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LCD for Serum Magnesium (L889)


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Contractor Information
Superceded StampSuperceded Stamp
Contractor Name back to top
Palmetto GBA 
Contractor Number back to top
00380 
Contractor Type back to top
FI 


LCD Information
Superceded StampSuperceded Stamp
LCD ID Number back to top
L889 
 
LCD Title back to top
Serum Magnesium 
 
Contractor's Determination Number back to top
95A-0018-L 
 
AMA CPT / ADA CDT Copyright Statement back to top
CPT codes, descriptions and other data only are copyright 2009 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply. Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright by the American Dental Association. © 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.  
 
CMS National Coverage Policy back to top
Title XVIII of the Social Security Act, §1862(a)(7) excludes routine physical examinations.

Title XVIII of the Social Security Act, §1862(a)(1)(A) allows coverage and payment for only those services that are considered to be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.

CMS Manual System, Pub 100-08, Medicare Program Integrity, Transmittal 63, dated January 23, 2004, Change Request 3010
 
 
Primary Geographic Jurisdiction back to top
South Carolina
 
 
Secondary Geographic Jurisdiction back to top
 
 
Oversight Region back to top
Region IV
 
 
Original Determination Effective Date back to top
For services performed on or after 02/26/1998  
 
Original Determination Ending Date back to top
 
 
Revision Effective Date back to top
For services performed on or after 10/01/2008  
 
Revision Ending Date back to top
09/30/2009 
 
Indications and Limitations of Coverage and/or Medical Necessity back to top
Magnesium is a mineral required by the body for the use of adenosine triphosphate (ATP) as a source of energy. It is also necessary for neuromuscular function and blood clotting.

A serum magnesium study is a quantitative analysis that measures serum levels of magnesium, the most abundant intracellular cation after potassium. It is vital to neuromuscular function and helps regulate intracellular metabolism, activates many essential enzymes, and affects the metabolism of nucleic acids and proteins. Magnesium also helps transport sodium and potassium across cell membranes and, through its effect on the secretion of parathyroid hormone, influences intracellular calcium levels. Most magnesium is found in bone and intracellular fluid; a small amount is found in extracellular fluid.

1. Serum magnesium is used to evaluate electrolyte status and to assess neuromuscular or renal function.

2. Magnesium deficiency produces neuromuscular disorders.

3. Magnesium deficiency may cause weakness, tremors, tetany, confusion, and convulsions.

4. Hypomagnesemia is associated with hypocalcemia, hypokalemia, long term hyperalimentation, intravenous therapy, diabetes mellitus (especially during treatment of ketoacidosis), alcoholism and other types of malnutrition, malabsorption, prolonged nasogastric suction, certain cardiac drugs, diuretics, renal tubular acidosis, chronic diarrhea, hyperparathyroidism, dialysis, pregnancy, and hyperaldosteronism.

5. Renal loss of magnesium occurs with cisplatin therapy.

6. Amphotericin toxicity has been cited as a cause of hypomagnesemia.

7. Magnesium deficiency may cause cardiac arrhythmias.

8. High magnesium levels produce decreased reflexes, somnolence, and heart block.

9. Increased magnesium levels occur most often in patients in renal failure.

10. Marked increased magnesium may be found in patients who take magnesium salts such as antacids.

11. Increased magnesium is found with Addison’s disease and in pregnant patients with severe pre-eclampsia or eclampsia who are receiving magnesium sulfate as an anticonvulsant.

12. Hypermagnesemia may occur in patients using magnesium-containing cathartics.

13. Indications for measurement of serum magnesium include:

·The presence of unexplained hypocalcemia

·Instances in which hypokalemia is unresponsive to potassium supplementation (high dose thiazide and loop diuretics)

·In patients with certain cardiac disorders such as congestive failure, ventricular ectopy, digitalis use, or left ventricular hypertrophy

·In patients with unexplained muscular paralysis

·In patients with neuromuscular irritability

·In patients with blood clotting disorders

·For patients receiving aminoglycosides, cyclosporine, or cisplatin.

NOTE: This policy applies only to individual serum magnesium tests.
 
 


Coding Information
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Bill Type Codes: back to top

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.
12x Hospital-inpatient or home health visits (Part B only)
13x Hospital-outpatient (HHA-A also) (under OPPS 13X must be used for ASC claims submitted for OPPS payment -- eff. 7/00)
14x Non-Patient Laboratory Specimens
18x Hospital-swing beds
21x SNF-inpatient, Part A
22x SNF-inpatient or home health visits (Part B only)
23x SNF-outpatient (HHA-A also)
71x Clinic-rural health
72x Clinic-hospital based or independent renal dialysis facility
73x Clinic-independent provider based FQHC (eff 10/91)
85x Special facility or ASC surgery-rural primary care hospital (eff 10/94)
 
 
Revenue Codes: back to top

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory; unless specified in the policy services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.

030X Laboratory-general classification
 
 
CPT/HCPCS Codes back to top

83735 MAGNESIUM
 
 
ICD-9 Codes that Support Medical Necessity back to top

153.0 - 153.9 MALIGNANT NEOPLASM OF HEPATIC FLEXURE - MALIGNANT NEOPLASM OF COLON UNSPECIFIED SITE
154.0 - 154.8 MALIGNANT NEOPLASM OF RECTOSIGMOID JUNCTION - MALIGNANT NEOPLASM OF OTHER SITES OF RECTUM RECTOSIGMOID JUNCTION AND ANUS
249.10 SECONDARY DIABETES MELLITUS WITH KETOACIDOSIS, NOT STATED AS UNCONTROLLED, OR UNSPECIFIED
249.11 SECONDARY DIABETES MELLITUS WITH KETOACIDOSIS, UNCONTROLLED
249.20 SECONDARY DIABETES MELLITUS WITH HYPEROSMOLARITY, NOT STATED AS UNCONTROLLED, OR UNSPECIFIED
249.21 SECONDARY DIABETES MELLITUS WITH HYPEROSMOLARITY, UNCONTROLLED
249.30 SECONDARY DIABETES MELLITUS WITH OTHER COMA, NOT STATED AS UNCONTROLLED, OR UNSPECIFIED
249.31 SECONDARY DIABETES MELLITUS WITH OTHER COMA, UNCONTROLLED
249.80 SECONDARY DIABETES MELLITUS WITH OTHER SPECIFIED MANIFESTATIONS, NOT STATED AS UNCONTROLLED, OR UNSPECIFIED
249.81 SECONDARY DIABETES MELLITUS WITH OTHER SPECIFIED MANIFESTATIONS, UNCONTROLLED
249.90 SECONDARY DIABETES MELLITUS WITH UNSPECIFIED COMPLICATION, NOT STATED AS UNCONTROLLED, OR UNSPECIFIED
249.91 SECONDARY DIABETES MELLITUS WITH UNSPECIFIED COMPLICATION, UNCONTROLLED
250.10 - 250.13 DIABETES WITH KETOACIDOSIS, TYPE II OR UNSPECIFIED TYPE, NOT STATED AS UNCONTROLLED - DIABETES WITH KETOACIDOSIS, TYPE I [JUVENILE TYPE], UNCONTROLLED
250.20 - 250.23 DIABETES WITH HYPEROSMOLARITY, TYPE II OR UNSPECIFIED TYPE, NOT STATED AS UNCONTROLLED - DIABETES WITH HYPEROSMOLARITY, TYPE I [JUVENILE TYPE], UNCONTROLLED
250.30 - 250.33 DIABETES WITH OTHER COMA, TYPE II OR UNSPECIFIED TYPE, NOT STATED AS UNCONTROLLED - DIABETES WITH OTHER COMA, TYPE I [JUVENILE TYPE], UNCONTROLLED
250.40 - 250.43 DIABETES WITH RENAL MANIFESTATIONS, TYPE II OR UNSPECIFIED TYPE, NOT STATED AS UNCONTROLLED - DIABETES WITH RENAL MANIFESTATIONS, TYPE I [JUVENILE TYPE], UNCONTROLLED
250.50 - 250.53 DIABETES WITH OPHTHALMIC MANIFESTATIONS, TYPE II OR UNSPECIFIED TYPE, NOT STATED AS UNCONTROLLED - DIABETES WITH OPHTHALMIC MANIFESTATIONS, TYPE I [JUVENILE TYPE], UNCONTROLLED
250.60 - 250.63 DIABETES WITH NEUROLOGICAL MANIFESTATIONS, TYPE II OR UNSPECIFIED TYPE, NOT STATED AS UNCONTROLLED - DIABETES WITH NEUROLOGICAL MANIFESTATIONS, TYPE I [JUVENILE TYPE], UNCONTROLLED
250.70 - 250.73 DIABETES WITH PERIPHERAL CIRCULATORY DISORDERS, TYPE II OR UNSPECIFIED TYPE, NOT STATED AS UNCONTROLLED - DIABETES WITH PERIPHERAL CIRCULATORY DISORDERS, TYPE I [JUVENILE TYPE], UNCONTROLLED
250.80 - 250.83 DIABETES WITH OTHER SPECIFIED MANIFESTATIONS, TYPE II OR UNSPECIFIED TYPE, NOT STATED AS UNCONTROLLED - DIABETES WITH OTHER SPECIFIED MANIFESTATIONS, TYPE I [JUVENILE TYPE], UNCONTROLLED
250.90 - 250.93 DIABETES WITH UNSPECIFIED COMPLICATION, TYPE II OR UNSPECIFIED TYPE, NOT STATED AS UNCONTROLLED - DIABETES WITH UNSPECIFIED COMPLICATION, TYPE I [JUVENILE TYPE], UNCONTROLLED
252.00 HYPERPARATHYROIDISM, UNSPECIFIED
252.01 - 252.08 PRIMARY HYPERPARATHYROIDISM - OTHER HYPERPARATHYROIDISM
252.1 HYPOPARATHYROIDISM
252.8 OTHER SPECIFIED DISORDERS OF PARATHYROID GLAND
252.9 UNSPECIFIED DISORDER OF PARATHYROID GLAND
255.10 HYPERALDOSTERONISM, UNSPECIFIED
255.11 GLUCOCORTICOID-REMEDIABLE ALDOSTERONISM
255.12 CONN'S SYNDROME
255.13 BARTTER'S SYNDROME
255.14 OTHER SECONDARY ALDOSTERONISM
258.01 MULTIPLE ENDOCRINE NEOPLASIA [MEN] TYPE I
258.02 MULTIPLE ENDOCRINE NEOPLASIA [MEN] TYPE IIA
258.03 MULTIPLE ENDOCRINE NEOPLASIA [MEN] TYPE IIB
259.3 ECTOPIC HORMONE SECRETION NOT ELSEWHERE CLASSIFIED
260 KWASHIORKOR
261 NUTRITIONAL MARASMUS
262 OTHER SEVERE PROTEIN-CALORIE MALNUTRITION
263.0 MALNUTRITION OF MODERATE DEGREE
263.8 OTHER PROTEIN-CALORIE MALNUTRITION
263.9 UNSPECIFIED PROTEIN-CALORIE MALNUTRITION
275.2 DISORDERS OF MAGNESIUM METABOLISM
275.40 UNSPECIFIED DISORDER OF CALCIUM METABOLISM
275.41 - 275.49 HYPOCALCEMIA - OTHER DISORDERS OF CALCIUM METABOLISM
275.5 HUNGRY BONE SYNDROME
276.2 ACIDOSIS
276.4 MIXED ACID-BASE BALANCE DISORDER
276.50 VOLUME DEPLETION, UNSPECIFIED
276.51 DEHYDRATION
276.52 HYPOVOLEMIA
276.7 HYPERPOTASSEMIA
276.8 HYPOPOTASSEMIA
276.9 ELECTROLYTE AND FLUID DISORDERS NOT ELSEWHERE CLASSIFIED
277.30 - 277.39 AMYLOIDOSIS, UNSPECIFIED - OTHER AMYLOIDOSIS
278.8 OTHER HYPERALIMENTATION
286.9 OTHER AND UNSPECIFIED COAGULATION DEFECTS
289.53 NEUTROPENIC SPLENOMEGALY
289.59 OTHER DISEASES OF SPLEEN
289.83 MYELOFIBROSIS
289.84 HEPARIN-INDUCED THROMBOCYTOPENIA (HIT)
293.0 - 293.1 DELIRIUM DUE TO CONDITIONS CLASSIFIED ELSEWHERE - SUBACUTE DELIRIUM
298.9 UNSPECIFIED PSYCHOSIS
303.00 - 303.03 ACUTE ALCOHOLIC INTOXICATION IN ALCOHOLISM UNSPECIFIED DRINKING BEHAVIOR - ACUTE ALCOHOLIC INTOXICATION IN ALCOHOLISM IN REMISSION
303.90 - 303.93 OTHER AND UNSPECIFIED ALCOHOL DEPENDENCE UNSPECIFIED DRINKING BEHAVIOR - OTHER AND UNSPECIFIED ALCOHOL DEPENDENCE IN REMISSION
307.1 ANOREXIA NERVOSA
307.20 TIC DISORDER UNSPECIFIED
307.22 CHRONIC MOTOR OR VOCAL TIC DISORDER
307.50 EATING DISORDER UNSPECIFIED
307.51 BULIMIA NERVOSA
307.52 PICA
307.59 OTHER DISORDERS OF EATING
333.2 MYOCLONUS
333.3 TICS OF ORGANIC ORIGIN
333.71 - 333.79 ATHETOID CEREBRAL PALSY - OTHER ACQUIRED TORSION DYSTONIA
333.85 SUBACUTE DYSKINESIA DUE TO DRUGS
333.94 RESTLESS LEGS SYNDROME
336.1 VASCULAR MYELOPATHIES
345.60 - 345.61 INFANTILE SPASMS WITHOUT INTRACTABLE EPILEPSY - INFANTILE SPASMS WITH INTRACTABLE EPILEPSY
359.4 TOXIC MYOPATHY
359.5 MYOPATHY IN ENDOCRINE DISEASES CLASSIFIED ELSEWHERE
359.6 SYMPTOMATIC INFLAMMATORY MYOPATHY IN DISEASES CLASSIFIED ELSEWHERE
359.89 OTHER MYOPATHIES
359.9 MYOPATHY UNSPECIFIED
402.00 - 402.01 MALIGNANT HYPERTENSIVE HEART DISEASE WITHOUT HEART FAILURE - MALIGNANT HYPERTENSIVE HEART DISEASE WITH HEART FAILURE
402.10 - 402.11 BENIGN HYPERTENSIVE HEART DISEASE WITHOUT HEART FAILURE - BENIGN HYPERTENSIVE HEART DISEASE WITH HEART FAILURE
402.90 - 402.91 UNSPECIFIED HYPERTENSIVE HEART DISEASE WITHOUT HEART FAILURE - UNSPECIFIED HYPERTENSIVE HEART DISEASE WITH HEART FAILURE
403.00 - 403.01 HYPERTENSIVE CHRONIC KIDNEY DISEASE, MALIGNANT, WITH CHRONIC KIDNEY DISEASE STAGE I THROUGH STAGE IV, OR UNSPECIFIED - HYPERTENSIVE CHRONIC KIDNEY DISEASE, MALIGNANT, WITH CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE
403.10 - 403.11 HYPERTENSIVE CHRONIC KIDNEY DISEASE, BENIGN, WITH CHRONIC KIDNEY DISEASE STAGE I THROUGH STAGE IV, OR UNSPECIFIED - HYPERTENSIVE CHRONIC KIDNEY DISEASE, BENIGN, WITH CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE
403.90 - 403.91 HYPERTENSIVE CHRONIC KIDNEY DISEASE, UNSPECIFIED, WITH CHRONIC KIDNEY DISEASE STAGE I THROUGH STAGE IV, OR UNSPECIFIED - HYPERTENSIVE CHRONIC KIDNEY DISEASE, UNSPECIFIED, WITH CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE
404.00 - 404.03 HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, MALIGNANT, WITHOUT HEART FAILURE AND WITH CHRONIC KIDNEY DISEASE STAGE I THROUGH STAGE IV, OR UNSPECIFIED - HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, MALIGNANT, WITH HEART FAILURE AND WITH CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE
404.10 - 404.13 HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, BENIGN, WITHOUT HEART FAILURE AND WITH CHRONIC KIDNEY DISEASE STAGE I THROUGH STAGE IV, OR UNSPECIFIED - HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, BENIGN, WITH HEART FAILURE AND CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE
404.90 - 404.93 HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, UNSPECIFIED, WITHOUT HEART FAILURE AND WITH CHRONIC KIDNEY DISEASE STAGE I THROUGH STAGE IV, OR UNSPECIFIED - HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE, UNSPECIFIED, WITH HEART FAILURE AND CHRONIC KIDNEY DISEASE STAGE V OR END STAGE RENAL DISEASE
410.00 - 410.92 ACUTE MYOCARDIAL INFARCTION OF ANTEROLATERAL WALL EPISODE OF CARE UNSPECIFIED - ACUTE MYOCARDIAL INFARCTION OF UNSPECIFIED SITE SUBSEQUENT EPISODE OF CARE
411.81 ACUTE CORONARY OCCLUSION WITHOUT MYOCARDIAL INFARCTION
415.11 IATROGENIC PULMONARY EMBOLISM AND INFARCTION
415.12 SEPTIC PULMONARY EMBOLISM
415.19 OTHER PULMONARY EMBOLISM AND INFARCTION
425.5 ALCOHOLIC CARDIOMYOPATHY
426.0 - 426.9 ATRIOVENTRICULAR BLOCK COMPLETE - CONDUCTION DISORDER UNSPECIFIED
427.0 - 427.2 PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA - PAROXYSMAL TACHYCARDIA UNSPECIFIED
427.31 - 427.32 ATRIAL FIBRILLATION - ATRIAL FLUTTER
427.41 - 427.42 VENTRICULAR FIBRILLATION - VENTRICULAR FLUTTER
427.5 CARDIAC ARREST
427.60 - 427.69 PREMATURE BEATS UNSPECIFIED - OTHER PREMATURE BEATS
427.81 SINOATRIAL NODE DYSFUNCTION
427.89 OTHER SPECIFIED CARDIAC DYSRHYTHMIAS
427.9 CARDIAC DYSRHYTHMIA UNSPECIFIED
428.0 - 428.9 CONGESTIVE HEART FAILURE UNSPECIFIED - HEART FAILURE UNSPECIFIED
429.79 CERTAIN SEQUELAE OF MYOCARDIAL INFARCTION NOT ELSEWHERE CLASSIFIED OTHER
429.83 TAKOTSUBO SYNDROME
429.89 OTHER ILL-DEFINED HEART DISEASES
458.0 - 458.1 ORTHOSTATIC HYPOTENSION - CHRONIC HYPOTENSION
458.21 HYPOTENSION OF HEMODIALYSIS
458.9 HYPOTENSION UNSPECIFIED
536.2 PERSISTENT VOMITING
555.9 REGIONAL ENTERITIS OF UNSPECIFIED SITE
556.0 - 556.9 ULCERATIVE (CHRONIC) ENTEROCOLITIS - ULCERATIVE COLITIS UNSPECIFIED
577.0 ACUTE PANCREATITIS
579.0 - 579.9 CELIAC DISEASE - UNSPECIFIED INTESTINAL MALABSORPTION
584.5 - 584.9 ACUTE RENAL FAILURE WITH LESION OF TUBULAR NECROSIS - ACUTE RENAL FAILURE UNSPECIFIED
585.1 - 585.9 CHRONIC KIDNEY DISEASE, STAGE I - CHRONIC KIDNEY DISEASE, UNSPECIFIED
586 RENAL FAILURE UNSPECIFIED
587 RENAL SCLEROSIS UNSPECIFIED
588.0 - 588.9 RENAL OSTEODYSTROPHY - UNSPECIFIED DISORDER RESULTING FROM IMPAIRED RENAL FUNCTION
590.00 CHRONIC PYELONEPHRITIS WITHOUT LESION OF RENAL MEDULLARY NECROSIS
593.81 VASCULAR DISORDERS OF KIDNEY
632 MISSED ABORTION
634.10 - 634.12 SPONTANEOUS ABORTION UNSPECIFIED COMPLICATED BY DELAYED OR EXCESSIVE HEMORRHAGE - SPONTANEOUS ABORTION COMPLETE COMPLICATED BY DELAYED OR EXCESSIVE HEMORRHAGE
634.30 - 634.32 SPONTANEOUS ABORTION UNSPECIFIED COMPLICATED BY RENAL FAILURE - SPONTANEOUS ABORTION COMPLETE COMPLICATED BY RENAL FAILURE
634.40 - 634.42 SPONTANEOUS ABORTION UNSPECIFIED COMPLICATED BY METABOLIC DISORDER - SPONTANEOUS ABORTION COMPLETE COMPLICATED BY METABOLIC DISORDER
634.50 - 634.52 SPONTANEOUS ABORTION UNSPECIFIED COMPLICATED BY SHOCK - SPONTANEOUS ABORTION COMPLETE COMPLICATED BY SHOCK
634.60 - 634.62 SPONTANEOUS ABORTION UNSPECIFIED COMPLICATED BY EMBOLISM - SPONTANEOUS ABORTION COMPLETE COMPLICATED BY EMBOLISM
634.70 - 634.72 SPONTANEOUS ABORTION UNSPECIFIED WITH OTHER SPECIFIED COMPLICATIONS - SPONTANEOUS ABORTION COMPLETE WITH OTHER SPECIFIED COMPLICATIONS
634.80 - 634.82 SPONTANEOUS ABORTION UNSPECIFIED WITH UNSPECIFIED COMPLICATION - SPONTANEOUS ABORTION COMPLETE WITH UNSPECIFIED COMPLICATION
635.10 - 635.12 LEGALLY INDUCED ABORTION UNSPECIFIED COMPLICATED BY DELAYED OR EXCESSIVE HEMORRHAGE - LEGALLY INDUCED ABORTION COMPLETE COMPLICATED BY DELAYED OR EXCESSIVE HEMORRHAGE
635.30 - 635.32 LEGALLY INDUCED ABORTION UNSPECIFIED COMPLICATED BY RENAL FAILURE - LEGALLY INDUCED ABORTION COMPLETE COMPLICATED BY RENAL FAILURE
635.40 - 635.42 LEGALLY INDUCED ABORTION UNSPECIFIED COMPLICATED BY METABOLIC DISORDER - LEGALLY INDUCED ABORTION COMPLETE COMPLICATED BY METABOLIC DISORDER
635.50 - 635.52 LEGALLY INDUCED ABORTION UNSPECIFIED COMPLICATED BY SHOCK - LEGALLY INDUCED ABORTION COMPLETE COMPLICATED BY SHOCK
635.60 - 635.62 LEGALLY INDUCED ABORTION UNSPECIFIED COMPLICATED BY EMBOLISM - LEGALLY INDUCED ABORTION COMPLETE COMPLICATED BY EMBOLISM
635.70 - 635.72 LEGALLY INDUCED ABORTION UNSPECIFIED WITH OTHER SPECIFIED COMPLICATIONS - LEGALLY INDUCED ABORTION COMPLETE WITH OTHER SPECIFIED COMPLICATIONS
635.80 - 635.82 LEGALLY INDUCED ABORTION UNSPECIFIED WITH UNSPECIFIED COMPLICATION - LEGALLY INDUCED ABORTION COMPLETE WITH UNSPECIFIED COMPLICATION
636.10 - 636.12 ILLEGAL ABORTION UNSPECIFIED COMPLICATED BY DELAYED OR EXCESSIVE HEMORRHAGE - ILLEGAL ABORTION COMPLETE COMPLICATED BY DELAYED OR EXCESSIVE HEMORRHAGE
636.30 - 636.32 ILLEGAL ABORTION UNSPECIFIED COMPLICATED BY RENAL FAILURE - ILLEGAL ABORTION COMPLETE COMPLICATED BY RENAL FAILURE
636.40 - 636.42 ILLEGAL ABORTION UNSPECIFIED COMPLICATED BY METABOLIC DISORDER - ILLEGAL ABORTION COMPLETE COMPLICATED BY METABOLIC DISORDER
636.50 - 636.52 ILLEGAL ABORTION UNSPECIFIED COMPLICATED BY SHOCK - ILLEGAL ABORTION COMPLETE COMPLICATED BY SHOCK
636.60 - 636.62 ILLEGAL ABORTION UNSPECIFIED COMPLICATED BY EMBOLISM - ILLEGAL ABORTION COMPLETE COMPLICATED BY EMBOLISM
636.70 - 636.72 ILLEGAL ABORTION UNSPECIFIED WITH OTHER SPECIFIED COMPLICATIONS - ILLEGAL ABORTION COMPLETE WITH OTHER SPECIFIED COMPLICATIONS
636.80 - 636.82 ILLEGAL ABORTION UNSPECIFIED WITH UNSPECIFIED COMPLICATION - ILLEGAL ABORTION COMPLETE WITH UNSPECIFIED COMPLICATION
637.10 - 637.12 UNSPECIFIED TYPE OF ABORTION UNSPECIFIED COMPLICATED BY DELAYED OR EXCESSIVE HEMORRHAGE - LEGALLY UNSPECIFIED ABORTION COMPLETE COMPLICATED BY DELAYED OR EXCESSIVE HEMORRHAGE
637.30 - 637.32 LEGALLY UNSPECIFIED TYPE OF ABORTION UNSPECIFIED COMPLICATED BY RENAL FAILURE - LEGALLY UNSPECIFIED ABORTION COMPLETE COMPLICATED BY RENAL FAILURE
637.40 - 637.42 LEGALLY UNSPECIFIED TYPE OF ABORTION UNSPECIFIED COMPLICATED BY METABOLIC DISORDER - LEGALLY UNSPECIFIED ABORTION COMPLETE COMPLICATED BY METABOLIC DISORDER
637.50 - 637.52 LEGALLY UNSPECIFIED TYPE OF ABORTION UNSPECIFIED COMPLICATED BY SHOCK - LEGALLY UNSPECIFIED ABORTION COMPLETE COMPLICATED BY SHOCK
637.60 - 637.62 LEGALLY UNSPECIFIED TYPE OF ABORTION UNSPECIFIED COMPLICATED BY EMBOLISM - LEGALLY UNSPECIFIED ABORTION COMPLETE COMPLICATED BY EMBOLISM
637.70 - 637.72 LEGALLY UNSPECIFIED TYPE OF ABORTION UNSPECIFIED WITH OTHER SPECIFIED COMPLICATIONS - LEGALLY UNSPECIFIED ABORTION COMPLETE WITH OTHER SPECIFIED COMPLICATIONS
637.80 - 637.82 LEGALLY UNSPECIFIED TYPE OF ABORTION UNSPECIFIED WITH UNSPECIFIED COMPLICATION - LEGALLY UNSPECIFIED ABORTION COMPLETE WITH UNSPECIFIED COMPLICATION
638.1 - 638.9 FAILED ATTEMPTED ABORTION COMPLICATED BY DELAYED OR EXCESSIVE HEMORRHAGE - FAILED ATTEMPTED ABORTION WITHOUT COMPLICATION
639.1 DELAYED OR EXCESSIVE HEMORRHAGE FOLLOWING ABORTION OR ECTOPIC AND MOLAR PREGNANCIES
639.3 RENAL FAILURE FOLLOWING ABORTION OR ECTOPIC AND MOLAR PREGNANCIES
639.4 METABOLIC DISORDERS FOLLOWING ABORTION OR ECTOPIC AND MOLAR PREGNANCIES
639.5 SHOCK FOLLOWING ABORTION OR ECTOPIC AND MOLAR PREGNANCIES
639.6 EMBOLISM FOLLOWING ABORTION OR ECTOPIC AND MOLAR PREGNANCIES
639.8 OTHER SPECIFIED COMPLICATIONS FOLLOWING ABORTION OR ECTOPIC AND MOLAR PREGNANCIES
639.9 UNSPECIFIED COMPLICATION FOLLOWING ABORTION OR ECTOPIC AND MOLAR PREGNANCIES
640.00 - 640.01 THREATENED ABORTION UNSPECIFIED AS TO EPISODE OF CARE - THREATENED ABORTION DELIVERED
640.03 THREATENED ABORTION ANTEPARTUM
640.80 - 640.81 OTHER SPECIFIED HEMORRHAGE IN EARLY PREGNANCY UNSPECIFIED AS TO EPISODE OF CARE - OTHER SPECIFIED HEMORRHAGE IN EARLY PREGNANCY DELIVERED
640.83 OTHER SPECIFIED HEMORRHAGE IN EARLY PREGNANCY ANTEPARTUM
640.90 - 640.91 UNSPECIFIED HEMORRHAGE IN EARLY PREGNANCY UNSPECIFIED AS TO EPISODE OF CARE - UNSPECIFIED HEMORRHAGE IN EARLY PREGNANCY DELIVERED
640.93 UNSPECIFIED HEMORRHAGE IN EARLY PREGNANCY ANTEPARTUM
641.00 - 641.01 PLACENTA PREVIA WITHOUT HEMORRHAGE UNSPECIFIED AS TO EPISODE OF CARE - PLACENTA PREVIA WITHOUT HEMORRHAGE WITH DELIVERY
641.03 PLACENTA PREVIA WITHOUT HEMORRHAGE ANTEPARTUM
641.10 - 641.11 HEMORRHAGE FROM PLACENTA PREVIA UNSPECIFIED AS TO EPISODE OF CARE - HEMORRHAGE FROM PLACENTA PREVIA WITH DELIVERY
641.13 HEMORRHAGE FROM PLACENTA PREVIA ANTEPARTUM
641.20 - 641.21 PREMATURE SEPARATION OF PLACENTA UNSPECIFIED AS TO EPISODE OF CARE - PREMATURE SEPARATION OF PLACENTA WITH DELIVERY
641.23 PREMATURE SEPARATION OF PLACENTA ANTEPARTUM
641.30 - 641.31 ANTEPARTUM HEMORRHAGE ASSOCIATED WITH COAGULATION DEFECTS UNSPECIFIED AS TO EPISODE OF CARE - ANTEPARTUM HEMORRHAGE ASSOCIATED WITH COAGULATION DEFECTS WITH DELIVERY
641.33 ANTEPARTUM HEMORRHAGE ASSOCIATED WITH COAGULATION DEFECTS
641.80 - 641.81 OTHER ANTEPARTUM HEMORRHAGE UNSPECIFIED AS TO EPISODE OF CARE - OTHER ANTEPARTUM HEMORRHAGE WITH DELIVERY
641.83 OTHER ANTEPARTUM HEMORRHAGE
641.90 - 641.91 UNSPECIFIED ANTEPARTUM HEMORRHAGE UNSPECIFIED AS TO EPISODE OF CARE - UNSPECIFIED ANTEPARTUM HEMORRHAGE WITH DELIVERY
641.93 UNSPECIFIED ANTEPARTUM HEMORRHAGE
642.00 - 642.04 BENIGN ESSENTIAL HYPERTENSION COMPLICATING PREGNANCY CHILDBIRTH AND THE PUERPERIUM UNSPECIFIED AS TO EPISODE OF CARE - POSTPARTUM BENIGN ESSENTIAL HYPERTENSION
642.10 - 642.14 HYPERTENSION SECONDARY TO RENAL DISEASE COMPLICATING PREGNANCY CHILDBIRTH AND THE PUERPERIUM UNSPECIFIED AS TO EPISODE OF CARE - HYPERTENSION SECONDARY TO RENAL DISEASE POSTPARTUM
642.20 - 642.24 OTHER PRE-EXISTING HYPERTENSION COMPLICATING PREGNANCY CHILDBIRTH AND THE PUERPERIUM UNSPECIFIED AS TO EPISODE OF CARE - OTHER PRE-EXISTING HYPERTENSION POSTPARTUM
642.30 - 642.34 TRANSIENT HYPERTENSION OF PREGNANCY UNSPECIFIED AS TO EPISODE OF CARE - POSTPARTUM TRANSIENT HYPERTENSION
642.40 - 642.44 MILD OR UNSPECIFIED PRE-ECLAMPSIA UNSPECIFIED AS TO EPISODE OF CARE - MILD OR UNSPECIFIED PRE-ECLAMPSIA POSTPARTUM
642.50 - 642.54 SEVERE PRE-ECLAMPSIA UNSPECIFIED AS TO EPISODE OF CARE - SEVERE PRE-ECLAMPSIA POSTPARTUM
642.60 - 642.64 ECLAMPSIA COMPLICATING PREGNANCY CHILDBIRTH OR THE PUERPERIUM UNSPECIFIED AS TO EPISODE OF CARE - ECLAMPSIA POSTPARTUM
642.70 - 642.74 PRE-ECLAMPSIA OR ECLAMPSIA SUPERIMPOSED ON PRE-EXISTING HYPERTENSION COMPLICATING PREGNANCY CHILDBIRTH OR THE PUERPERIUM UNSPECIFIED AS TO EPISODE OF CARE - PRE-ECLAMPSIA OR ECLAMPSIA SUPERIMPOSED ON PRE-EXISTING HYPERTENSION POSTPARTUM
642.90 - 642.94 UNSPECIFIED HYPERTENSION COMPLICATING PREGNANCY CHILDBIRTH OR THE PUERPERIUM UNSPECIFIED AS TO EPISODE OF CARE - UNSPECIFIED POSTPARTUM HYPERTENSION
643.10 - 643.11 HYPEREMESIS GRAVIDARUM WITH METABOLIC DISTURBANCE UNSPECIFIED AS TO EPISODE OF CARE - HYPEREMESIS GRAVIDARUM WITH METABOLIC DISTURBANCE DELIVERED
643.13 HYPEREMESIS GRAVIDARUM WITH METABOLIC DISTURBANCE ANTEPARTUM
643.20 - 643.21 LATE VOMITING OF PREGNANCY UNSPECIFIED AS TO EPISODE OF CARE - LATE VOMITING OF PREGNANCY DELIVERED
643.23 LATE VOMITING OF PREGNANCY ANTEPARTUM
643.80 - 643.81 OTHER VOMITING COMPLICATING PREGNANCY UNSPECIFIED AS TO EPISODE OF CARE - OTHER VOMITING COMPLICATING PREGNANCY DELIVERED
643.83 OTHER VOMITING COMPLICATING PREGNANCY ANTEPARTUM
643.90 - 643.91 UNSPECIFIED VOMITING OF PREGNANCY UNSPECIFIED AS TO EPISODE OF CARE - UNSPECIFIED VOMITING OF PREGNANCY DELIVERED
643.93 UNSPECIFIED VOMITING OF PREGNANCY ANTEPARTUM
646.20 - 646.24 UNSPECIFIED RENAL DISEASE IN PREGNANCY UNSPECIFIED AS TO EPISODE OF CARE - UNSPECIFIED POSTPARTUM RENAL DISEASE
646.80 - 646.84 OTHER SPECIFIED COMPLICATIONS OF PREGNANCY UNSPECIFIED AS TO EPISODE OF CARE - OTHER SPECIFIED POSTPARTUM COMPLICATIONS
646.90 - 646.91 UNSPECIFIED COMPLICATION OF PREGNANCY UNSPECIFIED AS TO EPISODE OF CARE - UNSPECIFIED COMPLICATION OF PREGNANCY WITH DELIVERY
646.93 UNSPECIFIED ANTEPARTUM COMPLICATION
648.00 - 648.04 DIABETES MELLITUS OF MOTHER COMPLICATING PREGNANCY CHILDBIRTH OR THE PUERPERIUM UNSPECIFIED AS TO EPISODE OF CARE - POSTPARTUM DIABETES MELLITUS
648.90 - 648.94 OTHER CURRENT CONDITIONS CLASSIFIABLE ELSEWHERE OF MOTHER COMPLICATING PREGNANCY CHILDBIRTH OR THE PUERPERIUM UNSPECIFIED AS TO EPISODE OF CARE - OTHER CURRENT CONDITIONS CLASSIFIABLE ELSEWHERE OF MOTHER POSTPARTUM
655.80 - 655.81 OTHER KNOWN OR SUSPECTED FETAL ABNORMALITY NOT ELSEWHERE CLASSIFIED AFFECTING MANAGEMENT OF MOTHER UNSPECIFIED AS TO EPISODE OF CARE - OTHER KNOWN OR SUSPECTED FETAL ABNORMALITY NOT ELSEWHERE CLASSIFIED AFFECTING MANAGEMENT OF MOTHER WITH DELIVERED
655.83 OTHER KNOWN OR SUSPECTED FETAL ABNORMALITY NOT ELSEWHERE CLASSIFIED AFFECTING MANAGEMENT OF MOTHER ANTEPARTUM CONDITION OR COMPLICATION
655.90 - 655.91 UNSPECIFIED SUSPECTED FETAL ABNORMALITY AFFECTING MANAGEMENT OF MOTHER UNSPECIFIED AS TO EPISODE OF CARE - UNSPECIFIED SUSPECTED FETAL ABNORMALITY AFFECTING MANAGEMENT OF MOTHER DELIVERED
655.93 UNSPECIFIED SUSPECTED FETAL ABNORMALITY AFFECTING MANAGEMENT OF MOTHER ANTEPARTUM CONDITION OR COMPLICATION
656.00 - 656.01 FETAL-MATERNAL HEMORRHAGE UNSPECIFIED AS TO EPISODE OF CARE IN PREGNANCY - FETAL-MATERNAL HEMORRHAGE WITH DELIVERY
656.03 FETAL-MATERNAL HEMORRHAGE ANTEPARTUM CONDITION OR COMPLICATION
656.30 - 656.31 FETAL DISTRESS AFFECTING MANAGEMENT OF MOTHER UNSPECIFIED AS TO EPISODE OF CARE - FETAL DISTRESS AFFECTING MANAGEMENT OF MOTHER DELIVERED
656.33 FETAL DISTRESS AFFECTING MANAGEMENT OF MOTHER ANTEPARTUM
656.40 - 656.41 INTRAUTERINE DEATH AFFECTING MANAGEMENT OF MOTHER UNSPECIFIED AS TO EPISODE OF CARE - INTRAUTERINE DEATH AFFECTING MANAGEMENT OF MOTHER DELIVERED
656.43 INTRAUTERINE DEATH AFFECTING MANAGEMENT OF MOTHER ANTEPARTUM
666.00 THIRD-STAGE POSTPARTUM HEMORRHAGE UNSPECIFIED AS TO EPISODE OF CARE
666.02 THIRD-STAGE POSTPARTUM HEMORRHAGE WITH DELIVERY
666.04 THIRD-STAGE POSTPARTUM HEMORRHAGE
666.10 OTHER IMMEDIATE POSTPARTUM HEMORRHAGE UNSPECIFIED AS TO EPISODE OF CARE
666.12 OTHER IMMEDIATE POSTPARTUM HEMORRHAGE WITH DELIVERY
666.14 OTHER IMMEDIATE POSTPARTUM HEMORRHAGE
666.20 DELAYED AND SECONDARY POSTPARTUM HEMORRHAGE UNSPECIFIED AS TO EPISODE OF CARE
666.22 DELAYED AND SECONDARY POSTPARTUM HEMORRHAGE WITH DELIVERY
666.24 DELAYED AND SECONDARY POSTPARTUM HEMORRHAGE
668.10 - 668.14 CARDIAC COMPLICATIONS OF ANESTHESIA OR OTHER SEDATION IN LABOR AND DELIVERY UNSPECIFIED AS TO EPISODE OF CARE - CARDIAC COMPLICATIONS OF ANESTHESIA OR OTHER SEDATION IN LABOR AND DELIVERY POSTPARTUM
668.80 - 668.84 OTHER COMPLICATIONS OF ANESTHESIA OR OTHER SEDATION IN LABOR AND DELIVERY UNSPECIFIED AS TO EPISODE OF CARE - OTHER COMPLICATIONS OF ANESTHESIA OR OTHER SEDATION IN LABOR AND DELIVERY POSTPARTUM
668.90 - 668.94 UNSPECIFIED COMPLICATION OF ANESTHESIA OR OTHER SEDATION IN LABOR AND DELIVERY UNSPECIFIED AS TO EPISODE OF CARE - UNSPECIFIED COMPLICATION OF ANESTHESIA OR OTHER SEDATION IN LABOR AND DELIVERY POSTPARTUM
669.10 - 669.14 OBSTETRIC SHOCK UNSPECIFIED AS TO EPISODE OF CARE - POSTPARTUM OBSTETRIC SHOCK
669.20 - 669.24 MATERNAL HYPOTENSION SYNDROME COMPLICATING LABOR AND DELIVERY UNSPECIFIED AS TO EPISODE OF CARE - MATERNAL HYPOTENSION SYNDROME POSTPARTUM
669.30 - 669.32 ACUTE RENAL FAILURE FOLLOWING LABOR AND DELIVERY UNSPECIFIED AS TO EPISODE OF CARE - ACUTE RENAL FAILURE WITH DELIVERY WITH POSTPARTUM COMPLICATION
669.34 ACUTE RENAL FAILURE FOLLOWING LABOR AND DELIVERY POSTPARTUM CONDITION OR COMPLICATION
669.40 - 669.44 OTHER COMPLICATIONS OF OBSTETRICAL SURGERY AND PROCEDURES UNSPECIFIED AS TO EPISODE OF CARE - OTHER COMPLICATIONS OF OBSTETRICAL SURGERY AND PROCEDURES POSTPARTUM CONDITION OR COMPLICATION
669.80 - 669.84 OTHER COMPLICATIONS OF LABOR AND DELIVERY UNSPECIFIED AS TO EPISODE OF CARE - OTHER COMPLICATIONS OF LABOR AND DELIVERY POSTPARTUM CONDITION OR COMPLICATION
669.90 - 669.94 UNSPECIFIED COMPLICATION OF LABOR AND DELIVERY UNSPECIFIED AS TO EPISODE OF CARE - UNSPECIFIED COMPLICATION OF LABOR AND DELIVERY POSTPARTUM CONDITION OR COMPLICATION
673.20 - 673.24 OBSTETRICAL BLOOD-CLOT EMBOLISM UNSPECIFIED AS TO EPISODE OF CARE - OBSTETRICAL BLOOD-CLOT EMBOLISM POSTPARTUM
676.60 - 676.64 GALACTORRHEA ASSOCIATED WITH CHILDBIRTH UNSPECIFIED AS TO EPISODE OF CARE - GALACTORRHEA POSTPARTUM CONDITION OR COMPLICATION
728.86 NECROTIZING FASCIITIS
728.87 MUSCLE WEAKNESS (GENERALIZED)
728.88 RHABDOMYOLYSIS
728.9 UNSPECIFIED DISORDER OF MUSCLE LIGAMENT AND FASCIA
729.71 - 729.79 NONTRAUMATIC COMPARTMENT SYNDROME OF UPPER EXTREMITY - NONTRAUMATIC COMPARTMENT SYNDROME OF OTHER SITES
729.82 CRAMP OF LIMB
729.90 DISORDERS OF SOFT TISSUE, UNSPECIFIED
729.91 POST-TRAUMATIC SEROMA
729.92 NONTRAUMATIC HEMATOMA OF SOFT TISSUE
729.99 OTHER DISORDERS OF SOFT TISSUE
731.0 OSTEITIS DEFORMANS WITHOUT BONE TUMOR
760.0 MATERNAL HYPERTENSIVE DISORDERS AFFECTING FETUS OR NEWBORN
760.1 MATERNAL RENAL AND URINARY TRACT DISEASES AFFECTING FETUS OR NEWBORN
760.4 MATERNAL NUTRITIONAL DISORDERS AFFECTING FETUS OR NEWBORN
760.71 NOXIOUS INFLUENCES AFFECTING FETUS OR NEWBORN VIA PLACENTA OR BREAST MILK, ALCOHOL
760.8 OTHER SPECIFIED MATERNAL CONDITIONS AFFECTING FETUS OR NEWBORN
763.81 - 763.89 ABNORMALITY IN FETAL HEART RATE OR RHYTHM BEFORE THE ONSET OF LABOR - OTHER SPECIFIED COMPLICATIONS OF LABOR AND DELIVERY AFFECTING FETUS OR NEWBORN
763.9 UNSPECIFIED COMPLICATION OF LABOR AND DELIVERY AFFECTING FETUS OR NEWBORN
780.01 - 780.02 COMA - TRANSIENT ALTERATION OF AWARENESS
780.09 ALTERATION OF CONSCIOUSNESS OTHER
780.2 SYNCOPE AND COLLAPSE
780.31 - 780.39 FEBRILE CONVULSIONS (SIMPLE), UNSPECIFIED - OTHER CONVULSIONS
780.71 CHRONIC FATIGUE SYNDROME
780.79 OTHER MALAISE AND FATIGUE
780.8 GENERALIZED HYPERHIDROSIS
780.97 ALTERED MENTAL STATUS
781.0 - 781.7 ABNORMAL INVOLUNTARY MOVEMENTS - TETANY
783.0 ANOREXIA
783.21 - 783.22 LOSS OF WEIGHT - UNDERWEIGHT
783.3 FEEDING DIFFICULTIES AND MISMANAGEMENT
783.9 OTHER SYMPTOMS CONCERNING NUTRITION METABOLISM AND DEVELOPMENT
785.0 TACHYCARDIA UNSPECIFIED
785.50 - 785.51 SHOCK UNSPECIFIED - CARDIOGENIC SHOCK
785.59 OTHER SHOCK WITHOUT TRAUMA
789.59 OTHER ASCITES
790.6 OTHER ABNORMAL BLOOD CHEMISTRY
794.31 NONSPECIFIC ABNORMAL ELECTROCARDIOGRAM (ECG) (EKG)
794.4 NONSPECIFIC ABNORMAL RESULTS OF FUNCTION STUDY OF KIDNEY
796.1 ABNORMAL REFLEX
796.2 ELEVATED BLOOD PRESSURE READING WITHOUT DIAGNOSIS OF HYPERTENSION
799.4 CACHEXIA
940.0 - 940.9 CHEMICAL BURN OF EYELIDS AND PERIOCULAR AREA - UNSPECIFIED BURN OF EYE AND ADNEXA
941.00 - 941.09 BURN OF UNSPECIFIED DEGREE OF UNSPECIFIED SITE OF FACE AND HEAD - BURN OF UNSPECIFIED DEGREE OF MULTIPLE SITES (EXCEPT WITH EYE) OF FACE HEAD AND NECK
941.20 - 941.29 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF FACE AND HEAD UNSPECIFIED SITE - BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF MULTIPLE SITES (EXCEPT WITH EYE) OF FACE HEAD AND NECK
941.30 - 941.39 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF UNSPECIFIED SITE OF FACE AND HEAD - FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF MULTIPLE SITES (EXCEPT WITH EYE) OF FACE HEAD AND NECK
941.40 - 941.49 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF UNSPECIFIED SITE OF FACE AND HEAD WITHOUT LOSS OF BODY PART - DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SITES (EXCEPT WITH EYE) OF FACE HEAD AND NECK WITHOUT LOSS OF A BODY PART
941.50 - 941.59 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF FACE AND HEAD UNSPECIFIED SITE WITH LOSS OF BODY PART - DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SITES (EXCEPT EYE) OF FACE HEAD AND NECK WITH LOSS OF A BODY PART
942.00 - 942.09 BURN OF UNSPECIFIED DEGREE OF UNSPECIFIED SITE OF TRUNK - BURN OF UNSPECIFIED DEGREE OF OTHER AND MULTIPLE SITES OF TRUNK
942.20 - 942.29 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF UNSPECIFIED SITE OF TRUNK - BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF OTHER AND MULTIPLE SITES OF TRUNK
942.30 - 942.39 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF UNSPECIFIED SITE OF TRUNK - FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF OTHER AND MULTIPLE SITES OF TRUNK
942.40 - 942.49 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF TRUNK UNSPECIFIED SITE WITHOUT LOSS OF BODY PART - DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF OTHER AND MULTIPLE SITES OF TRUNK WITHOUT LOSS OF BODY PART
942.50 - 942.59 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF UNSPECIFIED SITE OF TRUNK WITH LOSS OF BODY PART - DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF OTHER AND MULTIPLE SITES OF TRUNK WITH LOSS OF A BODY PART
943.00 - 943.09 BURN OF UNSPECIFIED DEGREE OF UNSPECIFIED SITE OF UPPER LIMB - BURN OF UNSPECIFIED DEGREE MULTIPLE SITES OF UPPER LIMB EXCEPT WRIST AND HAND
943.20 - 943.29 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF UNSPECIFIED SITE OF UPPER LIMB - BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF MULTIPLE SITES OF UPPER LIMB EXCEPT WRIST AND HAND
943.30 - 943.39 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF UNSPECIFIED SITE OF UPPER LIMB - FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF MULTIPLE SITES OF UPPER LIMB EXCEPT WRIST AND HAND
943.40 - 943.49 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF UNSPECIFIED SITE OF UPPER LIMB WITHOUT LOSS OF A BODY PART - DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SITES OF UPPER LIMB EXCEPT WRIST AND HAND WITHOUT LOSS OF UPPER LIMB
943.50 - 943.59 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF UNSPECIFIED SITE OF UPPER LIMB WITH LOSS OF A BODY PART - DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SITES OF UPPER LIMB EXCEPT WRIST AND HAND WITH LOSS OF UPPER LIMB
944.00 - 944.08 BURN OF UNSPECIFIED DEGREE OF UNSPECIFIED SITE OF HAND - BURN OF UNSPECIFIED DEGREE OF MULTIPLE SITES OF WRIST(S) AND HAND(S)
944.20 - 944.28 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF UNSPECIFIED SITE OF HAND - BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF MULTIPLE SITES OF WRIST(S) AND HAND(S)
944.30 - 944.38 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF UNSPECIFIED SITE OF HAND - FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF MULTIPLE SITES OF WRIST(S) AND HAND(S)
944.40 - 944.48 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF UNSPECIFIED SITE OF HAND WITHOUT LOSS OF HAND - DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SITES OF WRIST(S) AND HAND(S) WITHOUT LOSS OF A BODY PART
944.50 - 944.58 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF UNSPECIFIED SITE OF HAND WITH LOSS OF HAND - DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SITES OF WRIST(S) AND HAND(S) WITH LOSS OF A BODY PART
945.00 - 945.09 BURN OF UNSPECIFIED DEGREE OF UNSPECIFIED SITE OF LOWER LIMB (LEG) - BURN OF UNSPECIFIED DEGREE OF MULTIPLE SITES OF LOWER LIMB(S)
945.20 - 945.29 BLISTERS EPIDERMAL LOSS (SECOND DEGREE) OF UNSPECIFIED SITE OF LOWER LIMB (LEG) - BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF MULTIPLE SITES OF LOWER LIMB(S)
945.30 - 945.39 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF UNSPECIFIED SITE OF LOWER LIMB - FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF MULTIPLE SITES OF LOWER LIMB(S)
945.40 - 945.49 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF UNSPECIFIED SITE OF LOWER LIMB (LEG) WITHOUT LOSS OF A BODY PART - DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SITES OF LOWER LIMB(S) WITHOUT LOSS OF A BODY PART
945.50 - 945.59 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF UNSPECIFIED SITE LOWER LIMB (LEG) WITH LOSS OF A BODY PART - DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SITES OF LOWER LIMB(S) WITH LOSS OF A BODY PART
946.0 BURNS OF MULTIPLE SPECIFIED SITES UNSPECIFIED DEGREE
946.2 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) OF MULTIPLE SPECIFIED SITES
946.3 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) OF MULTIPLE SPECIFIED SITES
946.4 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SPECIFIED SITES WITHOUT LOSS OF A BODY PART
946.5 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE) OF MULTIPLE SPECIFIED SITES WITH LOSS OF A BODY PART
947.0 - 947.9 BURN OF MOUTH AND PHARYNX - BURN OF INTERNAL ORGAN UNSPECIFIED SITE
948.00 BURN (ANY DEGREE) INVOLVING LESS THAN 10 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF LESS THAN 10 PERCENT OR UNSPECIFIED AMOUNT
948.10 - 948.11 BURN (ANY DEGREE) INVOLVING 10-19 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF LESS THAN 10 PERCENT OR UNSPECIFIED AMOUNT - BURN (ANY DEGREE) INVOLVING 10-19 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF 10-19%
948.20 - 948.22 BURN (ANY DEGREE) INVOLVING 20-29 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF LESS THAN 10 PERCENT OR UNSPECIFIED AMOUNT - BURN (ANY DEGREE) INVOLVING 20-29 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF 20-29%
948.30 - 948.33 BURN (ANY DEGREE) INVOLVING 30-39 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF LESS THAN 10 PERCENT OR UNSPECIFIED AMOUNT - BURN (ANY DEGREE) INVOLVING 30-39 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF 30-39%
948.40 - 948.44 BURN (ANY DEGREE) INVOLVING 40-49 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF LESS THAN 10 PERCENT OR UNSPECIFIED AMOUNT - BURN (ANY DEGREE) INVOLVING 40-49 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF 40-49%
948.50 - 948.55 BURN (ANY DEGREE) INVOLVING 50-59 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF LESS THAN 10 PERCENT OR UNSPECIFIED AMOUNT - BURN (ANY DEGREE) INVOLVING 50-59 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF 50-59%
948.60 - 948.66 BURN (ANY DEGREE) INVOLVING 60-69 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF LESS THAN 10 PERCENT OR UNSPECIFIED AMOUNT - BURN (ANY DEGREE) INVOLVING 60-69 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF 60-69%
948.70 - 948.77 BURN (ANY DEGREE) INVOLVING 70-79 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF LESS THAN 10 PERCENT OR UNSPECIFIED AMOUNT - BURN (ANY DEGREE) INVOLVING 70-79 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF 70-79%
948.80 - 948.88 BURN (ANY DEGREE) INVOLVING 80-89 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF LESS THAN 10 PERCENT OR UNSPECIFIED AMOUNT - BURN (ANY DEGREE) INVOLVING 80-89 PERCENT OF BODY SURFACE WITH THIRD DEGREE BURN OF 80-89%
948.90 - 948.99 BURN (ANY DEGREE) INVOLVING 90 PERCENT OR MORE OF BODY SURFACE WITH THIRD DEGREE BURN OF LESS THAN 10 PERCENT OR UNSPECIFIED AMOUNT - BURN (ANY DEGREE) INVOLVING 90 PERCENT OR MORE OF BODY SURFACE WITH THIRD DEGREE BURN OF 90% OR MORE OF BODY SURFACE
949.0 BURN OF UNSPECIFIED SITE UNSPECIFIED DEGREE
949.2 BLISTERS WITH EPIDERMAL LOSS DUE TO BURN (SECOND DEGREE) UNSPECIFIED SITE
949.3 FULL-THICKNESS SKIN LOSS DUE TO BURN (THIRD DEGREE NOS) UNSPECIFIED SITE
949.4 DEEP NECROSIS OF UNDERLYING TISSUE DUE TO BURN (DEEP THIRD DEGREE) UNSPECIFIED SITE WITHOUT LOSS OF A BODY PART
949.5 DEEP NECROSIS OF UNDERLYING TISSUES DUE TO BURN (DEEP THIRD DEGREE UNSPECIFIED SITE WITH LOSS OF A BODY PART
958.4 TRAUMATIC SHOCK
958.90 - 958.99 COMPARTMENT SYNDROME, UNSPECIFIED - TRAUMATIC COMPARTMENT SYNDROME OF OTHER SITES
973.0 POISONING BY ANTACIDS AND ANTIGASTRIC SECRETION DRUGS
973.3 POISONING BY OTHER CATHARTICS INCLUDING INTESTINAL ATONIA
991.6 HYPOTHERMIA
995.20 UNSPECIFIED ADVERSE EFFECT OF UNSPECIFIED DRUG, MEDICINAL AND BIOLOGICAL SUBSTANCE
995.21 - 995.29 ARTHUS PHENOMENON - UNSPECIFIED ADVERSE EFFECT OF OTHER DRUG, MEDICINAL AND BIOLOGICAL SUBSTANCE
995.91 SEPSIS
997.1 CARDIAC COMPLICATIONS NOT ELSEWHERE CLASSIFIED
998.0 POSTOPERATIVE SHOCK NOT ELSEWHERE CLASSIFIED
998.9 UNSPECIFIED COMPLICATION OF PROCEDURE NOT ELSEWHERE CLASSIFIED
999.9 OTHER AND UNSPECIFIED COMPLICATIONS OF MEDICAL CARE NOT ELSEWHERE CLASSIFIED
V56.0 AFTERCARE INVOLVING EXTRACORPOREAL DIALYSIS
V56.8 AFTERCARE INVOLVING OTHER DIALYSIS
V58.11 ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY
V58.12 ENCOUNTER FOR IMMUNOTHERAPY FOR NEOPLASTIC CONDITION
V58.69 LONG-TERM (CURRENT) USE OF OTHER MEDICATIONS
 
 
Diagnoses that Support Medical Necessity back to top
N/A 
 
ICD-9 Codes that DO NOT Support Medical Necessity back to top
N/A
 
 
ICD-9 Codes that DO NOT Support Medical Necessity Asterisk Explanation back to top
 
 
Diagnoses that DO NOT Support Medical Necessity back to top
N/A 


General Information
Superceded StampSuperceded Stamp
Documentation Requirements back to top
1. Documentation supporting the medical necessity should be legible, maintained in the patient’s medical record, and must be made available to the Intermediary upon request.

2. Documentation for serum magnesium performed on ESRD patients should show the test was reasonable and necessary. Facilities should note that serum magnesium is part of the ESRD composite rate.
 
 
Appendices back to top
N/A 
 
Utilization Guidelines back to top
 
 
Sources of Information and Basis for Decision back to top
Carrier Medical Director Clinical Laboratory Workgroup

Jacobs, et al. Laboratory Test Handbook. Lexicomp Inc.1994

 
 
Advisory Committee Meeting Notes back to top
This policy does not reflect the sole opinion of the contractor or Contractor Medical Director. Although the final decision rests with the Intermediary, this policy was developed in cooperation with advisory groups, which include representatives from the affected provider community. Advisory Committee Meeting Date: N/A. 
 
Start Date of Comment Period back to top
09/30/1997 
 
End Date of Comment Period back to top
11/14/1997 
 
Start Date of Notice Period back to top
01/15/1998 
 
Revision History Number back to top
Revision #17, 10/01/2008
Revision #16, 10/03/2007
Revision #15, 10/01/2007
Revision #14, 10/01/2006
Revision #13, 11/02/2005
Revision #12, 10/01/2005
Revision #11, 05/24/2005
Revision #10, 11/22/2004
Revision #9, 10/01/2004
Revision #8, 10/01/2003
Revision #7, 07/04/2003
Revision #6, 08/28/2002
Revision #5, 04/01/2002
Revision #4, 10/15/2000
Revision #3, 08/25/2000
Revision #2, 12/15/1999
Revision #1, 08/15/1999 
 
Revision History Explanation back to top
Revision #17, 10/01/2008
Under T & ADA/CDT Copyright Statementyright date was changed from 2007 to 2008. Under Codes That Support Medical Necessity added ICD-9 codes 249.10, 249.11, 249.20, 241.21, 249.30, 249.31, 249.80, 249.81, 249.90, 249.91, 275.5, 289.84, 729.90, 729.91, 729.92, 729.99. This LCD has had its annual review. This revision becomes effective on 10/01/2008.

Revision #16, 10/03/2007
Under Revision History #15 changed the ICD-9 code listed in the verbiage under ICD-9 Codes That Support Medical Necessity from “355.9” to now read “555.9”. Under Revision History #15 deleted the verbiage “ICD-9 code 258.0 was expanded to a 5th digit to now read 258.01, 258.02, and 258.03. ICD-9 code 789.5 was extended to a 5th digit to now read 789.59.” Changed the verbiage to now read, “Under ICD-9 Codes That Support Medical Necessity added ICD-9 codes 258.01, 258.02, 258.03 and 789.59." This revision becomes effective 10/03/2007.

Revision #15, 10/01/2007
Under the AMA/CPT & ADA/CDT Copyright Statement, the copyright date was changed from 2006 to 2007. Under CMS National Coverage Policy changed the publication number for the cited manual reference from “100-8” to now read “100-08”. Under Indications and Limitations of Coverage and/or Medical Necessity deleted redundant verbiage in the 1st and 2nd paragraphs. Under the last bullet for #13 added verbiage. Under ICD-9 Codes That Support Medical Necessity added ICD-9 codes 258.01, 258.02, 258.03, 359.4, 359.6, 415.12, 555.9, 556.0- 556.9, 577.0, 590.00, 676.60-676.64, 728.86, 728.87, 728.88, 731.0, 780.8, 789.59, 940.0-940.9, 941.00-941.09, 941.20-941.29, 941.30-941.39, 941.40-941.49, 941.50-941.59, 942.00-942.09, 942.20-942.29, 942.30-942.39, 942.40-942.49, 942.50-942.59, 943.00-943.09, 943.20-943.29, 943.30-943.39, 943.40-943.49, 943.50-943.59, 944.00-944.08, 944.20-944.28, 944.30-944.38, 944.40-944.48, 944.50-944.58, 945.00-945.09, 945.20-945.29, 945.30-945.39, 945.40-945.49, 945.50-945.59, 946.0, 946.2, 946.3, 946.4, 946.5, 947.0-947.9, 948.00, 948.10-948.11, 948.20-948.22, 948.30-948.33, 948.40-948.44, 948.50-948.55, 948.60-948.66, 948.70-948.77, 948.80-948.88, 948.90-948.99, 949.0, 949.2, 949.3, 949.4, 949.5, 973.0, 973.3, 991.6 and 995.91. Under Documentation Requirements for statement #2 the punctuation was corrected. This revision becomes effective 10/01/2007.

Revision #14, 10/01/2006
Under the AMA/CPT & ADA/CDT Copyright Statement section of this policy, the copyright date was changed from 2005 to 2006. Under ICD-9 Codes That Support Medical Necessity added ICD-9 codes 277.30-277.39, 289.53, 289.83, 333.71-333.79, 333.85, 333.94, 429.83, 729.71-729.79, 780.97, 958.90-958.99 and 995.21-995.29. ICD-9 code 995.2 was expanded to a 5th digit to now read 995.20. The verbiage was revised for 255.10, 403.00-403.01, 403.10-403.11, 403.90-403.91, 404.00-404.03, 404.10-404.13, and 404.90-404.93. Under Sources of Information and Basis for Decision deleted Existing Palmetto GBA Part B Policy #95-0018- L. This policy was reviewed for annual validation. This revision becomes effective 10/01/2006.

Revision #13, 11/02/2005
Under CMS National Coverage Policy verbiage revised for Title XVIII of the Social Security Act, section 1862 (a)(7). Under ICD-9 Codes That Support Medical Necessity added ICD-9 codes 780.71-780.79. This revision becomes effective 11/02/2005.

Revision #12, 10/01/2005
Under the AMA/CPT & ADA/CDT Copyright Statement section of this policy, the copyright date was changed from 2004 to 2005. Under Bill Type Codes section of the policy, Federally Qualified Health Centers (73x) was added. Under ICD-9 Codes That Support Medical Necessity section ICD-9 code 276.5 expanded to 276.50, 576.51, and 276.52. These codes were originally added to the policy on 05/24/05 and updated with the 10/1/05 ICD-9 updates. Also code V58.1 was expanded to V58.11 and V58.12. ICD-9 code 585 that was originally added on 08/25/00, has expanded to 585.1-585.9. These changes become effective 10/1/2005.

Revision #11, 05/24/2005
Converted the Local Medical Review Policy to a Local Coverage Determination. This revision becomes effective May 10, 2005.

Under CMS National Coverage Policy added Title XVIII of the Social Security Act, section 1862 (a)(7) and Change Request 3010. Deleted Change Request 2592. Under Indications and Limitations of Coverage and/or Medical Necessity added paragraph #1. In statement #3, added the word “confusion.” In statement #4 added the following verbiage, “prolonged nasogastric suction, certain cardiac drugs, diuretics, renal tubular acidosis, chronic diarrhea…” In statement #13 added, “ In patients with unexplained muscular paralysis; in patient’s with neuromuscular irritability; in patient’s with blood clotting disorders.” Added the last sentence “NOTE…” Under ICD-9 Codes That Support Medical Necessity added numerous ICD-9 codes as noted by the subscript effective date “05/24/05”. This revision is effective 05/24/2005.

Revision #10, 11/22/2004
Under AMA CPT Copyright Statement section of this policy, deleted the reference to CDT-4 copyright language, as this policy does not contain CDT-4 codes or descriptions. Under ICD-9 Codes That Support Medical Necessity section of the policy, deleted the verbiage related to Appeal rights, as this information will appear on the Palmetto GBA web site under Appeals information. Under Noncovered ICD-9 Code(s) removed verbiage as repetitive. These changes become effective 11/22/2004.



Revision #10, 11/22/2004
Under AMA CPT Copyright Statement section of this policy, deleted the reference to CDT-4 copyright language, as this policy does not contain CDT-4 codes or descriptions. Under ICD-9 Codes That Support Medical Necessity section of the policy, deleted the verbiage related to Appeal rights, as this information will appear on the Palmetto GBA web site under Appeals information. Under Noncovered ICD-9 Code(s) removed verbiage as repetitive. These changes become effective 11/22/2004.

Revision #9, 10/01/2004
Under AMA CPT Copyright Statement section of this policy the copyright date has been changed from 2003 to 2004. Added the American Dental Association copyright statement. Under ICD-9 Codes That Support Medical Necessity section of the policy extended ICD-9 code 252.0 to 252.00. Added ICD-9 codes 252.01- 252.08. Under Coding Guidelines section of the policy in statement #2, the copyright date has been changed from 2003 to 2004. These changes will become effective 10/01/2004

Revision #8, 10/01/2003
Under AMA CPT Copyright Statement section of this policy the copyright date has been changed from 202 to 2003. ICD-9-CM codes 255.10, 255.11, 255.12, 255.13 and 255.14 have been added to the list of ICD-9-CM Codes That Support Medical Necessity section of this policy. ICD-9-CM code 255.1.have been deleted. Under Coding Guidelines section of the policy in statement #2, the copyright date has been changed from 2002 to 2003. These changes will become effective 10/01/2003.

Revision #7, 07/04/2003
ICD-9-CM code V58.69 has been added. This code is effective 07/04/2003.

Revision #6 08/28/2002
Under Type of Bill Code section Critical Access Hospital (85x) was added to the policy.

Revision #5 04/01/2002
Verbiage Coding Guidelines section of this policy has been changed to state that this policy applies to scenarios where a individual serum magnesium test is ordered. ** This policy does not apply to serum magnesium determinations preformed as part of an organ/disease panel.

Revision #4 10/15/2000
Revision #3 08/25/2000
Revision #2 12/15/1999
Revision #1 08/15/1999



This LCD was converted from an LMRP on 5/10/2005


 
 
Reason for Change back to top
ICD9 Addition/Deletion
Maintenance (annual review with new changes, formatting, etc.)
 
Last Reviewed On Date back to top
09/13/2008 
 
Related Documents back to top
This LCD has no Related Documents.
 
LCD Attachments back to top
There are no attachments for this LCD.


All Versions back to top
Superceded StampSuperceded Stamp
Updated on 09/02/2009 with effective dates 10/01/2009 - N/A
Updated on 09/19/2008 with effective dates 10/01/2008 - 09/30/2009
Updated on 02/18/2008 with effective dates 10/03/2007 - 09/30/2008
Updated on 12/03/2007 with effective dates 10/03/2007 - N/A
Updated on 09/28/2007 with effective dates 10/03/2007 - N/A
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

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Page Last Modified: 11/30/2009 8:47:16 AM

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