Arkansas Payment Improvement Initiative Episodes of … Care Payment Improvement Buildin g a healthie r future for all Arkansan s Arkansas Payment Improvement Initiative

HealthCarePaymentImprovement

Building a healthier future for all Arkansans

Arkansas Payment Improvement Initiative

www.paymentinitiative.org

Arkansas Blue Cross and Blue Shield AHCPII Help Desk

[email protected] 888.800.3283Last Update: October 2, 2017Arkansas Blue Plans in this report refers to Arkansas Blue Cross and Blue Shield, Health Advantage and/or BlueAdvantage Administrators of Arkansas.M

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Cholecystectomy Episode Reimbursement Program

PRINCIPAL ACCOUNTABLE PROVIDER MANUAL

Episodes of Care

Cholecystectomy Episode Reimbursement Program

The Arkansas Health Care Payment Improvement Initiative (AHCPII) was developed as a joint effort between Arkansas Medicaid, QualChoice and Arkansas Blue Cross and Blue Shield, its affiliates and subsidiaries (Arkansas Blue Cross). More information may be found within this manual or at www.paymentinitiative.org.

The Cholecystectomy Episode Program (Program) will incentivize better coordination of care, encourage clinical effectiveness, and reward high quality care in order to reduce complications that threaten quality and increase costs.

Episode Definition

This episode includes all care related to the procedure. The episode begins on the date of the procedure and includes all related services during the cholecystectomy through 90 days after the procedure, including inpatient and outpatient facility services, professional services, and related medications.

Principal Accountable Provider (PAP)

The PAP for the Cholecystectomy episode is the primary surgeon performing the Cholecystectomy procedure. The PAP for each episode is identified retrospectively through claims data. As leaders, however, PAPs will share in the savings and excess costs of episodes. A provider must have five or more eligible cases of an episode to be considered a PAP. For example, a physician must have performed at least five eligible Cholecystectomy episodes. The provider billing for the service on the claim is held responsible in the episode calculations. For this reason accurate coding is essential.

Claims Submission

Claims filing procedures will be the same as they are today as described in Arkansas Blue Cross’ Provider Network Agreements and provider manuals.

Supplemental Quality Measures

In order to participate in upside savings, providers must meet: 1. A quality metric related to the 30-day readmission rate using the same re-admission

criteria as CMS. 2. Additionally, PAPs will receive reports highlighting their performance on common bile

duct injury, abdominal blood vessel injury, bowel injury, the number of laparoscopic cholecystectomies converted to open surgeries, the number of cholecystectomies initiated via open surgery and the percent of episodes with CT scan prior to cholecystectomy, if applicable, for each patient must be entered via the AHIN portal in order for the PAP to participate in sharing any applicable savings.

Adjustments and Exclusions

Reference the Cholecystectomy Algorithm Summary for details.

Reports for Principal Accountable Providers (PAPs)

http://www.arkansasbluecross.com/doclib/documents/providers/ahcpii%20program%20overview.pdf

http://www.paymentinitiative.org/

Reference the AHCPII Overview Page within this manual for details and instructions on accessing the PAP Reports on the Provider Portal.

Financial Settlements in the Episodes of Care Model

Reference the AHCPII Overview Page within this manual for details on the Financial Settlement Process.

Provider Appeal Process

Reference the AHCPII Overview Page within this manual for details on the Provider Appeal Process.

This Program document is referenced in the provider agreements and amendments (defined as ("Program") of the Preferred Payment Plan, True Blue PPO, Arkansas' First Source PPO and Health Advantage Network Participating Provider Agreements. Therefore it is considered to be part of these agreements.

Cholecystectomy Algorithm Summary




Cholecystectomy Algorithm Summary v1.6 Page 2 of 16

Triggers An episode is triggered when a patient shows a claim with a Cholecystectomy CPT procedure code. The patient’s claims will also be processed by the OptumInsights ETG software, where they must be assigned an Episode Treatment Group (ETG) for “Cholelithiasis…with surgery” or “Other diseases of hepatobiliary system, with surgery”. For specific ICD-9-CM, DRG, and CPT/HCPCS procedure codes, please see dataset.

PAP assignment

The Principal Accountable Provider (PAP) for an episode is the physician enrolled in an Arkansas Blue Plan provider network who performs the cholecystectomy procedure.

Exclusions Episodes meeting one or more of the following criteria will be excluded: A. The patient has claims or enrollment records that indicate coordination of benefits with another payer not associated with the Arkansas

Blue Plans within the duration of the episode B. The patient does not have continuous coverage with at least one Arkansas Blue Plan throughout the entire episode C. Provider terminated prior to report publication D. Procedure occurred late in the performance period, episode will likely appear on next report E. The overall episode cost for the patient exceeds the outlier criteria. Currently, the outlier threshold is set at three standard deviations

above the average episode cost for all patients otherwise included in the reporting period for all PAPs F. Episode overlaps with another episode G. Intensive care within 30 days prior to the trigger H. Procedure as an open surgery I. Procedure began laparoscopic and converted to open J. The patient was discharged against medical advice or due to expiration. K. Patient was pregnant during episode L. Patient less than 1 year old M. Patient 65 years or older N. Patient has a claim in episode with a DRG of 1)other female reproductive system operating room procedures without complication and

comorbidities/major complication and comorbidities O. Patient has a concurrent diagnosis of: 1) Acute pancreatitis, 2) Cholangitis, 3) Cirrhosis P. Patient claims indicate one of the following comorbidities within 365 days before the trigger procedure and within 90 days after the trigger

procedure: 1) Transplant, 2) Dialysis, 3) ESRD (end-stage renal disease), 4) Suicide and intentional self-inflicted injury, 5) Cancer, 6) Certain complications of pregnancy, 7) HIV, 8) Sickle cell anemia

Q. Patient is an Exchange member R. Patient is an Access Only member S. Non-par self-insured groups: ABB Inc. (ABB/Baldor and Thomas & Betts), Green Bay Packaging, Hytrol Conveyor Co, Inc, Mana, Nabholz

Inc, Navistar Inc, NYSC NYS Holding Company (Nucor), Replacement Parts, Riceland Foods Inc, Southern Steel & Wire (effective 1/1/16), and White River Medical Center


Episode time window

The episode begins the day of the trigger procedure and ends 90 days after the trigger procedure.

Claims included

The following services are included in the episode: A. Claims with an ETG “Cholelithiasis…with surgery” or “Other diseases of hepatobiliary system, with surgery” within 90 days of the trigger

procedure B. All claims for inpatient admissions within 30 days after the discharge from the inpatient stay for the surgery. Claims with a DRG on the

CMS list of exclusions for gastrointestinal procedures will not be included in the episode. C. Claims for anesthesia that are within two days of the trigger

Quality measures

Quality measures “to pass” (payment related): A. There are currently no measures linked to Gain Sharing.

Quality measures “to track” (not payment related): A. Bile duct injury rate – Percentage of episodes with claims having a diagnosis indicating a bile duct injury on the Quality list. B. Abdominal blood vessel injury rate – The percentage of episodes with a diagnosis indicating an abdominal blood vessel injury on the

Quality list. C. CT Rate – Percentage of episodes within 30 days prior to trigger procedure indicating a CT Scan procedure code D. GI perforation rate – The percentage of episodes with a diagnosis indicating a gastrointestinal perforation on the Quality list.

Utilization Measures

Utilization measures “to track” (not payment related): A. Open procedure - Number of procedures performed as “Open” identified by the trigger procedure code billed without diagnosis V64.41 B. Converted procedure - Number of procedures initiated as “Laparoscopic” and converted to “Open” – Identified by the trigger procedure

code billed with diagnosis V64.41 Adjustments The total reimbursements attributed to the PAP will be adjusted based on complications that resulted in variations in treatment using a

multiplier determined by regression. Over time, risk factors may be added or subtracted based on new research and/or empirical evidence.

Trigger codes Claims with following CPT codes are considered when triggering an episode: CPT: 47562, 47563, 47564, 47570, 47600, 47605, 47610, 47612, 47620

Cholecystectomy Algorithm Summary v1.6 Page 4 of 16 Exclusion codes

Patients who have co-morbid condition(s) indicated by the following ICD-9-CM codes will be excluded: ICD-9-CM codes: 042, 042.0, 079.53, 140, 140.0, 140.1, 140.3, 140.4, 140.5, 140.6, 140.8, 140.9, 141, 141.0, 141.1, 141.2, 141.3, 141.4, 141.5, 141.6, 141.8, 141.9, 142, 142.0, 142.1, 142.2, 142.8, 142.9, 143, 143.0, 143.1, 143.8, 143.9, 144, 144.0, 144.1, 144.8, 144.9, 145, 145.0, 145.1, 145.2, 145.3, 145.4, 145.5, 145.6, 145.8, 145.9, 146, 146.0, 146.1, 146.2, 146.3, 146.4, 146.5, 146.6, 146.7, 146.8, 146.9, 147, 147.0, 147.1, 147.2, 147.3, 147.8, 147.9, 148, 148.0, 148.1, 148.2, 148.3, 148.8, 148.9, 149, 149.0, 149.1, 149.8, 149.9, 150, 150.0, 150.1, 150.2, 150.3, 150.4, 150.5, 150.8, 150.9, 151, 151.0, 151.1, 151.2, 151.3, 151.4, 151.5, 151.6, 151.8, 151.9, 152, 152.0, 152.1, 152.2, 152.3, 152.8, 152.9, 153, 153.0, 153.1, 153.2, 153.3, 153.4, 153.5, 153.6, 153.7, 153.8, 153.9, 154, 154.0, 154.1, 154.2, 154.3, 154.8, 155, 155.0, 155.1, 155.2, 156, 156.0, 156.1, 156.2, 156.8, 156.9, 157, 157.0, 157.1, 157.2, 157.3, 157.4, 157.8, 157.9, 158, 158.0, 158.8, 158.9, 159, 159.0, 159.1, 159.8, 159.9, 160, 160.0, 160.1, 160.2, 160.3, 160.4, 160.5, 160.8, 160.9, 161, 161.0, 161.1, 161.2, 161.3, 161.8, 161.9, 162, 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 163, 163.0, 163.1, 163.8, 163.9, 164, 164.0, 164.1, 164.2, 164.3, 164.8, 164.9, 165, 165.0, 165.8, 165.9, 170, 170.0, 170.1, 170.2, 170.3, 170.4, 170.5, 170.6, 170.7, 170.8, 170.9, 171, 171.0, 171.2, 171.3, 171.4, 171.5, 171.6, 171.7, 171.8, 171.9, 172, 172.0, 172.1, 172.2, 172.3, 172.4, 172.5, 172.6, 172.7, 172.8, 172.9, 173, 173.0, 173.00, 173.01, 173.02, 173.09, 173.1, 173.10, 173.11, 173.12, 173.19, 173.2, 173.20, 173.21, 173.22, 173.29, 173.3, 173.30, 173.31, 173.32, 173.39, 173.4, 173.40, 173.41, 173.42, 173.49, 173.5, 173.50, 173.51, 173.52, 173.59, 173.6, 173.60, 173.61, 173.62, 173.69, 173.7, 173.70, 173.71, 173.72, 173.79, 173.8, 173.80, 173.81, 173.82, 173.89, 173.9, 173.90, 173.91, 173.92, 173.99, 174, 174.0, 174.1, 174.2, 174.3, 174.4, 174.5, 174.6, 174.8, 174.9, 175, 175.0, 175.9, 176, 176.0, 176.1, 176.2, 176.3, 176.4, 176.5, 176.8, 176.9, 179, 180, 180.0, 180.1, 180.8, 180.9, 181, 182, 182.0, 182.1, 182.8, 183, 183.0, 183.2, 183.3, 183.4, 183.5, 183.8, 183.9, 184, 184.0, 184.1, 184.2, 184.3, 184.4, 184.8, 184.9, 185, 186, 186.0, 186.9, 187, 187.1, 187.2, 187.3, 187.4, 187.5, 187.6, 187.7, 187.8, 187.9, 188, 188.0, 188.1, 188.2, 188.3, 188.4, 188.5, 188.6, 188.7, 188.8, 188.9, 189, 189.0, 189.1, 189.2, 189.3, 189.4, 189.8, 189.9, 190, 190.0, 190.1, 190.2, 190.3, 190.4, 190.5, 190.6, 190.7, 190.8, 190.9, 191, 191.0, 191.1, 191.2, 191.3, 191.4, 191.5, 191.6, 191.7, 191.8, 191.9, 192, 192.0, 192.1, 192.2, 192.3, 192.8, 192.9, 193, 194, 194.0, 194.1, 194.3, 194.4, 194.5, 194.6, 194.8, 194.9, 195, 195.0, 195.1, 195.2, 195.3, 195.4, 195.5, 195.8, 196, 196.0, 196.1, 196.2, 196.3, 196.5, 196.6, 196.8, 196.9, 197, 197.0, 197.1, 197.2, 197.3, 197.4, 197.5, 197.6, 197.7, 197.8, 198, 198.0, 198.1, 198.2, 198.3, 198.4, 198.5, 198.6, 198.7, 198.8, 198.81, 198.82, 198.89, 199, 199.0, 199.1, 199.2, 200, 200.0, 200.00, 200.01, 200.02, 200.03, 200.04, 200.05, 200.06, 200.07, 200.08, 200.1, 200.10, 200.11, 200.12, 200.13, 200.14, 200.15, 200.16, 200.17, 200.18, 200.2, 200.20, 200.21, 200.22, 200.23, 200.24, 200.25, 200.26, 200.27, 200.28, 200.3, 200.30, 200.31, 200.32, 200.33, 200.34, 200.35, 200.36, 200.37, 200.38, 200.4, 200.40, 200.41, 200.42, 200.43, 200.44, 200.45, 200.46, 200.47, 200.48, 200.5, 200.50, 200.51, 200.52, 200.53, 200.54, 200.55, 200.56, 200.57, 200.58, 200.6, 200.60, 200.61, 200.62, 200.63, 200.64, 200.65, 200.66, 200.67, 200.68, 200.7, 200.70, 200.71, 200.72, 200.73, 200.74, 200.75, 200.76, 200.77, 200.78, 200.8, 200.80, 200.81, 200.82, 200.83, 200.84, 200.85, 200.86, 200.87, 200.88, 201, 201.0, 201.00, 201.01, 201.02, 201.03, 201.04, 201.05, 201.06, 201.07, 201.08, 201.1, 201.10, 201.11, 201.12, 201.13, 201.14, 201.15, 201.16, 201.17, 201.18, 201.2, 201.20, 201.21, 201.22, 201.23, 201.24, 201.25, 201.26, 201.27, 201.28, 201.4, 201.40, 201.41, 201.42, 201.43, 201.44, 201.45, 201.46, 201.47, 201.48, 201.5, 201.50, 201.51, 201.52, 201.53, 201.54, 201.55, 201.56, 201.57, 201.58, 201.6, 201.60, 201.61, 201.62, 201.63, 201.64, 201.65, 201.66, 201.67, 201.68, 201.7, 201.70, 201.71, 201.72, 201.73, 201.74, 201.75, 201.76, 201.77, 201.78, 201.9, 201.90, 201.91, 201.92, 201.93, 201.94, 201.95, 201.96, 201.97, 201.98, 202, 202.0, 202.00, 202.01, 202.02, 202.03, 202.04, 202.05, 202.06, 202.07, 202.08, 202.1, 202.10, 202.11, 202.12, 202.13, 202.14, 202.15, 202.16, 202.17, 202.18, 202.2, 202.20, 202.21, 202.22, 202.23, 202.24, 202.25, 202.26, 202.27, 202.28, 202.3, 202.30, 202.31, 202.32, 202.33, 202.34, 202.35, 202.36, 202.37, 202.38, 202.4, 202.40, 202.41, 202.42, 202.43, 202.44, 202.45, 202.46, 202.47, 202.48, 202.5, 202.50, 202.51, 202.52, 202.53, 202.54, 202.55, 202.56, 202.57, 202.58, 202.6, 202.60, 202.61, 202.62, 202.63, 202.64, 202.65, 202.66, 202.67, 202.68, 202.7, 202.70, 202.71, 202.72, 202.73, 202.74, 202.75, 202.76, 202.77, 202.78, 202.8, 202.80, 202.81, 202.82, 202.83, 202.84, 202.85, 202.86, 202.87, 202.88, 202.9, 202.90, 202.91, 202.92, 202.93,


Exclusion codes (continued)

ICD-9-CM codes: 202.94, 202.95, 202.96, 202.97, 202.98, 203, 203.0, 203.00, 203.01, 203.02, 203.1, 203.10, 203.11, 203.12, 203.8, 203.80, 203.81, 203.82, 204, 204.0, 204.00, 204.01, 204.02, 204.1, 204.10, 204.11, 204.12, 204.2, 204.20, 204.21, 204.22, 204.8, 204.80, 204.81, 204.82, 204.9, 204.90, 204.91, 204.92, 205, 205.0, 205.00, 205.01, 205.02, 205.1, 205.10, 205.11, 205.12, 205.2, 205.20, 205.21, 205.22, 205.3, 205.30, 205.31, 205.32, 205.8, 205.80, 205.81, 205.82, 205.9, 205.90, 205.91, 205.92, 206, 206.0, 206.00, 206.01, 206.02, 206.1, 206.10, 206.11, 206.12, 206.2, 206.20, 206.21, 206.22, 206.8, 206.80, 206.81, 206.82, 206.9, 206.90, 206.91, 206.92, 207, 207.0, 207.00, 207.01, 207.02, 207.1, 207.10, 207.11, 207.12, 207.2, 207.20, 207.21, 207.22, 207.8, 207.80, 207.81, 207.82, 208, 208.0, 208.00, 208.01, 208.02, 208.1, 208.10, 207.11, 208.12, 208.2, 208.20, 208.21, 208.22, 208.8, 208.80, 208.81, 208.82, 208.9, 208.90, 208.91, 208.92, 209.0, 209.00, 209.01, 209.02, 209.03, 209.1, 209.10, 209.11, 209.12, 209.13, 209.14, 209.15, 209.16, 209.17, 209.2, 209.20, 209.21, 209.22, 209.23, 209.24, 209.25, 209.26, 209.27, 209.29, 209.3, 209.30, 209.31, 209.32, 209.33, 209.34, 209.35, 209.36, 209.7, 209.70, 209.71, 209.72, 209.73, 209.74, 209.75, 209.79, 228, 228.0, 228.00, 228.01, 228.02, 228.03, 228.04, 228.09, 228.1, 230, 230.0, 230.1, 230.2, 230.3, 230.4, 230.5, 230.6, 230.7, 230.8, 230.9, 231, 231.0, 231.1, 231.2, 231.8, 231.9, 232, 232.0, 232.1, 232.2, 232.3, 232.4, 232.5, 232.6, 232.7, 232.8, 232.9, 233, 233.0, 233.1, 233.2, 233.3, 233.30, 233.31, 233.32, 233.39, 233.4, 233.5, 233.6, 233.7, 233.9, 234, 234.0, 234.8, 234.9, 235, 235.0, 235.1, 235.2, 235.3, 235.4, 235.5, 235.6, 235.7, 235.8, 235.9, 236, 236.0, 236.1, 236.2, 236.3, 236.4, 236.5, 236.6, 236.7, 236.9, 236.90, 236.91, 236.99, 237, 237.0, 237.1, 237.2, 237.3, 237.4, 237.5, 237.6, 237.7, 237.70, 237.71, 237.72, 237.73, 237.79, 237.9, 238, 238.0, 238.1, 238.2, 238.3, 238.4, 238.5, 238.6, 238.7, 238.71, 238.72, 238.73, 238.74, 238.75, 238.76, 238.77, 238.79, 238.8, 238.9, 239, 239.0, 239.1, 239.2, 239.3, 239.4, 239.5, 239.6, 239.7, 239.8, 239.81, 239.89, 239.9, 279.10, 279.19, 282.6, 282.60, 282.61, 282.62, 282.63, 282.64, 282.68, 282.69, 560.31, 571.2, 571.5, 571.6, 574.40, 574.50, 576.1, 577, 577.0, 577.1, 577.2, 577.8, 577.9, 585.5, 585.6, 630, 631, 631.0, 631.8, 632, 633, 633.0, 633.00, 633.01, 633.1, 633.10, 633.11, 633.2, 633.20, 633.21, 633.8, 633.80, 633.81, 633.9, 633.90, 633.91, 634, 634.0, 634.00, 634.01, 634.02, 634.1, 634.10, 634.11, 634.12, 634.2, 634.20, 634.21, 634.22, 634.3, 634.30, 634.31, 634.32, 634.4, 634.40, 634.41, 634.42, 634.5, 634.50, 634.51, 634.52, 634.6, 634.60, 634.61, 634.62, 634.7, 634.70, 634.71, 634.72, 634.8, 634.80, 634.81, 634.82, 634.9, 634.90, 634.91, 634.92, 635.00, 635.01, 635.02, 635.10, 635.11, 635.12, 635.20, 635.21, 635.22, 635.30, 635.31, 635.32, 635.40, 635.41, 635.42, 635.50, 635.51, 635.52, 635.60, 635.61, 635.62, 635.70, 635.71, 635.72, 635.80, 635.81, 635.82, 635.90, 635.91, 635.92, 636.00, 636.01, 636.02, 636.10, 636.11, 636.12, 636.20, 636.21, 636.22, 636.30, 636.31, 636.32, 636.40, 636.41, 636.42, 636.50, 636.51, 636.52, 636.60, 636.61, 636.62, 636.70, 636.71, 636.72, 636.80, 636.81, 636.82, 636.90, 636.91, 636.92, 637.00, 637.01, 637.02, 637.10, 637.11, 637.12, 637.20, 637.21, 637.22, 637.30, 637.31, 637.32, 637.40, 637.41, 637.42, 637.50, 637.51, 637.52, 637.60, 637.61, 637.62, 637.70, 637.71, 637.72, 637.80, 637.81, 637.82, 637.90, 637.91, 637.92, 638.0, 638.1, 638.2, 638.3, 638.4, 638.5, 638.6, 638.7, 638.8, 638.9, 639, 639.0, 639.1, 639.2, 639.3, 639.4, 639.5, 639.6, 639.8, 639.9, 640, 640.0, 640.00, 640.01, 640.03, 640.8, 640.80, 640.81, 640.83, 640.9, 640.90, 640.91, 640.93, 641, 641.0, 641.00, 641.01, 641.03, 641.1, 641.10, 641.11, 641.13, 641.2, 641.20, 641.21, 641.23, 641.3, 641.30, 641.31, 641.33, 641.8, 641.80, 641.81, 641.83, 641.9, 641.90, 641.91, 641.93, 642, 642.0, 642.00, 642.01, 642.02, 642.03, 642.04, 642.1, 642.10, 642.11, 642.12, 642.13, 642.14, 642.2, 642.20, 642.21, 642.22, 642.23, 642.24, 642.3, 642.30, 642.31, 642.32, 642.33, 642.34, 642.4, 642.40, 642.41, 642.42, 642.43, 642.44, 642.5, 642.50, 642.51, 642.52, 642.53, 642.54, 642.6, 642.60, 642.61, 642.62, 642.63, 642.64, 642.7, 642.70, 642.71, 642.72, 642.73, 642.74, 642.9, 642.90, 642.91, 642.92, 642.93, 642.94, 643, 643.0, 643.00, 643.01, 643.03, 643.1, 643.10, 643.11, 643.13, 643.2, 643.20, 643.21, 643.23, 643.8, 643.80, 643.81, 643.83, 643.9, 643.90, 643.91, 643.93, 644, 644.0, 644.00, 644.03, 644.1, 644.10, 644.13, 644.2, 644.20, 644.21, 645, 645.1, 645.10, 645.11, 645.13, 645.2, 645.20, 645.21, 645.23, 646, 646.0, 646.00, 646.01, 646.03, 646.1, 646.10, 646.11, 646.12, 646.13, 646.14, 646.2, 646.20, 646.21, 646.22, 646.23, 646.24, 646.3, 646.30, 646.31, 646.33, 646.4, 646.40, 646.41, 646.42, 646.43, 646.44, 646.5, 646.50, 646.51, 646.52, 646.53, 646.54, 646.6, 646.60, 646.61, 646.62, 646.63, 646.64, 646.7, 646.70,



ICD-9-CM codes: 646.71, 646.73, 646.8, 646.80, 646.81, 646.82, 646.83, 646.84, 646.9, 646.90, 646.91, 646.93, 647, 647.0, 647.00, 647.01, 647.02, 647.03, 647.04, 647.1, 647.10, 647.11, 647.12, 647.13, 647.14, 647.2, 647.20, 647.21, 647.22, 647.23, 647.24, 647.3, 647.30, 647.31, 647.32, 647.33, 647.34, 647.4, 647.40, 647.41, 647.42, 647.43, 647.44, 647.5, 647.50, 647.51, 647.52, 647.53, 647.54, 647.6, 647.60, 647.61, 647.62, 647.63, 647.64, 647.8, 647.80, 647.81, 647.82, 647.83, 647.84, 647.9, 647.90, 647.91, 647.92, 647.93, 647.94, 648, 648.0, 648.00, 648.01, 648.02, 648.03, 648.04, 648.1, 648.10, 648.11, 648.12, 648.13, 648.14, 648.2, 648.20, 648.21, 648.22, 648.23, 648.24, 648.3, 648.30, 648.31, 648.32, 648.33, 648.34, 648.4, 648.40, 648.41, 648.42, 648.43, 648.44, 648.5, 648.50, 648.51, 648.52, 648.53, 648.54, 648.6, 648.60, 648.61, 648.62, 648.63, 648.64, 648.7, 648.70, 648.71, 648.72, 648.73, 648.74, 648.8, 648.80, 648.81, 648.82, 648.83, 648.84, 648.9, 648.90, 648.91, 648.92, 648.93, 648.94, 649, 649.0, 649.00, 649.01, 649.02, 649.03, 649.04, 649.1, 649.10, 649.11, 649.12, 649.13, 649.14, 649.2, 649.20, 649.21, 649.22, 649.23, 649.24, 649.3, 649.30, 649.31, 649.32, 649.33, 649.34, 649.4, 649.40, 649.41, 649.42, 649.43, 649.44, 649.5, 649.50, 649.51, 649.53, 649.6, 649.60, 649.61, 649.62, 649.63, 649.64, 649.7, 649.70, 649.71, 649.73, 649.8, 649.81, 649.82, 650, 651, 651.0, 651.00, 651.01, 651.03, 651.1, 651.10, 651.11, 651.13, 651.2, 651.20, 651.21, 651.23, 651.3, 651.30, 651.31, 651.33, 651.4, 651.40, 651.41, 651.43, 651.5, 651.50, 651.51, 651.53, 651.6, 651.60, 651.61, 651.63, 651.7, 651.70, 651.71, 651.73, 651.8, 651.80, 651.81, 651.83, 651.9, 651.90, 651.91, 651.93, 652, 652.0, 652.00, 652.01, 652.03, 652.1, 652.10, 652.11, 652.13, 652.2, 652.20, 652.21, 652.23, 652.3, 652.30, 652.31, 652.33, 652.4, 652.40, 652.41, 652.43, 652.5, 652.50, 652.51, 652.53, 652.6, 652.60, 652.61, 652.63, 652.7, 652.70, 652.71, 652.73, 652.8, 652.80, 652.81, 652.83, 652.9, 652.90, 652.91, 652.93, 653, 653.0, 653.00, 653.01, 653.03, 653.1, 653.10, 653.11, 653.13, 653.2, 653.20, 653.21, 653.23, 653.3, 653.30, 653.31, 653.33, 653.4, 653.40, 653.41, 653.43, 653.5, 653.50, 653.51, 653.53, 653.6, 653.60, 653.61, 653.63, 653.7, 653.70, 653.71, 653.73, 653.8, 653.80, 653.81, 653.83, 653.9, 653.90, 653.91, 653.93, 654, 654.0, 654.00, 654.01, 654.02, 654.03, 654.04, 654.1, 654.10, 654.11, 654.12, 654.13, 654.14, 654.2, 654.20, 654.21, 654.23, 654.3, 654.30, 654.31, 654.32, 654.33, 654.34, 654.4, 654.40, 654.41, 654.42, 654.43, 654.44, 654.5, 654.50, 654.51, 654.52, 654.53, 654.54, 654.6, 654.60, 654.61, 654.62, 654.63, 654.64, 654.7, 654.70, 654.71, 654.72, 654.73, 654.74, 654.8, 654.80, 654.81, 654.82, 654.83, 654.84, 654.9, 654.90, 654.91, 654.92, 654.93, 654.94, 655, 655.0, 655.00, 655.01, 655.03, 655.1, 655.10, 655.11, 655.13, 655.2, 655.20, 655.21, 655.23 655.3, 655.30, 655.31, 655.33, 655.4, 655.40, 655.41, 655.43, 655.5, 655.50, 655.51, 655.53, 655.6, 655.60, 655.61, 655.63, 655.7, 655.70, 655.71, 655.73, 655.8, 655.80, 655.81, 655.83, 655.9, 655.90, 655.91, 655.93, 656, 656.0, 656.00, 656.01, 656.03, 656.1, 656.10, 656.11, 656.13, 656.2, 656.20, 656.21, 656.23, 656.3, 656.30, 656.31, 656.33, 656.4, 656.40, 656.41, 656.43, 656.5, 656.50, 656.51, 656.53, 656.6, 656.60, 656.61, 656.63, 656.7, 656.70, 656.71, 656.73, 656.8, 656.80, 656.81, 656.83, 656.9, 656.90, 656.91, 656.93, 657, 657.00, 657.01, 657.03, 658, 658.0, 658.00, 658.01, 658.03, 658.1, 658.10, 658.11, 658.13, 658.2, 658.20, 658.21, 658.23, 658.3, 658.30, 658.31, 658.33, 658.4, 658.40, 658.41, 658.43, 658.8, 658.80, 658.81, 658.83, 658.9, 658.90, 658.91, 658.93, 659, 659.0, 659.00, 659.01, 659.03, 659.1, 659.10, 659.11, 659.13, 659.2, 659.20, 659.21, 659.23, 659.3, 659.30, 659.31, 659.33, 659.4, 659.40, 659.41, 659.43, 659.5, 659.50, 659.51, 659.53, 659.6, 659.60, 659.61, 659.63, 659.7, 659.70, 659.71, 659.73, 659.8, 659.80, 659.81, 659.83, 659.9, 659.90, 659.91, 659.93, 660, 660.0, 660.00, 660.01, 660.03, 660.1,660.10,660.11,660.13,660.2, 660.20, 660.21, 660.23, 660.3, 660.30, 660.31, 660.33, 660.4, 660.40, 660.41, 660.43, 660.5, 660.50, 660.51, 660.53, 660.6, 660.60, 660.61, 660.63, 660.7, 660.70, 660.71, 660.73, 660.8, 660.80, 660.81, 660.83, 660.9, 660.90, 660.91, 660.93, 661, 661.0, 661.00, 661.01, 661.03, 661.1, 661.10, 661.11, 661.13, 661.2, 661.20, 661.21, 661.23, 661.3, 661.30, 661.31, 661.33, 661.4, 661.40, 661.41, 661.43, 661.9, 661.90, 661.91, 661.93, 662, 662.0, 662.00, 662.01, 662.03, 662.1, 662.10, 662.11, 662.13, 662.2, 662.20, 662.21, 662.23, 662.3, 662.30, 662.31, 662.33, 663, 663.0, 663.00, 663.01, 663.03, 663.1, 663.10, 663.11, 663.13, 663.2, 663.20, 663.21, 663.23, 663.3, 663.30, 663.31, 663.33, 663.4, 663.40, 663.41, 663.43, 663.5, 663.50, 663.51, 663.53, 663.6, 663.60, 663.61, 663.63, 663.8, 663.80, 663.81, 663.83, 663.9, 663.90, 663.91, 663.93, 664, 664.0, 664.00, 664.01, 664.04, 664.1, 664.10, 664.11, 664.14, 664.2, 664.20,



Patients who have co-morbid condition(s) indicated by the following ICD-9-CM codes will be excluded: ICD-9-CM codes: 664.21, 664.24, 664.3, 664.30, 664.31, 664.34, 664.4, 664.40, 664.41, 664.44, 664.5, 664.50, 664.51, 664.54, 664.6, 664.60, 664.61, 664.64, 664.8, 664.80, 664.81, 664.84, 664.9, 664.90, 664.91, 664.94, 665, 665.0, 665.00, 665.01, 665.03, 665.1, 665.10, 665.11, 665.2, 665.20, 665.22, 665.24, 665.3, 665.30, 665.31, 665.34, 665.4, 665.40, 665.41, 665.44, 665.5, 665.50, 665.51, 665.54, 665.6, 665.60, 665.61, 665.64, 665.7, 665.70, 665.71, 665.72, 665.74, 665.8, 665.80, 665.81, 665.82, 665.83, 665.84, 665.9, 665.90, 665.91, 665.92, 665.93, 665.94, 666, 666.0, 666.00, 666.02, 666.04, 666.1, 666.10, 666.12, 666.14, 666.2, 666.20, 666.22, 666.24, 666.3, 666.30, 666.32, 666.34, 667, 667.0, 667.00, 667.02, 667.04, 667.1, 667.10, 667.12, 667.14, 668, 668.0, 668.00, 668.01, 668.02, 668.03, 668.04, 668.1, 668.10, 668.11, 668.12, 668.13, 668.14, 668.2, 668.20, 668.21, 668.22, 668.23, 668.24, 668.8, 668.80, 668.81, 668.82, 668.83, 668.84, 668.9, 668.90, 668.91, 668.92, 668.93, 668.94, 669, 669.0, 669.00, 669.01, 669.02, 669.03, 669.04, 669.1, 669.10, 669.11, 669.12, 669.13, 669.14, 669.2, 669.20, 669.21, 669.22, 669.23, 669.24, 669.3, 669.30, 669.32, 669.34, 669.4, 669.40, 669.41, 669.42, 669.43, 669.44, 669.5, 669.50, 669.51, 669.6, 669.60, 669.61, 669.7, 669.70, 669.71, 669.8, 669.80, 669.81, 669.82, 669.83, 669.84, 669.9, 669.90, 669.91, 669.92, 669.93, 669.94, 795.71, 795.8, 996.56, 996.68, 996.73, E950, E950.0, E950.1, E950.2, E950.3, E950.4, E950.5, E950.6, E950.7, E950.8, E950.9, E951, E951.0, E951.1, E951.8, E952, E952.0, E952.1, E952.8, E952.9, E953, E953.0, E953.1, E953.8, E953.9, E954, E955, E955.0, E955.1, E955.2, E955.3, E955.4, E955.5, E955.6, E955.7, E955.9, E956, E957, E957.0, E957.1, E957.2, E957.9, E958, E958.0, E958.1, E958.2, E958.3, E958.4, E958.5, E958.6, E958.7, E958.8, E958.9, V08, V22, V22.0, V22.1, V22.2, V23, V23.0, V23.1, V23.2, V23.3, V23.4, V23.41, V23.42, V23.42, V23.49, V23.5, V23.7, V23.8, V23.81, V23.82, V23.83, V23.84, V23.85, V23.86, V23.87, V23.89, V23.9, V24, V24.0, V24.1, V24.2, V27, V27.0, V27.1, V27.2, V27.3, V27.4, V27.5, V27.6, V27.7, V27.9, V42.0, V42.1, V42.5, V42.7, V45.1, V45.11, V45.12, V56.0, V56.1, V56.2, V56.3, V56.31, V56.32, V56.8, V62.84

Claims with the following DRG codes are excluded based on the CMS exclusions for Cholecystectomy: MS-DRG codes: 0001, 0002, 0005, 0006, 0007, 0008, 0010, 0011, 0012, 0013, 0014, 0016, 0017, 0020, 0021, 0022, 0023, 0024, 0025, 0026, 0027, 0028, 0029, 0030, 0031, 0032, 0033, 0034, 0035, 0036, 0037, 0038, 0039, 0040, 0041, 0042, 0113, 0114, 0115, 0116, 0117, 0129, 0130, 0131, 0132, 0133, 0134, 0135, 0136, 0137, 0138, 0139, 0216, 0217, 0218, 0219, 0220, 0221, 0222, 0223, 0224, 0225, 0226, 0227, 0228, 0229, 0230, 0231, 0232, 0233, 0234, 0235, 0236, 0237, 0238, 0239, 0240, 0241, 0242, 0243, 0244, 0245, 0246, 0247, 0248, 0249, 0250, 0251, 0255, 0256, 0257, 0258, 0259, 0260, 0261, 0262, 0263, 0264, 0265, 0326, 0327, 0328, 0329, 0330, 0331, 0332, 0333, 0334, 0335, 0336, 0337, 0338, 0339, 0340, 0341, 0342, 0343, 0344, 0345, 0346, 0347, 0348, 0349, 0350, 0351, 0352, 0353, 0354, 0355, 0405, 0406, 0407, 0408, 0409, 0410, 0411, 0412, 0413, 0414, 0415, 0416, 0417, 0418, 0419, 0420, 0421, 0422, 0423, 0424, 0425, 0453, 0454, 0455, 0456, 0457, 0458, 0459, 0460, 0461, 0462, 0463, 0464, 0465, 0466, 0467, 0468, 0469, 0470, 0471, 0472, 0473, 0474, 0475, 0476, 0477, 0478, 0479, 0480, 0481, 0482, 0483, 0484, 0485, 0486, 0487, 0488, 0489, 0490, 0491, 0492, 0493, 0494, 0495, 0496, 0497, 0498, 0499, 0500, 0501, 0502, 0503, 0504, 0505, 0506, 0507, 0508, 0509, 0510, 0511, 0512, 0513, 0514, 0515, 0516, 0517, 0570, 0571, 0572, 0573, 0574, 0575, 0576, 0577, 0578, 0579, 0580, 0581, 0582, 0583, 0584, 0585, 0614, 0615, 0616, 0617, 0618, 0619, 0620, 0621, 0622, 0623, 0624, 0625, 0626, 0627, 0652, 0653, 0654, 0655, 0656, 0657, 0658, 0659, 0660, 0661, 0662, 0663, 0664, 0665, 0666, 0667, 0668, 0669, 0670, 0671, 0672, 0673, 0674, 0675, 0707, 0708, 0709, 0710, 0711, 0712, 0713, 0714, 0715, 0716, 0717, 0718, 0734, 0735, 0736, 0737, 0738, 0739, 0740, 0741, 0742, 0743, 0744, 0745, 0746, 0747, 0748,



MS-DRG codes: 0749, 0750, 0765, 0766, 0767, 0768, 0769, 0770, 0799, 0800, 0801, 0820, 0821, 0822, 0823, 0824, 0825, 0826, 0827, 0828, 0829, 0830, 0856, 0857, 0858, 0876, 0901, 0902, 0903, 0904, 0905, 0906, 0907, 0908, 0909, 0927, 0928, 0929, 0955, 0956, 0957, 0958, 0959, 0969, 0970, 0984, 0985, 0986 Claims with the following CPT procedure codes will be excluded: CPT procedure codes: 74300 Please see the final pages of this document for a list of the corresponding ICD-10 codes

Claims included codes

Claims with an ETG “Cholelithiasis…with surgery” or “Other diseases of hepatobiliary system, with surgery” within 90 days of the trigger procedure.

All claims for inpatient admissions within 30 days after the discharge from the inpatient stay for the surgery. Claims with a DRG on the CMS list of exclusions for gastrointestinal procedures will not be included in the episode.

Claims with the following CPT procedure codes will be included in episode: CPT procedure: 00700, 00740, 00750, 00752, 00790, 00797, 00840

Quality codes Quality measures “to pass” (payment related): A. There are currently no measures linked to Gain Sharing.

Quality measures “to track” (not payment related): A. Bile Duct Injury - ICD-9 Diagnosis: 868.02 B. Abdominal Blood Vessel Injury – ICD-9 Diagnosis: 902, 902.0, 902.1, 902.10, 902.11, 902.19, 902.2, 902.20, 902.21, 902.22, 902.23,

902.24, 902.25, 902.26, 902.27, 902.29, 902.3, 902.31, 902.32, 902.33, 902.34, 902.39, 902.4, 902.40, 902.41, 902.42, 902.49, 902.5, 902.50, 902.51, 902.52, 902.53, 902.54, 902.55, 902.56, 902.59, 902.8, 902.81, 902.82, 902.87, 902.89, 902.9

C. CT Scan - CPT Procedure: 0042T, 70450, 70460, 70470, 70480, 70481, 70482, 70486, 70487, 70488, 70490, 70491, 70492, 70496, 70498, 71250, 71260, 71270, 71275, 72125, 72126, 72127, 72128, 72129, 72130, 72131, 72132, 72133, 72191, 72192, 72193, 72194, 73200, 73201, 73202, 73206, 73700, 73701, 73702, 73706, 74150, 74160, , 74170, 74175, 74176, 74177, 74178, 74261, 74262, 74263, 75571, 75572, 75573, 75574, 75635, 76380, 76497, 77011, 77012, 77013, 77014, 77078

D. GI Perforation – ICD-9 Diagnosis: 569.83 Please see the final pages of this document for a list of the corresponding ICD-10 codes

Utilization codes Utilization measures “to track” (not payment related): “Open” procedure: CPT Procedure: 47600, 47605, 47610, 47612, 47620 ICD-9 Procedure: 51.21, 51.22 “Converted” procedure (initiated as Laparoscopic): ICD-9 Diagnosis: V64.41 Please see the final pages of this document for a list of the corresponding ICD-10 codes


Exclusion codes

Patients who have co-morbid condition(s) indicated by the following ICD-9-CM codes will be excluded: ICD-10-CM codes: B20, B9735, C000, C001, C003, C004, C005, C006, C008, C002, C009, C01, C020, C021, C022, C023, C024, C028, C029, C07, C080, C081, C089, C030, C031, C039, C040, C041, C048, C049, C060, C061, C050, C051, C052, C058, C059, C062, C0680, C0689, C069, C098, C099, C090, C091, C100, C101, C102, C103, C104, C108, C109, C110, C111, C112, C113, C118, C119, C130, C12, C131, C132, C138, C139, C140, C142, C148, C153, C154, C155, C158, C159, C160, C164, C163, C161, C162, C165, C166, C168, C169, C170, C171, C172, C173, C178, C179, C183, C184, C186, C187, C180, C181, C182, C185, C188, C189, C19, C20, C211, C210, C212, C218, C220, C222, C223, C224, C227, C228, C221, C229, C23, C240, C241, C248, C249, C250, C251, C252, C253, C254, C257, C258, C259, C480, C451, C481, C488, C482, C260, C261, C269, C300, C301, C310, C311, C312, C313, C318, C319, C320, C321, C322, C323, C328, C329, C33, C3400, C3401, C3402, C3410, C3411, C3412, C342, C3430, C3431, C3432, C3480, C3481, C3482, C3490, C3491, C3492, C384, C450, C37, C380, C452, C381, C382, C388, C383, C390, C399, C410, C411, C412, C413, C4000, C4001, C4002, C4010, C4011, C4012, C414, C4020, C4021, C4022, C4030, C4031, C4032, C4080, C4081, C4082, C4090, C4091, C4092, C419, C470, C490, C4710, C4711, C4712, C4910, C4911, C4912, C4720, C4721, C4722, C4920, C4921, C4922, C473, C493, C474, C494, C475, C495, C476, C496, C478, C498, C479, C499, C430, D030, C4310, C4311, C4312, D0310, D0311, D0312, C4320, C4321, C4322, D0320, D0321, D0322, C4330, C4331, C4339, D0330, D0339, C434, D034, C4351, C4352, C4359, D0351, D0352, D0359, C4360, C4361, C4362, D0360, D0361, D0362, C4370, C4371, C4372, D0370, D0371, D0372, C438, D038, C439, D039, C4400, C4401, C4402, C4409, C44101, C44102, C44109, C44111, C44112, C44119, C44121, C44122, C44129, C44191, C44192, C44199, C44201, C44202, C44209, C44211, C44212, C44219, C44221, C44222, C44229, C44291, C44292, C44299, C44300, C44301, C44309, C44310, C44311, C44319, C44320, C44321, C44329, C44390, C44391, C44399, C4440, C4441, C4442, C4449, C44500, C44501, C44509, C44510, C44511, C44519, C44520, C44521, C44529, C44590, C44591, C44599, C44601, C44602, C44609, C44611, C44612, C44619, C44621, C44622, C44629, C44691, C44692, C44699, C44701, C44702, C44709, C44711, C44712, C44719, C44721, C44722, C44729, C44791, C44792, C44799, C4480, C4481, C4482, C4489, C4490, C4491, C4492, C4499, C50011, C50012, C50019, C50111, C50112, C50119, C50211, C50212, C50219, C50311, C50312, C50319, C50411, C50412, C50419, C50511, C50512, C50519, C50611, C50612, C50619, C50811, C50812, C50819, C50911, C50912, C50919, C50021, C50022, C50029, C50121, C50122, C50129, C50221, C50222, C50229, C50321, C50322, C50329, C50421, C50422, C50429, C50521, C50522, C50529, C50621, C50622, C50629, C50821, C50822, C50829, C50921, C50922, C50929, C460, C461, C462, C464, C4650, C4651, C4652, C463, C467, C469, C55, C530, C531, C538, C539, C58, C541, C542, C543, C549, C540, C548, C561, C562, C569, C5700, C5701, C5702, C5710, C5711, C5712, C573, C5720, C5721, C5722, C574, C574, C52, C510, C511, C512, C519, C518, C577, C578, C579, C61, C6200, C6201, C6202, C6210, C6211, C6212, C6290, C6291, C6292, C600, C601, C602, C609, C6300, C6301, C6302, C6310, C6311, C6312, C632, C608, C637, C638, C639, C670, C671, C672, C673, C674, C675, C676, C677, C678, C679, C641, C642, C649, C651, C652, C659, C661, C662, C669, C680, C681, C688, C689, C6940, C6941, C6942, C6960, C6961, C6962, C6900, C6901, C6902, C6910, C6911, C6912, C6920, C6921, C6922, C6930, C6931, C6932, C6950, C6951, C6952, C6980, C6981, C6982, C6990, C6991, C6992, C710, C711, C712, C713, C714, C715, C716, C717, C718, C719, C7220, C7221, C7222, C7230, C7231, C7232, C7240, C7241, C7242, C7250, C7259, C700, C709, C720, C721, C701, C729, C73, C7400, C7401, C7402, C7410, C7411, C7412, C7490, C7491, C7492, C750, C751, C752, C753, C754, C755, C758, C759, C760, C761, C762, C763, C7640, C7641, C7642, C7650, C7651, C7652, C457, C768, C770, C771, C772, C773, C774, C775, C778, C779, C7800, C7801, C7802, C781, C782, C7830, C7839, C784, C785, C786, C787, C7880, C7889, C7900, C7901, C7902, C7910, C7911, C7919, C792, C7931, C7932, C7940, C7949, C7951, C7952, C7960, C7961, C7962, C7970, C7971, C7972, C7981, C7982, C7989, C799, C800, C459, C801, C802, C8330, C8339, C8331, C8332, C8333, C8334, C8335, C8336, C8337, C8338, C8350, C8359, C8351, C8352, C8353, C8354, C8355, C8356, C8357, C8358, C8370, C8379, C8371, C8372, C8373, C8374, C8375, C8376, C8377, C8378, C8380, C8389, C884, C8382, C8383,



ICD-10-CM codes: C8387, C8310, C8319, C8311, C8312, C8313, C8314, C8315, C8316, C8317, C8318, C8381, C8460, C8469, C8470, C8479, C8461, C8471, C8462, C8472, C8463, C8473, C8464, C8474, C8465, C8475, C8466, C8476, C8467, C8477, C8468, C8478, C8300, C8309, C8390, C8399, C865, C866, C8301, C8391, C8302, C8392, C8303, C8393, C8304, C8384, C8394, C8305, C8385, C8395, C8306, C8386, C8396, C8307, C8397, C8308, C8388, C8398, C8171, C8173, C8174, C8177, C8170, C8179, C8172, C8175, C8176, C8178, C8100, C8109, C8140, C8149, C8101, C8141, C8102, C8142, C8103, C8143, C8104, C8144, C8105, C8145, C8106, C8146, C8107, C8147, C8108, C8148, C8110, C8119, C8111, C8112, C8113, C8114, C8115, C8116, C8117, C8118, C8120, C8129, C8121, C8122, C8123, C8124, C8125, C8126, C8127, C8128, C8130, C8139, C8131, C8132, C8133, C8134, C8135, C8136, C8137, C8138, C8190, C8199, C8191, C8192, C8193, C8194, C8195, C8196, C8197, C8198, C8200, C8209, C8210, C8219, C8220, C8229, C8230, C8239, C8240, C8249, C8260, C8269, C8280, C8289, C8290, C8299, C8201, C8211, C8221, C8231, C8241, C8261, C8281, C8291, C8202, C8212, C8222, C8232, C8242, C8262, C8282, C8292, C8203, C8213, C8223, C8233, C8243, C8263, C8283, C8293, C8204, C8214, C8224, C8234, C8244, C8264, C8284, C8294, C8205, C8215, C8225, C8235, C8245, C8265, C8285, C8295, C8206, C8216, C8226, C8236, C8246, C8266, C8286, C8296, C8207, C8217, C8227, C8237, C8247, C8267, C8287, C8297, C8208, C8218, C8228, C8238, C8248, C8268, C8288, C8298, C8400, C8409, C8401, C8402, C8403, C8404, C8405, C8406, C8407, C8408, C8410, C8419, C8411, C8412, C8413, C8414, C8415, C8416, C8417, C8418, C96A, C9140, C9141, C9142, C960, C962, C8440, C8449, C8441, C8442, C8443, C8444, C8445, C8446, C8447, C8448, C8250, C8259, C8490, C8499, C84A0, C84A9, C84Z0, C84Z9, C8510, C8519, C8520, C8529, C8580, C8589, C8590, C8599, C864, C8251, C8491, C84A1, C84Z1, C8511, C8521, C8581, C8591, C860, C8252, C8492, C84A2, C84Z2, C8512, C8522, C8582, C8592, C8253, C8493, C84A3, C84Z3, C8513, C8523, C8583, C8593, C862, C863, C8254, C8494, C84A4, C84Z4, C8514, C8524, C8584, C8594, C8255, C8495, C84A5, C84Z5, C8515, C8525, C8585, C8595, C8256, C8496, C84A6, C84Z6, C8516, C8526, C8586, C8596, C8257, C8497, C84A7, C84Z7, C8517, C8527, C8587, C8597, C861, C8258, C8498, C84A8, C84Z8, C8518, C8528, C8588, C8598, C964, C969, C96Z, C9000, C9001, C9002, C9010, C9011, C9012, C882, C883, C889, C9020, C9030, C9021, C9031, C9022, C9032, C9100, C9101, C9102, C9110, C9111, C9112, C9130, C9150, C9160, C91A0, C91Z0, C9131, C9151, C9161, C91A1, C91Z1, C9132, C9152, C9162, C91A2, C91Z2, C9190, C9191, C9192, C9200, C9240, C9250, C9260, C92A0, C9201, C9241, C9251, C9261, C92A1, C9202, C9242, C9252, C9262, C92A2, C9210, C9211, C9212, C9220, C9221, C9222, C9230, C9231, C9232, C92Z0, C92Z1, C92Z2, C9290, C9291, C9292, C9300, C9301, C9302, C9310, C9311, C9312, C9392, C9330, C93Z0, C9331, C93Z1, C9332, C93Z2, C9390, C9391, C9400, C9401, C9402, C9420, C9421, C9422, C9430, C9480, C9431, C9481, C9432, C9482, C9500, C9501, C9502, C9510, C9511, C9512, C9590, C9591, C9592, C7A019, C7A010, C7A011, C7A012, C7A029, C7A020, C7A021, C7A022, C7A023, C7A024, C7A025, C7A026, C7A00, C7A090, C7A091, C7A092, C7A093, C7A094, C7A095, C7A096, C7A098, C7A1, C7A8, C4A0, C4A10, C4A11, C4A12, C4A20, C4A21, C4A22, C4A30, C4A31, C4A39, C4A4, C4A60, C4A61, C4A62, C4A70, C4A71, C4A72, C4A51, C4A52, C4A59, C4A8, C4A9, C7B00, C7B01, C7B02, C7B03, C7B04, C7B1, C7B09, C7B8, D1800, D1801, D1802, D1803, D1809, D181, D0000, D0001, D0002, D0003, D0004, D0005, D0006, D0007, D0008, D001, D002, D010, D011, D012, D013, D0140, D0149, D015, D017, D019, D020, D021, D0220, D0221, D0222, D023, D024, D040, D0410, D0411, D0412, D0420, D0421, D0422, D0430, D0439, D044, D045, D0460, D0461, D0462, D0470, D0471, D0472, D048, D049, D0500, D0501, D0502, D0510, D0511, D0512, D0580, D0581, D0582, D0590, D0591, D0592, D060, D061, D067, D069, D070, D0730, D072, D071, D0739, D075, D074, D0760, D0761, D0769, D090, D0910, D0919, D0920, D0921, D0922, D093, D098, D099, D37030, D37031, D37032, D37039, D3701, D3702, D3704, D3705, D3709, D371, D372, D373, D374, D375, D376, D483, D484, D378, D379, D380, D381, D382, D383, D384, D385, D386, D390, D392, D3910, D3911, D3912, D398, D399, D4010, D4011, D4012, D400, D408, D409, D414, D419, D4100, D4101, D4102, D4110, D4111, D4112, D4120, D4121, D4122, D413, D418, D443, D444, D445, D4410, D4411, D4412, D446, D447, D440, D442, D449, D430, D431, D432, D434, D420, D421, D429, Q8500, Q8501, Q8502, Q8503, Q8509, D433, D438, D439, D480, D481, D482,



ICD-10-CM codes: D485, D4860, D4861, D4862, D45, D470, D473, D460, D461, D4620, D4621, D464, D46A, D46B, D4622, D46C, D469, D46Z, D47Z1, C888, C9440, C9441, C9442, C946, D471, D479, D47Z9, D487, D489, D490, D491, D492, D493, D494, D495, D496, D497, D4981, D4989, D499, D831, D806, D808, D809, D571, D5700, D5701, D5702, D5720, D57211, D57212, D57219, D5780, D57811, D57812, D57819, K563, K702, K7030, K7031, K740, K7460, K7469, K743, K744, K745, K8040, K8044, K8046, K8030, K8032, K8034, K8036, K8050, K8030, K8031, K8032, K8033, K8034, K8035, K8036, K8037, K830, B252, K850, K851, K852, K853, K858, K859, K860, K861, K862, K863, K868, K869, N185, N186, O010, O011, O019, O0281, O020, O0289, O029, O021, O000, O001, O002, O008, O009, O030, O0337, O035, O0387, O031, O036, O0334, O0384, O0332, O0382, O0333, O0383, O0331, O0381, O037, O032, O0335, O0336, O0338, O0339, O0385, O0386, O0388, O0389, O0330, O0380, O034, O039, O045, O0487, O046, O0484, O0482, O0483, O0481, O047, O0485, O0486, O0488, O0489, O0480, Z332, O070, O0737, O071, O0734, O0732, O0733, O0731, O072, O0735, O0736, O0738, O0739, O0730, O074, A34, O080, O0882, O081, O086, O084, O085, O083, O082, O087, O0881, O0883, O0889, O089, O200, O208, O209, O4400, O4401, O4402, O4403, O4410, O4411, O4412, O4413, O458X9, O4590, O458X1, O458X2, O458X3, O4591, O4592, O4593, O45009, O45019, O45029, O45099, O46009, O46019, O46029, O46099, O45001, O45002, O45003, O45011, O45012, O45013, O45021, O45022, O45023, O45091, O45092, O45093, O46001, O46002, O46003, O46011, O46012, O46013, O46021, O46022, O46023, O46091, O46092, O46093, O670, O468X9, O468X1, O468X2, O468X3, O678, O4690, O4691, O4692, O4693, O679, O10019, O10919, O10011, O10012, O10013, O1002, O10911, O10912, O10913, O1092, O1003, O1093, O10419, O10411, O10412, O10413, O1042, O1043, O10119, O10219, O10319, O10111, O10112, O10113, O1012, O10211, O10212, O10213, O1022, O10311, O10312, O10313, O1032, O1013, O1023, O1033, O139, O131, O132, O133, O161, O162, O163, O1400, O1490, O1402, O1403, O1492, O1493, O152, O1410, O1420, O1412, O1413, O1422, O1423, O1500, O159, O1502, O1503, O151, O152, O119, O111, O112, O113, O169, O161, O169, O210, O211, O212, O218, O219, O219, O6000, O6002, O6003, O4700, O479, O4702, O4703, O471, O6010X0, O6010X1, O6010X2, O6010X3, O6010X4, O6010X5, O6010X9, O6020X0, O6020X1, O6020X2, O6020X3, O6020X4, O6020X5, O6020X9, O6012X0, O6012X1, O6012X2, O6012X3, O6012X4, O6012X5, O6012X9, O6013X0, O6013X1, O6013X2, O6013X3, O6013X4, O6013X5, O6013X9, O6014X0, O6014X1, O6014X2, O6014X3, O6014X4, O6014X5, O6014X9, O6022X0, O6022X1, O6022X2, O6022X3, O6022X4, O6022X5, O6022X9, O6023X0, O6023X1, O6023X2, O6023X3, O6023X4, O6023X5, O6023X9, O480, O481, O3100X0, O3100X1, O3100X2, O3100X3, O3100X4, O3100X5, O3100X9, O3101X0, O3101X1, O3101X2, O3101X3, O3101X4, O3101X5, O3101X9, O3102X0, O3102X1, O3102X2, O3102X3, O3102X4, O3102X5, O3102X9, O3103X0, O3103X1, O3103X2, O3103X3, O3103X4, O3103X5, O3103X9, O1200, O1220, O2600, O1201, O1202, O1203, O1221, O1222, O1223, O2601, O2602, O2603, O1210, O1220, O26839, O1221, O1222, O1223, O1211, O1212, O1213, O26831, O26832, O26833, O2620, O2621, O2622, O2623, O26829, O26821, O26822, O26823, O2300, O2310, O2320, O2330, O2340, O23519, O23529, O23599, O2390, O2301, O2302, O2303, O2311, O2312, O2313, O2321, O2322, O2323, O2331, O2332, O2333, O2341, O2342, O2343, O23511, O23512, O23513, O23521, O23522, O23523, O23591, O23592, O23593, O2391, O2392, O2393, O8611, O8613, O8619, O8620, O8621, O8622, O8629, O26619, O26611, O26612, O26613, O2662, O2610, O2630, O2640, O26719, O26819, O26899, O29019, O29029, O29099, O29119, O29129, O29199, O29219, O29299, O293X9, O2940, O295X9, O2960, O298X9, O2990, O99350, O2611, O2612, O2613, O2631, O2632, O2633, O2641, O2642, O2643, O26711, O26712, O26713, O2672, O26811, O26812, O26813, O2686, O26891, O26892, O26893, O2691, O2692, O2693, O29011, O29012, O29013, O29021, O29022, O29023, O29091, O29092, O29093, O29111, O29112, O29113, O29121, O29122, O29123, O29191, O29192, O29193, O29211, O29212, O29213, O29291, O29292, O29293, O293X1, O293X2, O293X3, O2941, O2942, O2943, O295X1, O295X2, O295X3, O2961, O2962, O2963, O298X1, O298X2, O298X3, O2991, O2992, O2993, O99351, O99352, O99353, O99354, O9989, O99355, O9989, O2663, O2673, O2690, O98119, O98111, O98112, O98113, O9812, O9813, O98219, O98211, O98212, O98213, O9822, O9823, O98319, O98311, O98312, O98313,



ICD-10-CM codes: O9832, O9833, O98019, O98011, O98012, O98013, O9802, O9803, O98619, O9862, O9863, O98419, O98519, O98719, O98411, O98412, O98413, O9842, O98511, O98512, O98513, O9852, O98711, O98712, O98713, O9872, O9843, O9853, O9873, O98819, O98611, O98612, O98613, O98811, O98812, O98813, O9882, O99830, O99834, O9883, O99835, O98919, O98911, O98912, O98913, O9892, O9893, O24019, O24119, O24319, O24819, O24919, O24011, O24012, O24013, O2402, O24111, O24112, O24113, O2412, O24311, O24312, O24313, O2432, O24811, O24812, O24813, O2482, O24911, O24912, O24913, O2492, O2493, O2403, O2413, O2433, O2483, O2493, O905, O99019, O99011, O99012, O99013, O9902, O9903, O9081, O99320, O99321, O99322, O99323, O99324, O99325, O99310, O99340, O99311, O99312, O99313, O99314, O99341, O99342, O99343, O99344, O906, O99315, O99345, O99419, O9943, O330, O24410, O24414, O24419, O24420, O24424, O24429, O99810, O99814, O24430, O24434, O24439, O99815, O2510, O99280, O99519, O99619, O99719, O9A119, O9A219, O9A319, O9A419, O9A519, O2511, O2512, O2513, O252, O99281, O99282, O99283, O99284, O99511, O99512, O99513, O9952, O99611, O99612, O99613, O9962, O99711, O99712, O99713, O9972, O99824, O9A111, O9A112, O9A113, O9A12, O9A211, O9A212, O9A213, O9A22, O9A311, O9A312, O9A313, O9A32, O9A411, O9A412, O9A413, O9A42, O9A511, O9A512, O9A513, O9A52, O99285, O99820, O253, O9953, O9963, O9973, O99825, O9A13, O9A23, O9A33, O9A43, O9A53, O99330, O99331, O99332, O99333, O99334, O99335, O99210, O99211, O99212, O99213, O99214, O99215, O99840, O99841, O99842, O99843, O99844, O99845, O99119, O99111, O99112, O99113, O9912, O9913, O9913, O26859, O26851, O26852, O26853, O26849, O26841, O26842, O26843, O26879, O26872, O26873, O7582, O80, O30009, O30019, O30039, O30049, O30099, O30001, O30002, O30003, O30011, O30012, O30013, O30031, O30032, O30033, O30041, O30042, O30043, O30091, O30092, O30093, O30109, O30101, O30102, O30103, O30111, O30112, O30113, O30121, O30122, O30123, O30191, O30192, O30193, O30209, O30211, O30212, O30213, O30221, O30222, O30223, O30291, O30292, O30293, O30201, O30202, O30203, O3110X0, O3110X1, O3110X2, O3120X0, O3120X1, O3120X2, O3111X0, O3111X1, O3111X2, O3112X0, O3112X1, O3112X2, O3113X0, O3113X1, O3113X2, O3121X0, O3121X1, O3121X2, O3122X0, O3122X1, O3122X2, O3123X0, O3123X1, O3123X2, O3110X3, O3110X4, O3110X5, O3110X9, O3120X3, O3120X4, O3120X5, O3120X9, O3111X3, O3111X4, O3111X5, O3111X9, O3112X3, O3112X4, O3112X5, O3112X9, O3113X3, O3113X4, O3113X5, O3113X9, O3121X3, O3121X4, O3121X5, O3121X9, O3122X3, O3122X4, O3122X5, O3122X9, O3123X3, O3123X4, O3123X5, O3123X9, O3130X0, O3130X1, O3130X2, O3130X3, O3130X4, O3130X5, O3130X9, O3131X0, O3131X1, O3131X2, O3131X3, O3131X4, O3131X5, O3131X9, O3132X0, O3132X1, O3132X2, O3132X3, O3132X4, O3132X5, O3132X9, O3133X0, O3133X1, O3133X2, O3133X3, O3133X4, O3133X5, O3133X9, O30809, O30811, O30812, O30813, O30821, O30822, O30823, O30891, O30892, O30893, O30801, O30802, O30803, O318X10, O318X11, O318X12, O318X13, O318X14, O318X15, O318X19, O318X20, O318X21, O318X22, O318X23, O318X24, O318X25, O318X29, O318X30, O318X31, O318X32, O318X33, O318X34, O318X35, O318X39, O3090, O318X90, O318X91, O318X92, O318X93, O318X94, O318X95, O318X99, O3091, O3092, O3093, O320XX0, O320XX1, O320XX2, O320XX3, O320XX4, O320XX5, O320XX9, O321XX0, O321XX1, O321XX2, O321XX3, O321XX4, O321XX5, O321XX9, O641XX0, O641XX1, O641XX2, O641XX3, O641XX4, O641XX5, O641XX9, O322XX0, O322XX1, O322XX2, O322XX3, O322XX4, O322XX5, O322XX9, O323XX0, O323XX1, O323XX2, O323XX3, O323XX4, O323XX5, O323XX9, O642XX0, O642XX1, O642XX2, O642XX3, O642XX4, O642XX5, O642XX9, O643XX0, O643XX1, O643XX2, O643XX3, O643XX4, O643XX5, O643XX9, O324XX0, O324XX1, O324XX2, O324XX3, O324XX4, O324XX5, O324XX9, O329XX0, O329XX1, O329XX2, O329XX3, O329XX4, O329XX5, O329XX9, O666, O326XX0, O326XX1, O326XX2, O326XX3, O326XX4, O326XX5, O326XX9, O328XX0, O328XX1, O328XX2, O328XX3, O328XX4, O328XX5, O328XX9, O644XX0, O644XX1, O644XX2, O644XX3, O644XX4, O644XX5, O644XX9, O645XX0, O645XX1, O645XX2, O645XX3, O645XX4, O645XX5, O645XX9, O648XX0, O648XX1, O648XX2, O648XX3, O648XX4, O648XX5, O648XX9, O649XX0, O649XX1, O649XX2, O649XX3, O649XX4, O649XX5, O649XX9, O650, O331, O651, O332, O652, O333XX0, O333XX1, O333XX2, O333XX3, O333XX4, O333XX5, O333XX9, O653,



ICD-10-CM codes: O334XX0, O334XX1, O334XX2, O334XX3, O334XX4, O334XX5, O334XX9, O654, O335XX0, O335XX1, O335XX2, O335XX3, O335XX4, O335XX5, O335XX9, O662, O336XX0, O336XX1, O336XX2, O336XX3, O336XX4, O336XX5, O336XX9, O337, O338, O339, O3400, O3401, O3402, O3403, O3410, O3411, O3412, O3413, O3421, O34519, O34539, O34511, O34512, O34513, O34531, O34532, O34533, O34529, O34599, O34521, O34522, O34523, O34591, O34592, O34593, O3430, O3431, O3432, O3433, O3440, O3441, O3442, O3443, O3460, O3461, O3462, O3463, O3470, O3471, O3472, O3473, O3480, O3490, O3429, O3481, O3482, O3483, O3491, O3492, O3493, O658, O659, O350XX0, O350XX1, O350XX2, O350XX3, O350XX4, O350XX5, O350XX9, O351XX0, O351XX1, O351XX2, O351XX3, O351XX4, O351XX5, O351XX9, O352XX0, O352XX1, O352XX2, O352XX3, O352XX4, O352XX5, O352XX9, O353XX0, O353XX1, O353XX2, O353XX3, O353XX4, O353XX5, O353XX9, O354XX0, O354XX1, O354XX2, O354XX3, O354XX4, O354XX5, O354XX9, O355XX0, O355XX1, O355XX2, O355XX3, O355XX4, O355XX5, O355XX9, O356XX0, O356XX1, O356XX2, O356XX3, O356XX4, O356XX5, O356XX9, O368120, O368121, O368122, O368123, O368124, O368125, O368129, O368130, O368131, O368132, O368133, O368134, O368135, O368139, O368190, O368191, O368192, O368193, O368194, O368195, O368199, O358XX0, O358XX1, O358XX2, O358XX3, O358XX4, O358XX5, O358XX9, O359XX0, O359XX1, O359XX2, O359XX3, O359XX4, O359XX5, O359XX9, O43019, O43011, O43012, O43013, O360190, O360191, O360192, O360193, O360194, O360195, O360199, O360990, O360991, O360992, O360993, O360994, O360995, O360999, O360110, O360111, O360112, O360113, O360114, O360115, O360119, O360120, O360121, O360122, O360123, O360124, O360125, O360129, O360130, O360131, O360132, O360133, O360134, O360135, O360139, O360910, O360911, O360912, O360913, O360914, O360915, O360919, O360920, O360921, O360922, O360923, O360924, O360925, O360929, O360930, O360931, O360932, O360933, O360934, O360935, O360939, O361190, O361191, O361192, O361193, O361194, O361195, O361199, O361990, O361991, O361992, O361993, O361994, O361995, O361999, O361110, O361111, O361112, O361113, O361114, O361115, O361119, O361120, O361121, O361122, O361123, O361124, O361125, O361129, O361130, O361131, O361132, O361133, O361134, O361135, O361139, O361910, O361911, O361912, O361913, O361914, O361915, O361919, O361920, O361921, O361922, O361923, O361924, O361925, O361929, O361930, O361931, O361932, O361933, O361934, O361935, O361939, O364XX0, O364XX1, O364XX2, O364XX3, O364XX4, O364XX5, O364XX9, O365190, O365191, O365192, O365193, O365194, O365195, O365199, O365990, O365991, O365992, O365993, O365994, O365995, O365999, O365110, O365111, O365112, O365113, O365114, O365115, O365119, O365120, O365121, O365122, O365123, O365124, O365125, O365129, O365130, O365131, O365132, O365133, O365134, O365135, O365139, O365910, O365911, O365912, O365913, O365914, O365915, O365919, O365920, O365921, O365922, O365923, O365924, O365925, O365929, O365930, O365931, O365932, O365933, O365934, O365935, O365939, O3660X0, O3660X1, O3660X2, O3660X3, O3660X4, O3660X5, O3660X9, O3661X0, O3661X1, O3661X2, O3661X3, O3661X4, O3661X5, O3661X9, O3662X0, O3662X1, O3662X2, O3662X3, O3662X4, O3662X5, O3662X9, O3663X0, O3663X1, O3663X2, O3663X3, O3663X4, O3663X5, O3663X9, O43029, O43109, O43119, O43199, O43819, O4390, O43021, O43022, O43023, O43101, O43102, O43103, O43111, O43112, O43113, O43191, O43192, O43193, O43811, O43812, O43813, O4391, O4392, O4393, O3620X0, O3620X1, O3620X2, O3620X3, O3620X4, O3620X5, O3620X9, O3670X0, O3670X1, O3670X2, O3670X3, O3670X4, O3670X5, O3670X9, O368990, O368991, O368992, O368993, O368994, O368995, O368999, O43899, O3621X0, O3621X1, O3621X2, O3621X3, O3621X4, O3621X5, O3621X9, O3622X0, O3622X1, O3622X2, O3622X3, O3622X4, O3622X5, O3622X9, O3623X0, O3623X1, O3623X2, O3623X3, O3623X4, O3623X5, O3623X9, O3671X0, O3671X1, O3671X2, O3671X3, O3671X4, O3671X5, O3671X9, O3672X0, O3672X1, O3672X2, O3672X3, O3672X4, O3672X5, O3672X9, O3673X0, O3673X1, O3673X2, O3673X3, O3673X4, O3673X5, O3673X9, O368910, O368911, O368912, O368913, O368914, O368915, O368919, O368920, O368921, O368922, O368923, O368924, O368925, O368929, O368930, O368931, O368932, O368933, O368934, O368935, O368939, O43891, O43892, O43893, O68, O770, O771, O778, O779,



ICD-10-CM codes: O3690X0, O3690X1, O3690X2, O3690X3, O3690X4, O3690X5, O3690X9, O3691X0, O3691X1, O3691X2, O3691X3, O3691X4, O3691X5, O3691X9, O3692X0, O3692X1, O3692X2, O3692X3, O3692X4, O3692X5, O3692X9, O3693X0, O3693X1, O3693X2, O3693X3, O3693X4, O3693X5, O3693X9, O409XX0, O409XX1, O409XX2, O409XX3, O409XX4, O409XX5, O409XX9, O401XX0, O401XX1, O401XX2, O401XX3, O401XX4, O401XX5, O401XX9, O402XX0, O402XX1, O402XX2, O402XX3, O402XX4, O402XX5, O402XX9, O403XX0, O403XX1, O403XX2, O403XX3, O403XX4, O403XX5, O403XX9, O4100X0, O4100X1, O4100X2, O4100X3, O4100X4, O4100X5, O4100X9, O4101X0, O4101X1, O4101X2, O4101X3, O4101X4, O4101X5, O4101X9, O4102X0, O4102X1, O4102X2, O4102X3, O4102X4, O4102X5, O4102X9, O4103X0, O4103X1, O4103X2, O4103X3, O4103X4, O4103X5, O4103X9, O4200, O42019, O4290, O42919, O4200, O42011, O42012, O42013, O4202, O42911, O42912, O42913, O4292, O42119, O4210, O42111, O42112, O42113, O4212, O755, O411090, O411091, O411092, O411093, O411094, O411095, O411099, O411290, O411291, O411292, O411293, O411294, O411295, O411299, O411490, O411491, O411492, O411493, O411494, O411495, O411499, O411010, O411011, O411012, O411013, O411014, O411015, O411019, O411020, O411021, O411022, O411023, O411024, O411025, O411029, O411030, O411031, O411032, O411033, O411034, O411035, O411039, O411210, O411211, O411212, O411213, O411214, O411215, O411219, O411220, O411221, O411222, O411223, O411224, O411225, O411229, O411230, O411231, O411232, O411233, O411234, O411235, O411239, O411410, O411411, O411412, O411413, O411414, O411415, O411419, O411420, O411421, O411422, O411423, O411424, O411425, O411429, O411430, O411431, O411432, O411433, O411434, O411435, O411439, O418X90, O418X91, O418X92, O418X93, O418X94, O418X95, O418X99, O418X10, O418X11, O418X12, O418X13, O418X14, O418X15, O418X19, O418X20, O418X21, O418X22, O418X23, O418X24, O418X25, O418X29, O418X30, O418X31, O418X32, O418X33, O418X34, O418X35, O418X39, O4190X0, O4190X1, O4190X2, O4190X3, O4190X4, O4190X5, O4190X9, O4191X0, O4191X1, O4191X2, O4191X3, O4191X4, O4191X5, O4191X9, O4192X0, O4192X1, O4192X2, O4192X3, O4192X4, O4192X5, O4192X9, O4193X0, O4193X1, O4193X2, O4193X3, O4193X4, O4193X5, O4193X9, O611, O610, O618, O619, O752, O753, O0941, O0942, O0943, O09511, O09512, O09513, O09521, O09522, O09523, O76, O759, O641XX0, O641XX1, O641XX2, O641XX3, O641XX4, O641XX5, O641XX9, O642XX0, O642XX1, O642XX2, O642XX3, O642XX4, O642XX5, O642XX9, O643XX0, O643XX1, O643XX2, O643XX3, O643XX4, O643XX5, O643XX9, O644XX0, O644XX1, O644XX2, O644XX3, O644XX4, O644XX5, O644XX9, O645XX0, O645XX1, O645XX2, O645XX3, O645XX4, O645XX5, O645XX9, O648XX0, O648XX1, O648XX2, O648XX3, O648XX4, O648XX5, O648XX9, O649XX0, O649XX1, O649XX2, O649XX3, O649XX4, O649XX5, O649XX9, O650, O651, O652, O653, O654, O655, O658, O659, O640XX0, O640XX1, O640XX2, O640XX3, O640XX4, O640XX5, O640XX9, O660, O661, O6640, O6641, O662, O663, O666, O668, O669, O620, O621, O622, O623, O624, O628, O629, O630, O639, O631, O632, O690XX0, O690XX1, O690XX2, O690XX3, O690XX4, O690XX5, O690XX9, O691XX0, O691XX1, O691XX2, O691XX3, O691XX4, O691XX5, O691XX9, O692XX0, O692XX1, O692XX2, O692XX3, O692XX4, O692XX5, O692XX9, O6981X0, O6981X1, O6981X2, O6981X3, O6981X4, O6981X5, O6981X9, O6982X0, O6982X1, O6982X2, O6982X3, O6982X4, O6982X5, O6982X9, O6989X0, O6989X1, O6989X2, O6989X3, O6989X4, O6989X5, O6989X9, O693XX0, O693XX1, O693XX2, O693XX3, O693XX4, O693XX5, O693XX9, O694XX0, O694XX1, O694XX2, O694XX3, O694XX4, O694XX5, O694XX9, O695XX0, O695XX1, O695XX2, O695XX3, O695XX4, O695XX5, O695XX9, O43129, O43121, O43122, O43123, O699XX0, O699XX1, O699XX2, O699XX3, O699XX4, O699XX5, O699XX9, O700, O701, O702, O703, O709, O717, O704, O7182, O719, O7100, O7102, O7103, O711, O712, O713, O714, O715, O716, O7181, O7189, O720, O721, O722, O723, O43219, O43229, O43239, O43211, O43212, O43213, O43221, O43222, O43223, O43231, O43232, O43233, O730, O731, O740, O741, O8909, O8901, O742, O891, O743, O892, O744, O745, O746, O747, O748, O898, O893, O894, O895, O896, O749, O899, O750, O751, O2650, O2651, O2652, O2653, O904, O754, O665, O82, O7581, O7589, R75, T85611A, T85621A, T85631A, T85691A, T8571XA, T82818A, T82828A, T82838A, T82848A, T82858A, T82868A, T82898A, T39012A, T39092A, T392X2A, T39312A, T39392A, T394X2A, T398X2A,



ICD-10-CM codes: T3992XA, T400X2A, T401X2A, T403X2A, T411X2A, T41202A, T41292A, T413X2A, T4142XA, T407X2A, T408X2A, T40902A, T40992A, T4272XA, T43012A, T43022A, T431X2A, T43202A, T43212A, T43222A, T43292A, T433X2A, T434X2A, T43502A, T43592A, T43602A, T43612A, T43622A, T43632A, T43692A, T438X2A, T4392XA, T360X2A, T361X2A, T362X2A, T363X2A, T364X2A, T365X2A, T366X2A, T367X2A, T368X2A, T3692XA, T370X2A, T371X2A, T372X2A, T373X2A, T374X2A, T375X2A, T378X2A, T3792XA, T380X2A, T381X2A, T382X2A, T383X2A, T384X2A, T385X2A, T386X2A, T387X2A, T38802A, T38812A, T38892A, T38902A, T38992A, T405X2A, T420X2A, T421X2A, T422X2A, T425X2A, T426X2A, T428X2A, T440X2A, T441X2A, T442X2A, T443X2A, T444X2A, T445X2A, T446X2A, T447X2A, T448X2A, T44902A, T44992A, T450X2A, T451X2A, T452X2A, T453X2A, T454X2A, T45512A, T45522A, T45602A, T45612A, T45622A, T45692A, T457X2A, T458X2A, T4592XA, T460X2A, T461X2A, T462X2A, T463X2A, T464X2A, T465X2A, T466X2A, T467X2A, T468X2A, T46902A, T46992A, T470X2A, T471X2A, T472X2A, T473X2A, T474X2A, T475X2A, T476X2A, T477X2A, T478X2A, T4792XA, T480X2A, T481X2A, T48202A, T48292A, T483X2A, T484X2A, T485X2A, T486X2A, T48902A, T48992A, T490X2A, T491X2A, T492X2A, T493X2A, T494X2A, T495X2A, T496X2A, T497X2A, T498X2A, T4992XA, T500X2A, T501X2A, T502X2A, T503X2A, T504X2A, T505X2A, T506X2A, T507X2A, T508X2A, T50902A, T50992A, T50A12A, T50A22A, T50A92A, T50B12A, T50B92A, T50Z12A, T50Z92A, T600X2A, T540X2A, T542X2A, T550X2A, T551X2A, T572X2A, T510X2A, T511X2A, T512X2A, T513X2A, T518X2A, T5192XA, T520X2A, T521X2A, T522X2A, T523X2A, T524X2A, T528X2A, T5292XA, T530X2A, T531X2A, T532X2A, T533X2A, T534X2A, T536X2A, T537X2A, T5392XA, T560X2A, T561X2A, T562X2A, T563X2A, T564X2A, T565X2A, T566X2A, T567X2A, T56812A, T56892A, T5692XA, T578X2A, T5792XA, T6102XA, T6112XA, T61772A, T61782A, T618X2A, T6192XA, T620X2A, T621X2A, T622X2A, T628X2A, T6292XA, T6402XA, T6482XA, T650X2A, T651X2A, T65212A, T65222A, T65292A, T653X2A, T654X2A, T655X2A, T656X2A, T65812A, T65822A, T65832A, T65892A, T6592XA, T410X2A, T415X2A, T535X2A, T573X2A, T590X2A, T591X2A, T593X2A, T59892A, T71162A, T71112A, X710XXA, X710XXD, X711XXA, X711XXD, X712XXA, X712XXD, X713XXA, X713XXD, X718XXA, X718XXD, X719XXA, X719XXD, X72XXXA, X72XXXD, X730XXA, X730XXD, X731XXA, X731XXD, X732XXA, X732XXD, X738XXA, X738XXD, X739XXA, X739XXD, X748XXA, X748XXD, X75XXXA, X75XXXD, X7401XA, X7401XD, X7409XA, X7409XD, X7402XA, X7402XD, X749XXA, X749XXD, X780XXA, X780XXD, X781XXA, X781XXD, X782XXA, X782XXD, X788XXA, X788XXD, X789XXA, X789XXD, X80XXXA, X80XXXD, X810XXA, X810XXD, X811XXA, X811XXD, X818XXA, X818XXD, X76XXXA, X76XXXD, X773XXA, X773XXD, X778XXA, X778XXD, X779XXA, X779XXD, X770XXA, X770XXD, X771XXA, X771XXD, X772XXA, X772XXD, X832XXA, X832XXD, X831XXA, X831XXD, X820XXA, X820XXD, X821XXA, X821XXD, X822XXA, X822XXD, X828XXA, X828XXD, X830XXA, X830XXD, X79XXXA, X79XXXD, X838XXA, X838XXD, T1491, Z21, Z3400, Z3401, Z3402, Z3403, Z3480, Z3481, Z3482, Z3483, Z3490, Z3491, Z3492, Z3493, Z331, O0900, O0901, O0902, O0903, O0910, O0911, O0912, O0913, O09291, O0940, O09211, O09212, O09213, O09219, O09291, O09292, O09293, O09299, O0930, O0931, O0932, O0933, O09519, O09529, O09611, O09612, O09613, O09619, O09621, O09622, O09623, O09629, O09811, O09812, O09813, O09819, O09821, O09822, O09823, O09829, O3680X0, O3680X1, O3680X2, O3680X3, O3680X4, O3680X5, O3680X9, O0970, O0971, O0972, O0973, O09891, O09892, O09893, O09899, O0990, O0991, O0992, O0993, Z390, Z391, Z392, Z370, Z371, Z372, Z373, Z374, Z3750, Z3751, Z3752, Z3753, Z3754, Z3759, Z3760, Z3761, Z3762, Z3763, Z3764, Z3769, Z377, Z379, Z4822, Z940, Z4821, Z48280, Z941, Z943, Z947, Z4823, Z944, Z992, Z9115, Z4931, Z4901, Z4902, Z4931, Z4932, R45851


Quality codes

Utilization codes

Quality measures “to track” (not payment related): A. Bile Duct Injury - ICD-10 Diagnosis: S36122A, S36123A, S36128A, S36129A, S3613XA B. Abdominal Blood Vessel Injury – ICD-10 Diagnosis: S3500XA, S3501XA, S3502XA, S3509XA, S3510XA, S3511XA, S3512XA,

S3519XA, S35211A, S35212A, S35218A, S35219A, S35221A, S35222A, S35228A, S35229A, S35231A, S35232A, S35238A, S35239A, S35291A, S35292A, S35298A, S35299A, S35311A, S35318A, S35319A, S35321A, S35328A, S35329A, S35331A, S35338A, S35339A, S35341A, S35348A, S35349A, S35401A, S35402A, S35403A, S35404A, S35405A, S35406A, S35411A, S35412A, S35413A, S35414A, S35415A, S35416A, S35491A, S35492A, S35493A, S35494A, S35495A, S35496A, S3550XA, S35511A, S35512A, S35513A, S35514A, S35515A, S35516A, S35531A, S35532A, S35533A, S35534A, S35535A, S35536A, S3559XA, S358X1A, S358X8A, S358X9A, S3590XA, S3591XA, S3599XA

C. GI Perforation – ICD-10 Diagnosis: K631

Utilization measures “to track” (not payment related): “Open” procedure: ICD-10 Procedure: 0F540ZZ, 0F543ZZ, 05FB40ZZ, 0FB43ZZ, 0FT40ZZ, J95811, J95812 “Converted” procedure (initiated as Laparoscopic): ICD-10 Diagnosis: NoDX

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