequela 2
S59209S Unspecified physeal fracture of lower end of radius, unspecified arm, sequela 2
S59909S Unspecified injury of unspecified elbow, sequela 2
S59919S Unspecified injury of unspecified forearm, sequela 2
S61509S Unspecified open wound of unspecified wrist, sequela 2
S6290xS Unspecified fracture of unspecified wrist and hand, sequela 2
S65209S Unspecified injury of superficial palmar arch of unspecified hand, sequela 2
S65909S
Unspecified injury of unspecified blood vessel at wrist and hand level of unspecified arm,
sequela 2S68019A Complete traumatic metacarpophalangeal amputation of unspecified thumb, initial encounter 5
S68029A Partial traumatic metacarpophalangeal amputation of unspecified thumb, initial encounter 1
S68119A Complete traumatic metacarpophalangeal amputation of unspecified finger, initial encounter 2
S68129A Partial traumatic metacarpophalangeal amputation of unspecified finger, initial encounter 1
S68419A Complete traumatic amputation of unspecified hand at wrist level, initial encounter 1
S68429A Partial traumatic amputation of unspecified hand at wrist level, initial encounter 1
58
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
S68519A Complete traumatic transphalangeal amputation of unspecified thumb, initial encounter 1
S68529A Partial traumatic transphalangeal amputation of unspecified thumb, initial encounter 1
S68619A Complete traumatic transphalangeal amputation of unspecified finger, initial encounter 1
S68629A Partial traumatic transphalangeal amputation of unspecified finger, initial encounter 1
S68719A Complete traumatic transmetacarpal amputation of unspecified hand, initial encounter 1
S68729A Partial traumatic transmetacarpal amputation of unspecified hand, initial encounter 1
S6990xS Unspecified injury of unspecified wrist, hand and finger(s), sequela 2
S71009S Unspecified open wound, unspecified hip, sequela 2
S71109S Unspecified open wound, unspecified thigh, sequela 2
S72309S Unspecified fracture of shaft of unspecified femur, sequela 2
S7290xS Unspecified fracture of unspecified femur, sequela 2
S7400xS Injury of sciatic nerve at hip and thigh level, unspecified leg, sequela 2
S7410xS Injury of femoral nerve at hip and thigh level, unspecified leg, sequela 2
S7490xA Injury of unspecified nerve at hip and thigh level, unspecified leg, initial encounter 2
S7490xS Injury of unspecified nerve at hip and thigh level, unspecified leg, sequela 2
S75999S
Other specified injury of unspecified blood vessel at hip and thigh level, unspecified leg,
sequela 2
S76909S
Unspecified injury of unspecified muscles, fascia and tendons at thigh level, unspecified thigh,
sequela 2
S78019A Complete traumatic amputation at unspecified hip joint, initial encounter 1
S78029A Partial traumatic amputation at unspecified hip joint, initial encounter 1
S78119A Complete traumatic amputation at level between unspecified hip and knee, initial encounter 1
S78129A Partial traumatic amputation at level between unspecified hip and knee, initial encounter 1
S78919A
Complete traumatic amputation of unspecified hip and thigh, level unspecified, initial
encounter 5
S78929A Partial traumatic amputation of unspecified hip and thigh, level unspecified, initial encounter 1
S82009S Unspecified fracture of unspecified patella, sequela 2
S82209S Unspecified fracture of shaft of unspecified tibia, sequela 2
S82409S Unspecified fracture of shaft of unspecified fibula, sequela 2
S8290xS Unspecified fracture of unspecified lower leg, sequela 2
S8410xA Injury of peroneal nerve at lower leg level, unspecified leg, initial encounter 2
S8490xA Injury of unspecified nerve at lower leg level, unspecified leg, initial encounter 1
S8490xS Injury of unspecified nerve at lower leg level, unspecified leg, sequela 2
S85909S Unspecified injury of unspecified blood vessel at lower leg level, unspecified leg, sequela 2
S86009S Unspecified injury of unspecified Achilles tendon, sequela 2
S86909S
Unspecified injury of unspecified muscle(s) and tendon(s) at lower leg level, unspecified leg,
sequela 2
S88019A Complete traumatic amputation at knee level, unspecified lower leg, initial encounter 1
S88029A Partial traumatic amputation at knee level, unspecified lower leg, initial encounter 1
59
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
S88119A
Complete traumatic amputation at level between knee and ankle, unspecified lower leg, initial
encounter 5
S88129A
Partial traumatic amputation at level between knee and ankle, unspecified lower leg, initial
encounter 1
S88911A Complete traumatic amputation of right lower leg, level unspecified, initial encounter 5
S88912A Complete traumatic amputation of left lower leg, level unspecified, initial encounter 1
S88919S Complete traumatic amputation of unspecified lower leg, level unspecified, sequela 2
S88929A Partial traumatic amputation of unspecified lower leg, level unspecified, initial encounter 5
S88929S Partial traumatic amputation of unspecified lower leg, level unspecified, sequela 2
S8990xS Unspecified injury of unspecified lower leg, sequela 2
S92909S Unspecified fracture of unspecified foot, sequela 2
S98911A Complete traumatic amputation of right foot, level unspecified, initial encounter 5
S98912A Complete traumatic amputation of left foot, level unspecified, initial encounter 1
S98919A Complete traumatic amputation of unspecified foot, level unspecified, initial encounter 5
S98921A Partial traumatic amputation of right foot, level unspecified, initial encounter 1
S98922A Partial traumatic amputation of left foot, level unspecified, initial encounter 1
S98929A Partial traumatic amputation of unspecified foot, level unspecified, initial encounter 1
S99919S Unspecified injury of unspecified ankle, sequela 2
S99929S Unspecified injury of unspecified foot, sequela 2
T1490 Injury, unspecified 2 9/30/2017
T1490XS Injury, unspecified, sequela 1 10/1/2017
T2000xS Burn of unspecified degree of head, face, and neck, unspecified site, sequela 2
T20019S Burn of unspecified degree of unspecified ear [any part, except ear drum], sequela 2
T2002xS Burn of unspecified degree of lip(s), sequela 2
T2003xS Burn of unspecified degree of chin, sequela 2
T2004xS Burn of unspecified degree of nose (septum), sequela 2
T2005xS Burn of unspecified degree of scalp [any part], sequela 2
T2006xS Burn of unspecified degree of forehead and cheek, sequela 2
T2007xS Burn of unspecified degree of neck, sequela 2
T2009xS Burn of unspecified degree of multiple sites of head, face, and neck, sequela 2
T2030xA Burn of third degree of head, face, and neck, unspecified site, initial encounter 5
T2070xA Corrosion of third degree of head, face, and neck, unspecified site, initial encounter 5
T2100xS Burn of unspecified degree of trunk, unspecified site, sequela 2
T2101xS Burn of unspecified degree of chest wall, sequela 2
T2102xS Burn of unspecified degree of abdominal wall, sequela 2
T2103xS Burn of unspecified degree of upper back, sequela 2
T2104xS Burn of unspecified degree of lower back, sequela 2
T2105xS Burn of unspecified degree of buttock, sequela 2
T2106xS Burn of unspecified degree of male genital region, sequela 2
T2107xS Burn of unspecified degree of female genital region, sequela 2
T2109xA Burn of unspecified degree of other site of trunk, initial encounter 5
60
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
T2109xS Burn of unspecified degree of other site of trunk, sequela 2
T2130xA Burn of third degree of trunk, unspecified site, initial encounter 5T2170xA Corrosion of third degree of trunk, unspecified site, initial encounter 5
T2200xS Burn of unspecified degree of shoulder and upper limb, except wrist and hand, unspecified 2
T22019S Burn of unspecified degree of unspecified forearm, sequela 2
T22029S Burn of unspecified degree of unspecified elbow, sequela 2
T22039S Burn of unspecified degree of unspecified upper arm, sequela 2T22049S Burn of unspecified degree of unspecified axilla, sequela 2
T22059S Burn of unspecified degree of unspecified shoulder, sequela 2
T22069S Burn of unspecified degree of unspecified scapular region, sequela 2
T22099A
Burn of unspecified degree of multiple sites of unspecified shoulder and upper limb, except
wrist and hand, initial encounter 5
T22099S
Burn of unspecified degree of multiple sites of unspecified shoulder and upper limb, except
wrist and hand, sequela 2
T2230xA
Burn of third degree of shoulder and upper limb, except wrist and hand, unspecified site, initial
encounter 5
T22329A Burn of third degree of unspecified elbow, initial encounter 5
T22499A
Corrosion of unspecified degree of multiple sites of unspecified shoulder and upper limb,
except wrist and hand, initial encounter 1
T2270xA
Corrosion of third degree of shoulder and upper limb, except wrist and hand, unspecified site,
initial encounter 5
T22729A Corrosion of third degree of unspecified elbow, initial encounter 1
T23009S Burn of unspecified degree of unspecified hand, unspecified site, sequela 2
T23079S Burn of unspecified degree of unspecified wrist, sequela 2
T23099A Burn of unspecified degree of multiple sites of unspecified wrist and hand, initial encounter 5
T23099S Burn of unspecified degree of multiple sites of unspecified wrist and hand, sequela 2
T23309A Burn of third degree of unspecified hand, unspecified site, initial encounter 5
T23329A Burn of third degree of unspecified single finger (nail) except thumb, initial encounter 5
T23339A
Burn of third degree of unspecified multiple fingers (nail), not including thumb, initial
encounter 5
T23349A Burn of third degree of unspecified multiple fingers (nail), including thumb, initial encounter 5
T23709A Corrosion of third degree of unspecified hand, unspecified site, initial encounter 1
T23729A Corrosion of third degree of unspecified single finger (nail) except thumb, initial encounter 1T23739A Corrosion of third degree of unspecified multiple fingers (nail), not including thumb, initial 1
T23749A
Corrosion of third degree of unspecified multiple fingers (nail), including thumb, initial
encounter 1
T24009S
Burn of unspecified degree of unspecified site of unspecified lower limb, except ankle and foot,
sequela 2
T24019S Burn of unspecified degree of unspecified thigh, sequela 2
61
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
T24029S Burn of unspecified degree of unspecified knee, sequela 2
T24039S Burn of unspecified degree of unspecified lower leg, sequela 2
T24099A
Burn of unspecified degree of multiple sites of unspecified lower limb, except ankle and foot,
initial encounter 5
T24099S
Burn of unspecified degree of multiple sites of unspecified lower limb, except ankle and foot,
sequela 2
T24309A
Burn of third degree of unspecified site of unspecified lower limb, except ankle and foot, initial
encounter 5
T24339A Burn of third degree of unspecified lower leg, initial encounter 5
T24399A
Burn of third degree of multiple sites of unspecified lower limb, except ankle and foot, initial
encounter 5
T24499A
Corrosion of unspecified degree of multiple sites of unspecified lower limb, except ankle and
foot, initial encounter 5
T24709A
Corrosion of third degree of unspecified site of unspecified lower limb, except ankle and foot,
initial encounter 5
T24739A Corrosion of third degree of unspecified lower leg, initial encounter 1
T25019S Burn of unspecified degree of unspecified ankle, sequela 2
T25029S Burn of unspecified degree of unspecified foot, sequela 2
T25099A Burn of unspecified degree of multiple sites of unspecified ankle and foot, initial encounter 5
T25099S Burn of unspecified degree of multiple sites of unspecified ankle and foot, sequela 2
T25319A Burn of third degree of unspecified ankle, initial encounter 5
T25329A Burn of third degree of unspecified foot, initial encounter 5
T25399A Burn of third degree of multiple sites of unspecified ankle and foot, initial encounter 5
T25499A
Corrosion of unspecified degree of multiple sites of unspecified ankle and foot, initial
encounter 5
T25729A Corrosion of third degree of unspecified foot, initial encounter 5
T25799A Corrosion of third degree of multiple sites of unspecified ankle and foot, initial encounter 5
T2600xS Burn of unspecified eyelid and periocular area, sequela 2
T2610xS Burn of cornea and conjunctival sac, unspecified eye, sequela 2
T2640xS Burn of unspecified eye and adnexa, part unspecified, sequela 2
T273xxA Burn of respiratory tract, part unspecified, initial encounter 5
T277xxA Corrosion of respiratory tract, part unspecified, initial encounter 5
T280xxS Burn of mouth and pharynx, sequela 2
T281xxS Burn of esophagus, sequela 2
T282xxS Burn of other parts of alimentary tract, sequela 2
T283xxS Burn of internal genitourinary organs, sequela 2
T2840xA Burn of unspecified internal organ, initial encounter 5
T2840xS Burn of unspecified internal organ, sequela 2
T28419S Burn of unspecified ear drum, sequela 2
T2849xS Burn of other internal organ, sequela 2
62
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
T2890xA Corrosions of unspecified internal organs, initial encounter 5
T300 Burn of unspecified body region, unspecified degree 2T304 Corrosion of unspecified body region, unspecified degree 2
T3111 Burns involving 10-19% of body surface with 10-19% third degree burns 5
T3122 Burns involving 20-29% of body surface with 20-29% third degree burns 5T3143 Burns involving 40-49% of body surface with 30-39% third degree burns 5
T3151 Burns involving 50-59% of body surface with 10-19% third degree burns 5
T3155 Burns involving 50-59% of body surface with 50-59% third degree burns 5
T3164 Burns involving 60-69% of body surface with 40-49% third degree burns 5
T3166 Burns involving 60-69% of body surface with 60-69% third degree burns 5
T3211 Corrosions involving 10-19% of body surface with 10-19% third degree corrosion 5
T3222 Corrosions involving 20-29% of body surface with 20-29% third degree corrosion 5
T3243 Corrosions involving 40-49% of body surface with 30-39% third degree corrosion 1
T3251 Corrosions involving 50-59% of body surface with 10-19% third degree corrosion 1
T3255 Corrosions involving 50-59% of body surface with 50-59% third degree corrosion 5
T3264 Corrosions involving 60-69% of body surface with 40-49% third degree corrosion 5
T3266 Corrosions involving 60-69% of body surface with 60-69% third degree corrosion 1
T3490xS Frostbite with tissue necrosis of unspecified sites, sequela 2
T3691xS Poisoning by unspecified systemic antibiotic, accidental (unintentional), sequela 2
T3692xS Poisoning by unspecified systemic antibiotic, intentional self-harm, sequela 2
T3693xS Poisoning by unspecified systemic antibiotic, assault, sequela 2
T3694xS Poisoning by unspecified systemic antibiotic, undetermined, sequela 2
T3791xS
Poisoning by unspecified systemic anti-infective and antiparasitics, accidental (unintentional),
sequela 2
T3792xS
Poisoning by unspecified systemic anti-infective and antiparasitics, intentional self-harm,
sequela 2T3793xS Poisoning by unspecified systemic anti-infective and antiparasitics, assault, sequela 2
T3794xS Poisoning by unspecified systemic anti-infective and antiparasitics, undetermined, sequela 2
T38801S
Poisoning by unspecified hormones and synthetic substitutes, accidental (unintentional),
sequela 2
T38802S Poisoning by unspecified hormones and synthetic substitutes, intentional self-harm, sequela 2
T38803S Poisoning by unspecified hormones and synthetic substitutes, assault, sequela 2
T38804S Poisoning by unspecified hormones and synthetic substitutes, undetermined, sequela 2
T40902S Poisoning by unspecified psychodysleptics [hallucinogens], intentional self-harm, sequela 2
T40903S Poisoning by unspecified psychodysleptics [hallucinogens], assault, sequela 2
T40904S Poisoning by unspecified psychodysleptics [hallucinogens], undetermined, sequela 2
T410X4S Poisoning by inhaled anesthetics, undetermined, sequela 2
T41204S Poisoning by unspecified general anesthetics, undetermined, sequela 2
T413X4S Poisoning by local anesthetics, undetermined, sequela 2
T423X4S Poisoning by barbiturates, undetermined, sequela 2
63
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
T424X4S Poisoning by benzodiazepines, undetermined, sequela 2
T4274xS Poisoning by unspecified antiepileptic and sedative-hypnotic drugs, undetermined, sequela 2
T428X4S
Poisoning by antiparkinsonism drugs and other central muscle-tone depressants,
undetermined, sequela 2
T43024S Poisoning by tetracyclic antidepressants, undetermined, sequela 2
T431X4S Poisoning by monoamine-oxidase-inhibitor antidepressants, undetermined, sequela 2
T43204S Poisoning by unspecified antidepressants, undetermined, sequela 2
T452X4S Poisoning by vitamins, undetermined, sequela 2
T4994xS Poisoning by unspecified topical agent, undetermined, sequela 2
T50904S
Poisoning by unspecified drugs, medicaments and biological substances, undetermined,
sequela 2
T543X4A Toxic effect of corrosive alkalis and alkali-like substances, undetermined, initial encounter 2
T560X4A Toxic effect of lead and its compounds, undetermined, initial encounter 2
T66xxxS Radiation sickness, unspecified, sequela 2
T68xxxS Hypothermia, sequela 2
T700xxS Otitic barotrauma, sequela 2
T701xxS Sinus barotrauma, sequela 2
T7020xS Unspecified effects of high altitude, sequela 2
T719xxS Asphyxiation due to unspecified cause, sequela 2
T730xxS Starvation, sequela 2
T744xxS Shaken infant syndrome, sequela 2
T7500xS Unspecified effects of lightning, sequela 2
T7692xS Unspecified child maltreatment, suspected, sequela 2
T7800xA Anaphylactic reaction due to unspecified food, initial encounter 2
T7801xA Anaphylactic reaction due to peanuts, initial encounter 2
T7802xA Anaphylactic reaction due to shellfish (crustaceans), initial encounter 2
T7803xA Anaphylactic reaction due to other fish, initial encounter 2
T7804xA Anaphylactic reaction due to fruits and vegetables, initial encounter 2
T7805xA Anaphylactic reaction due to tree nuts and seeds, initial encounter 2
T7807xA Anaphylactic reaction due to milk and dairy products, initial encounter 2
T7808xA Anaphylactic reaction due to eggs, initial encounter 2
T7809xA Anaphylactic reaction due to other food products, initial encounter 2
T782xxA Anaphylactic shock, unspecified, initial encounter 2
T79A0xS Compartment syndrome, unspecified, sequela 2
T819xxA Unspecified complication of procedure, initial encounter 2
T827xxA
Infection and inflammatory reaction due to other cardiac and vascular devices, implants and
grafts, initial encounter 3
T8460xA
Infection and inflammatory reaction due to internal fixation device of unspecified site, initial
encounter 2
64
ICD-10 CSHCS-Qualifying Diagnosis Codes
Effective 10/1/2018
T84619A
Infection and inflammatory reaction due to internal fixation device of unspecified bone of arm,
initial encounter 2
T84629A
Infection and inflammatory reaction due to internal fixation device of unspecified bone of leg,
initial encounter 2
T8463xA Infection and inflammatory reaction due to internal fixation device of spine, initial encounter 2
T847xxA
Infection and inflammatory reaction due to other internal orthopedic prosthetic devices,
implants and grafts, initial encounter 2
T8579xA
Infection and inflammatory reaction due to other internal prosthetic devices, implants and
grafts, initial encounter 3
T8600 Unspecified complication of bone marrow transplant 5
T8610 Unspecified complication of kidney transplant 5
T8620 Unspecified complication of heart transplant 5
T8630 Unspecified complication of heart-lung transplant 5
T8640 Unspecified complication of liver transplant 5
T865 Complications of stem cell transplant 5
T86819 Unspecified complication of lung transplant 5
T86839 Unspecified complication of bone graft 2
T86842 Corneal transplant infection 2
T86859 Unspecified complication of intestine transplant 5
T86890 Other transplanted tissue rejection 5
T8690 Unspecified complication of unspecified transplanted organ and tissue 2
T8699 Other complications of unspecified transplanted organ and tissue 2
T879 Unspecified complications of amputation stump 3
T889xxS Complication of surgical and medical care, unspecified, sequela 2
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