ICD-10 Special Bulletin 2017 International Classification of Diseases, Tenth Revision, Special Bulletin OCTOBER 2016 GENERAL INFORMATION 2017 ICD Implementation On October 1, 2016, Texas Medicaid & Healthcare Partnership (TMHP) applied the 2017 annual International Classification of Diseases (ICD) updates that are effective for dates of service on or after October 1, 2016. The annual ICD updates include the following: • ICD-10 Clinical Modification (ICD-10-CM) • ICD-10 Procedure Coding System (ICD-10-PCS) This combined Special Bulletin includes the ICD updates for Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program. This bulletin is intended to notify providers of program and coding changes related to the 2017 updates for ICD and Current Procedural Terminology (CPT®). All providers are encouraged to review the “General Information” section of this bulletin. Policy updates for a specific program or provider type are discussed in designated sections of the bulletin. Claims Filing The new 2017 ICD diagnosis codes and inpatient hospital surgical procedure codes may be billed beginning October 1, 2016. Important: To avoid fraudulent billing, providers must submit the ICD codes that are most appropriate for the services provided. The ICD-10-PCS procedure codes are inpatient hospital surgical procedure codes and must be submitted, as applicable, only on inpatient hospital claims. Note: For professional and outpatient procedures and services, providers must continue to use the American Medical Association (AMA) Current Procedural Terminology (CPT) manual and the CMS Health Care Common Procedure Coding System (HCPCS) manual. Prior Authorization Forms The following prior authorization form instructions have been revised: • CCP Prior Authorization Request Form Instructions • Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form Instructions In This Issue General Information 1 2017 ICD Implementation......................................................................................................................................... 1 Claims Filing.................................................................................................................................................................. 1 Prior Authorization Forms........................................................................................................................................ 1 Medicaid Fee-for-Service and Managed Care Providers 3 Texas Medicaid ICD Updates....................................................................................................................................3 Home Health and Comprehensive Care Program (CCP) Providers 11 Home Health Services Benefit Changes............................................................................................................ 11 CCP Services Benefit Changes..............................................................................................................................12 Children With Special Health Care Needs (CSHCN) Services Program Providers 14 CSHCN Services Program Updates..................................................................................................................... 14 CSHCN Services Program Benefit Changes..................................................................................................... 14 All Code Changes: Added, Revised, and Discontinued 19 2017 ICD Diagnosis Code Additions................................................................................................................... 19 Discontinued Diagnosis Codes............................................................................................................................ 26 Diagnosis Code Description Changes............................................................................................................... 28 Inpatient Hospital ICD-10-PCS 30 Inpatient Hospital ICD-10-PCS Surgical Procedure Code Updates.......................................................... 30 Use of the AMA’s copyrighted CPT® is allowed in this publication with the following disclosure: “Current Procedural Terminology (CPT) is copyright 2015 American Medical Association. All rights reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable Federal Acquisition Regulation System/ Defense Federal Acquisition Regulation Supplement (FARS/DFARS) apply.” The American Dental Association requires the following copyright notice in all publications containing Current Dental Terminology (CDT) codes: “Current Dental Terminology (including procedure codes, nomenclature, descriptors, and other data contained therein) is copyright © 2014 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.” Medicaid Fee-for-Service and Managed Care Providers MEDICAID FEE-FOR-SERVICE AND MANAGED CARE PROVIDERS Texas Medicaid ICD Updates The 2017 ICD updates for Texas Medicaid are included in the ICD tables in the “All Code Changes” section of this bulletin beginning on page “2017 ICD Diagnosis Code Additions” on page 19. The 2017 ICD deletions and replacements are effective October 1, 2016, for dates of service on or after October 1, 2016, for Texas Medicaid. Providers may refer to the “General Information” section for more information. Texas Medicaid Benefit Changes The following Texas Medicaid benefit changes have been made to support the 2017 ICD-CM diagnosis code updates and are effective for dates of service on or after October 1, 2016. For more information, call the TMHP Contact Center at 1-800-925-9126. Note: These changes apply to Texas Medicaid fee-for-service and Medicaid managed care claims and authorization requests that are submitted to TMHP for processing. The policy articles in this bulletin contain the following information: • Revised: The description has been revised for these diagnosis codes. Providers may refer to the appropriate copyright holder for the revised descriptions. • Discontinued: Discontinued diagnosis codes are no longer reimbursed after September 30, 2016. • Added: Added diagnosis codes are new diagnosis codes added by the Centers for Medicare & Medicaid Services (CMS). Allergen Immunotherapy The following diagnosis codes may be reimbursed when submitted with procedure codes 95115, 95117, 95145, 95146, 95147, 95148, 95149, 95165, and 95170: Added Diagnosis Codes M041 M042 M048 M049 The following diagnosis code may be reimbursed with procedure code 95180: Added Diagnosis Code Z516 Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook, subsection 9.2.4.1, “Allergy Immunotherapy,” for more information. Ambulatory Electroencephalogram The following diagnosis code may be reimbursed when submitted with procedure codes 95950, 95951, 95953, and 95956: Added Diagnosis Code Z052 Discontinued Diagnosis Codes S060X2A S060X2D S060X2S ICD-10 Special Bulletin, No. 10 3 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Medicaid Fee-for-Service and Managed Care Providers Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physicians Assistants Handbook, subsection 9.2.26.2, “Ambulatory Electroencephalogram (Ambulatory EEG),” for more information. Cardiac Rehabilitation The following diagnosis codes may be reimbursed when submitted with procedure codes 93797, 93798, and S9472 and revenue code B943: Added Diagnosis Codes I160 I161 I169 Z98890 Refer to: The current Texas Medicaid Provider Procedures Manual, Inpatient and Outpatient Handbook, subsection 4.2.6, “Cardiac Rehabilitation,” for more information. Clubfoot Casting The following diagnosis codes may be reimbursed when submitted with procedure codes 29450 and 29750: Added Diagnosis Codes Q6621 Q6622 Discontinued Diagnosis Code Q662 Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physicians Assistants Handbook, subsection 9.2.58.1, “Clubfoot Casting,” for more information. Colony Stimulating Factors The following diagnosis codes may be reimbursed when submitted with procedure codes J1442, J1447, J2505, J2820, and Q5101: Added Diagnosis Codes C49A0 C49A1 C49A2 D4959 D8940 D8941 C49A3 D8942 C49A4 D8943 C49A5 D8949 C49A9 D49511 D49512 D49519 Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physicians Assistants Handbook, subsection 9.2.39.37, “Colony Stimulating Factors (Filgrastim, Pegfilgrastim, and Sargramostim),” for more information. Colorectal Cancer Screening The following diagnosis codes may be reimbursed once every two years for clients who meet the definition of high-risk when they are submitted with procedure codes G0105 and G0120: Added Diagnosis Codes K523 K52831 K52832 K52838 K52839 Refer to: The current Texas Medicaid Provider Procedures Manual, Inpatient and Outpatient Hospital Services Handbook, subsection 4.2.8, “Colorectal Cancer Screening,” and the Medical and Nursing Specialists, Physicians, and Physicians Assistants Handbook, subsection 9.2.15.2, “Colorectal Cancer Screening,” for more information. ICD-10 Special Bulletin, No. 10 4 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Medicaid Fee-for-Service and Managed Care Providers Cytogenetics Testing The following diagnosis codes may be reimbursed when submitted with procedure codes 88230, 88233, 88235, 88237, 88239, 88245, 88248, 88249, 88261, 88262, 88263, 88264, 88271, 88272, 88273, 88274, 88275, 88280, 88283, 88285, 88289, and 88291: Added Diagnosis Codes Q2521 Q2529 Q2540 Q2546 Q2547 Q2548 Q52124 Q52129 Q6621 Z8482 Discontinued Diagnosis Codes Q252 Q254 Q662 Q2541 Q2549 Q6622 Q2542 Q52120 Q826 Q2543 Q52121 Q8782 Q2544 Q52122 Z317 Q2545 Q52123 Z333 The combination diagnosis code table has been removed. Each of the paired codes is now listed as a single diagnosis code. Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physicians Assistants Handbook, subsection 9.2.40.6, “Cytogenetics Testing,” for more information. Developmental and Neurological Assessment and Testing The following diagnosis codes may be reimbursed when submitted with procedure code 96116: Added Diagnosis Codes F3281 F3289 F3481 F429 F5081 F5089 H93A9 I602 I63013 I63313 I63323 I63333 I63513 I63523 I63533 I69014 I69015 I69018 I69114 I69115 I69118 I69214 I69215 I69218 I69314 I69315 I69318 I69814 I69815 I69818 I69914 I69915 I69918 Discontinued Diagnosis Codes F328 F348 F42 I6911 I6921 I6931 S060X3A S060X3D S060X3S S060X5S S060X6A S060X6D F3489 F640 I63033 I63343 I63543 I69019 I69119 I69219 I69319 I69819 I69919 F422 F8082 I63113 I63413 I69010 I69110 I69210 I69310 I69810 I69910 F423 H93A1 I63133 I63423 I69011 I69111 I69211 I69311 I69811 I69911 F424 H93A2 I63213 I63433 I69012 I69112 I69212 I69312 I69812 I69912 F428 H93A3 I63233 I63443 I69013 I69113 I69213 I69313 I69813 I69913 F508 I6981 S060X4A S060X6S I6020 I6991 S060X4D I6021 S060X2A S060X4S I6022 S060X2D S060X5A I6901 S060X2S S060X5D Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physicians Assistants Handbook, subsection 9.2.25, “Developmental and Neurological Assessment and Training,” for more information. ICD-10 Special Bulletin, No. 10 5 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Medicaid Fee-for-Service and Managed Care Providers Echoencephalography The following diagnosis codes may be reimbursed when submitted with procedure code 76506: Added Diagnosis Codes D47Z2 I602 I63523 I69213 I69214 I69215 Discontinued Diagnosis Codes I6020 I6021 I6022 S060X3S S060X4A S060X4D S060X6D S060X6S S060X8A I63533 I69218 I63543 I69219 I69210 I69211 I69212 S060X2A S060X4S S060X8D S060X2D S060X5A S060X8S S060X2S S060X5D S060X3A S060X5S S060X3D S060X6A Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook, subsection 9.2.26.5, “Echoencephalography,” for more information. Evoked Response Tests and Neuromuscular Procedures The following diagnosis codes may be reimbursed when submitted with electromyography (EMG) and nerve conduction studies (NCS) procedure codes: Added Diagnosis Codes G5603 G5613 G5623 G5713 G5723 G5733 G5793 G6182 K5903 M50120 M50121 M50122 M50320 M50321 M50322 M50920 M50921 M50922 R29702 R29703 R29704 R29710 R29711 R29712 R29718 R29719 R29720 R29726 R29727 R29728 R29734 R29735 R29736 R29742 R39191 R39192 Discontinued Diagnosis Codes M5002 M5012 M5022 G5633 G5743 K5904 M50123 M50323 M50923 R29705 R29713 R29721 R29729 R29737 R39198 G5643 G5753 M50020 M50220 M50820 M6284 R29706 R29714 R29722 R29730 R29738 T85840A G5683 G5763 M50021 M50221 M50821 N39491 R29707 R29715 R29723 R29731 R29739 T85840D M5032 M5082 M5092 G5693 G5773 M50022 M50222 M50822 N39492 R29708 R29716 R29724 R29732 R29740 T85840S G5703 G5783 M50023 M50223 M50823 R29701 R29709 R29717 R29725 R29733 R29741 Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physicians Assistants Handbook, subsection 9.2.28.2, “Evoked Response Tests and Neuromuscular Procedures,” for more information. Gynecological and Reproductive Health Services The following diagnosis codes may be reimbursed for family planning annual examinations when submitted with the applicable evaluation and management (E/M) procedure code: Added Diagnosis Codes Z30015 Z30016 Z30017 Z3044 Z3045 Z3046 Refer to: The current Texas Medicaid Provider Procedures Manual Gynecological and Reproductive Health and Family Planning Title XIX Services Handbook, subsection 2.2, “Services, Benefits, Limitations, and Prior Authorization,” and the Women’s Health Services Handbook, subsection 4.2, “Services, Benefits, Limitations, and Prior Authorization,” for more information. ICD-10 Special Bulletin, No. 10 6 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Medicaid Fee-for-Service and Managed Care Providers Inpatient Behavioral Health The following diagnosis codes may be reimbursed for psychological and neurological testing procedure codes 96101 and 96118: Added Diagnosis Codes F3281 F3289 F3481 F3489 F422 F423 F424 F428 F429 F5081 F5089 F640 F8082 H93A1 H93A2 H93A3 H93A9 I602 I63013 I63033 I63113 I63133 I63213 I63233 I63313 I63323 I63333 I63343 I63413 I63423 I63433 I63443 I63513 I63523 I63533 I63543 I69010 I69011 I69012 I69013 I69014 I69015 I69018 I69019 I69110 I69111 I69112 I69113 I69114 I69115 I69118 I69119 I69210 I69211 I69212 I69213 I69214 I69215 I69218 I69219 I69310 I69311 I69312 I69313 I69314 I69315 I69318 I69319 I69810 I69811 I69812 I69813 I69814 I69815 I69818 I69819 I69910 I69911 I69912 I69913 I69914 I69915 I69918 I69919 Discontinued Diagnosis Codes F328 F348 F42 F508 I6021 I6022 I6901 I6911 I6921 I6931 I6981 S060X2A S060X2D S060X2S S060X3A S060X3D S060X3S S060X4A S060X4D S060X4S S060X5A S060X5D S060X5S S060X6A S060X6D S060X6S The following diagnosis codes may be reimbursed for counseling and psychotherapy procedure codes 90832, 90833, 90834, 90836, 90837, 90838, 90847, and 90853 and for psychiatric diagnostic interview procedure codes 90791 and 90792: Added Diagnosis Codes F3281 F3289 F3481 F429 F5081 F5089 Discontinued Diagnosis Codes F42 F508 F3489 F640 F422 F8082 F423 F424 F428 Refer to: The current Texas Medicaid Provider Procedures Manual, Behavioral Health, Rehabilitation, and Case Management Services Handbook, subsection 4.2, “Services, Benefits, Limitations, and Prior Authorization,” subsection 6.10.2 “Psychiatric Diagnostic Evaluation with Medical Services,” subsection 6.11, “Psychological and Neuropsychological Testing,” subsection 6.12, “Psychotherapy or Counseling,” for more information. Otology and Audiometry Services The following diagnosis codes may be reimbursed when submitted with procedure code 92568: Added Diagnosis Codes H90A11 H90A12 H90A21 H90A22 H90A31 H90A32 Refer to: The current Texas Medicaid Provider Procedures Manual, Vision and Hearing Services Handbook, subsection 2.2, “Services, Benefits, Limitations, and Prior Authorization,” for more information. ICD-10 Special Bulletin, No. 10 7 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Medicaid Fee-for-Service and Managed Care Providers Outpatient Behavioral Health The following diagnosis codes may be reimbursed for psychological and neurological testing procedure codes 96101 and 96118: Added Diagnosis Codes F3281 F3289 F3481 F429 F5081 F5089 H93A9 I602 I63013 I63313 I63323 I63333 I63513 I63523 I63533 I69014 I69015 I69018 I69114 I69115 I69118 I69214 I69215 I69218 I69314 I69315 I69318 I69814 I69815 I69818 I69914 I69915 I69918 Discontinued Diagnosis Codes F328 F348 F42 I6921 I6931 I6981 S060X3S S060X4A S060X4D S060X6D S060X6S F3489 F640 I63033 I63343 I63543 I69019 I69119 I69219 I69319 I69819 I69919 F422 F8082 I63113 I63413 I69010 I69110 I69210 I69310 I69810 I69910 F423 H93A1 I63133 I63423 I69011 I69111 I69211 I69311 I69811 I69911 F424 H93A2 I63213 I63433 I69012 I69112 I69212 I69312 I69812 I69912 F428 H93A3 I63233 I63443 I69013 I69113 I69213 I69313 I69813 I69913 F508 S060X2A S060X4S I6021 S060X2D S060X5A I6022 S060X2S S060X5D I6901 S060X3A S060X5S I6911 S060X3D S060X6A The following diagnosis codes may be reimbursed for outpatient behavioral health counseling and psychotherapy procedure codes 90832, 90833, 90834, 90836, 90837, 90838, 90847, and 90853 and for psychiatric diagnostic interview procedure codes 90791 and 90792: Added Diagnosis Codes F3281 F3289 F3481 F3489 F422 F423 F424 F428 F429 F5081 F5089 F640 F8082 Discontinued Diagnosis Codes F42 F508 Refer to: The current Texas Medicaid Provider Procedures Manual, Behavioral Health, Rehabilitation, and Case Management Services Handbook, subsection 4.2, “Services, Benefits, Limitations, and Prior Authorization,” subsection 6.10.2 “Psychiatric Diagnostic Evaluation with Medical Services,” subsection 6.11, “Psychological and Neuropsychological Testing,” subsection 6.12, “Psychotherapy or Counseling,” for more information. Pathology and Laboratory Services – Urinalysis and Chemistry The following diagnosis codes may be reimbursed when submitted with procedure code 83698: Added Diagnosis Codes E7800 E7801 Discontinued Diagnosis Code E780 Refer to: The current Texas Medicaid Provider Procedures Manual, Radiology and Laboratory Services Handbook, subsection 2.2.15, “Urinalysis and Chemistry,” for more information. ICD-10 Special Bulletin, No. 10 8 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Medicaid Fee-for-Service and Managed Care Providers Physician Evaluation and Management Services The following diagnosis codes may be reimbursed when submitted with procedure code 99078: Added Diagnosis Codes E083211 E083212 E083213 E083219 E083291 E083292 E083293 E083311 E083312 E083313 E083319 E083391 E083392 E083393 E083411 E083412 E083413 E083419 E083491 E083492 E083493 E083511 E083512 E083513 E083519 E083521 E083522 E083523 E083531 E083532 E083533 E083539 E083541 E083542 E083543 E083551 E083552 E083553 E083559 E083591 E083592 E083593 E0837X1 E0837X2 E0837X3 E0837X9 E093211 E093212 E093213 E093291 E093292 E093293 E093299 E093311 E093312 E093313 E093391 E093392 E093393 E093399 E093411 E093412 E093413 E093491 E093492 E093493 E093499 E093511 E093512 E093513 E093521 E093522 E093523 E093529 E093531 E093532 E093533 E093541 E093542 E093543 E093549 E093551 E093552 E093553 E093591 E093592 E093593 E093599 E0937X1 E0937X2 E0937X3 E103211 E103212 E103213 E103219 E103291 E103292 E103293 E103311 E103312 E103313 E103319 E103391 E103392 E103393 E103411 E103412 E103413 E103419 E103491 E103492 E103493 E103511 E103512 E103513 E103519 E103521 E103522 E103523 E103531 E103532 E103533 E103539 E103541 E103542 E103543 E103551 E103552 E103553 E103559 E103591 E103592 E103593 E1037X1 E1037X2 E1037X3 E1037X9 E1100 E113211 E113212 E113219 E113291 E113292 E113293 E113299 E113311 E113312 E113319 E113391 E113392 E113393 E113399 E113411 E113412 E113419 E113491 E113492 E113493 E113499 E113511 E113512 E113519 E113521 E113522 E113523 E113529 E113531 E113532 E113539 E113541 E113542 E113543 E113549 E113551 E113552 E113559 E113591 E113592 E113593 E113599 E1137X1 E1137X2 E1137X9 E1165 E133211 E133212 E133213 E133219 E133291 E133293 E133299 E133311 E133312 E133313 E133319 E133391 E133393 E133399 E133411 E133412 E133413 E133419 E133491 E133493 E133499 E133511 E133512 E133513 E133519 E133521 E133523 E133529 E133531 E133532 E133533 E133539 E133541 E133543 E133549 E133551 E133552 E133553 E133559 E133591 E133593 E133599 E1337X1 E1337X2 E1337X3 E1337X9 O09A0 O09A2 O09A3 Discontinued Diagnosis Codes E10321 E10329 E10331 E10339 E10341 E10349 E10351 E11321 E11329 E11331 E11339 E11341 E11349 E11351 E13321 E13329 E13331 E13339 E13341 E13349 E13351 E083299 E083399 E083499 E083529 E083549 E083599 E093219 E093319 E093419 E093519 E093539 E093559 E0937X9 E103299 E103399 E103499 E103529 E103549 E103599 E113213 E113313 E113413 E113513 E113533 E113553 E1137X3 E133292 E133392 E133492 E133522 E133542 E133592 O09A1 E10359 E11359 E13359 The combination diagnosis table has been removed. Each of the paired codes is now listed as a single diagnosis code for procedure code 99078. ICD-10 Special Bulletin, No. 10 9 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Medicaid Fee-for-Service and Managed Care Providers Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialist, Physicians, and Physicians Assistants Handbook, subsection 9.2.56, “Physician Evaluation and Management (E/M) Services,” for more information. Sleep Studies The following diagnosis codes may be reimbursed when submitted with polysomnography procedure codes 95782, 95783, 95808, 95810, and 95811: Added Diagnosis Codes N5235 N5236 N5237 Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physicians Assistants Handbook, subsection 9.2.67, “Sleep Studies,” for more information. Therapeutic Apheresis The following diagnosis codes may be reimbursed when submitted with procedure codes 36511, 36512, 36513, 36514, 36515, and 36516: Added Diagnosis Codes D47Z2 D8940 D8941 Discontinued Diagnosis Code E780 D8942 D8943 D8949 E7800 E7801 G6182 Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physicians Assistants Handbook, subsection 9.2.71, “Therapeutic Apheresis,” for more information. Vision Services Nonsurgical The following diagnosis codes may be reimbursed when submitted with ophthalmological ultrasound procedure code 76154 and gonioscopy procedure code 92020: Added Diagnosis Codes H401110 H401111 H401112 H401123 H401124 H401130 H401191 H401192 H401193 Discontinued Diagnosis Codes H4011X0 H4011X1 H4011X2 H401113 H401131 H401194 H401114 H401132 H4011X3 H4011X4 H401120 H401133 H401121 H401134 H401122 H401190 The following diagnosis codes may be reimbursed when submitted with corneal topography procedure code 92065: Added Diagnosis Codes H53041 H53042 H53043 H53049 The following diagnosis codes may be reimbursed when submitted with polycarbonate lens procedure code V2784: Added Diagnosis Codes H53041 H53042 T85898D T85898S H53043 H53049 T85890A T85890D T85890S T85898A Refer to: The current Texas Medicaid Provider Procedures Manual, subsection 4.3.5.6, “Gonioscopy,” and subsection 4.3.5, “Orthoptic or Pleoptic Training,” for more information. ICD-10 Special Bulletin, No. 10 10 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Home Health and Comprehensive Care Program (CCP) Providers Vitamin B12 (Cyanocobalamin) Injections The following diagnosis codes may be reimbursed when submitted with vitamin B12 procedure code J3420: Added Diagnosis Codes K9041 K9049 Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physicians Assistants Handbook, subsection 9.2.39.34, “Vitamin B12 (Cyanocobalamin) Injections,” for more information. HOME HEALTH AND COMPREHENSIVE CARE PROGRAM (CCP) PROVIDERS Home Health Services Benefit Changes The following Texas Medicaid Home Health Services benefit changes have been made to support the 2017 ICD updates and are effective for dates of service on or after October 1, 2016. For more information, call the TMHP Contact Center at 1-800-925-9126. Diabetic Equipment and Supplies – Home Health The following diagnosis codes may be reimbursed without prior authorization when submitted with blood testing and supplies procedure codes: Added Diagnosis Codes E083211 E083212 E083311 E083312 E083411 E083412 E083511 E083512 E083531 E083532 E083551 E083552 E0837X1 E0837X2 E093219 E093291 E093319 E093391 E093419 E093491 E093519 E093521 E093539 E093541 E093559 E093591 E0937X9 E103211 E103299 E103311 E103399 E103411 E103499 E103511 E103529 E103531 E103549 E103551 E103599 E1037X1 E113219 E113291 E113319 E113391 E113419 E113491 E113519 E113521 ICD-10 Special Bulletin, No. 10 E083213 E083313 E083413 E083513 E083533 E083553 E0837X3 E093292 E093392 E093492 E093522 E093542 E093592 E103212 E103312 E103412 E103512 E103532 E103552 E1037X2 E113292 E113392 E113492 E113522 E083219 E083319 E083419 E083519 E083539 E083559 E0837X9 E093293 E093393 E093493 E093523 E093543 E093593 E103213 E103313 E103413 E103513 E103533 E103553 E1037X3 E113293 E113393 E113493 E113523 E083291 E083391 E083491 E083521 E083541 E083591 E0852 E093299 E093399 E093499 E093529 E093549 E093599 E103219 E103319 E103419 E103519 E103539 E103559 E1037X9 E113299 E113399 E113499 E113529 11 E083292 E083392 E083492 E083522 E083542 E083592 E093211 E093311 E093411 E093511 E093531 E093551 E0937X1 E103291 E103391 E103491 E103521 E103541 E103591 E113211 E113311 E113411 E113511 E113531 E083293 E083393 E083493 E083523 E083543 E083593 E093212 E093312 E093412 E093512 E093532 E093552 E0937X2 E103292 E103392 E103492 E103522 E103542 E103592 E113212 E113312 E113412 E113512 E113532 E083299 E083399 E083499 E083529 E083549 E083599 E093213 E093313 E093413 E093513 E093533 E093553 E0937X3 E103293 E103393 E103493 E103523 E103543 E103593 E113213 E113313 E113413 E113513 E113533 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Home Health and Comprehensive Care Program (CCP) Providers Added Diagnosis Codes (continued) E113539 E113541 E113542 E113559 E113591 E113592 E1137X9 E133211 E133212 E133299 E133311 E133312 E133399 E133411 E133412 E133499 E133511 E133512 E133529 E133531 E133532 E133549 E133551 E133552 E133599 E1337X1 E1337X2 R7303 Discontinued Diagnosis Codes E08321 E08329 E08331 E09321 E09329 E09331 E10321 E10329 E10331 E11321 E11329 E11331 E13321 E13329 E13331 E113543 E113593 E133213 E133313 E133413 E133513 E133533 E133553 E1337X3 E113549 E113599 E133219 E133319 E133419 E133519 E133539 E133559 E1337X9 E113551 E1137X1 E133291 E133391 E133491 E133521 E133541 E133591 O24415 E113552 E1137X2 E133292 E133392 E133492 E133522 E133542 E133592 O24425 E113553 E1137X3 E133293 E133393 E133493 E133523 E133543 E133593 O24435 E08339 E09339 E10339 E11339 E13339 E08341 E09341 E10341 E11341 E13341 E08349 E09349 E10349 E11349 E13349 E08351 E09351 E10351 E11351 E13351 E08359 E09359 E10359 E11359 E13359 The combination diagnosis code table has been removed. Each of the paired codes is now listed as a single diagnosis code. Refer to: The current Texas Medicaid Provider Procedures Manual, Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook, subsection 2.2.11.3, “Glucose Testing Equipment and Other Supplies,” for more information. CCP Services Benefit Changes The following Texas Medicaid CCP benefit changes have been made to support the 2017 ICD updates and are effective for dates of service on or after October 1, 2016. For more information, call the TMHP Contact Center at 1-800-925-9126. Blood Pressure Devices – CCP The following diagnosis codes may be reimbursed when submitted with procedure codes A4660 and A4670: Added Diagnosis Codes I160 I161 T82856D T82856S I169 N130 T82855A T82855D T82855S T82856A The combination diagnosis code table has been removed. Each of the paired codes is now listed as a single diagnosis code. Refer to: The current Texas Medicaid Provider Procedures Manual, Children’s Services Handbook, subsection 2.6.4, “Blood Pressure Devices,” and the Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook, subsection 2.2.6, “Blood Pressure Devices,” for more information. ICD-10 Special Bulletin, No. 10 12 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Home Health and Comprehensive Care Program (CCP) Providers Nutritional Products – CCP The following diagnosis code will no longer be covered for nutritional products procedure codes: Discontinued Diagnosis Code E780 Refer to: The current Texas Medicaid Provider Procedures Manual, Children’s Services Handbook, subsection 2.6.11, “Nutritional Products,” for more information. Respiratory Care Equipment – CCP The following diagnosis code may be reimbursed when submitted with procedure codes E0618 and E0619: Added Diagnosis Code Z8482 Refer to: The current Texas Medicaid Provider Procedures Manual, Children’s Services Handbook, subsection 2.6.5.1, “Services, Benefits, and Limitations,” for more information. ICD-10 Special Bulletin, No. 10 13 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Children With Special Health Care Needs (CSHCN) Services Program Providers CHILDREN WITH SPECIAL HEALTH CARE NEEDS (CSHCN) SERVICES PROGRAM PROVIDERS CSHCN Services Program Updates The 2017 ICD updates for the CSHCN Services Program are included in the ICD tables in the “All Code Changes” section of this bulletin beginning on page “2017 ICD Diagnosis Code Additions” on page 19. The 2017 ICD deletions are effective October 1, 2016, for dates of service on or after October 1, 2016, for the CSHCN Services Program. Providers may refer to the “General Information” section for more information. CSHCN Services Program Benefit Changes The following CSHCN Services Program benefit changes have been made to support the 2017 ICD updates and are effective for dates of service on or after October 1, 2016. For more information, call the TMHP-CSHCN Services Program Contact Center at 1-800-568-2413. The policy articles below contain the following information: • Revised: The description has been revised for these diagnosis codes. Providers may refer to the appropriate copyright holder for the revised descriptions. • Discontinued: Discontinued diagnosis codes are no longer reimbursed after September 30, 2016. • Added: Added diagnosis codes are new procedure codes added by the Centers for Medicare & Medicaid Services (CMS). Ambulatory Blood Pressure Monitoring and Devices The following diagnosis codes may be reimbursed when submitted with procedure codes A4660 and A4670: Added Diagnosis Codes I160 I161 I169 The combination diagnosis table has been removed. Each of the paired codes is now listed as a single diagnosis code. Refer to: The current CSHCN Services Program Provider Manual, section 11.2.1.1, “Ambulatory Blood Pressure Monitoring,” for more information. Cytogenetics Testing The following diagnosis codes may be reimbursed when submitted with procedure codes 88230, 88233, 88237, 88239, 88245, 88248, 88249, 88261, 88262, 88263, 88264, 88271, 88272, 88273, 88274, 88275, 88280, 88283, 88285, 88289, and 88291: Added Diagnosis Codes Q2521 Q2529 Q2540 Q2546 Q2547 Q2548 Z8482 Discontinued Diagnosis Codes Q252 Q254 Q662 Q2541 Q2549 Q2542 Q6621 Q2543 Q6622 Q2544 Q826 Q2545 Q8782 The combination diagnosis code table has been removed. Each of the paired codes is now listed as a single diagnosis code. ICD-10 Special Bulletin, No. 10 14 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Children With Special Health Care Needs (CSHCN) Services Program Providers Refer to: The current CSHCN Services Program Provider Manual, section 31.2.275.5, “Cytogenetics Testing,” for more information. Diabetic Equipment and Supplies The following diagnosis codes may be reimbursed without prior authorization when submitted with blood testing and supplies procedure codes: Added Diagnosis Codes E083211 E083212 E083213 E083311 E083312 E083313 E083411 E083412 E083413 E083511 E083512 E083513 E083531 E083532 E083533 E083551 E083552 E083553 E0837X1 E0837X2 E0837X3 E093291 E093292 E093293 E093391 E093392 E093393 E093491 E093492 E093493 E093521 E093522 E093523 E093541 E093542 E093543 E093591 E093592 E093593 E103211 E103212 E103213 E103311 E103312 E103313 E103412 E103413 E103419 E103512 E103513 E103519 E103532 E103533 E103539 E103552 E103553 E103559 E1037X2 E1037X3 E1037X9 E113292 E113293 E113299 E113392 E113393 E113399 E113492 E113493 E113499 E113522 E113523 E113529 E113542 E113543 E113549 E113592 E113593 E113599 E133212 E133213 E133219 E133312 E133313 E133319 E133412 E133413 E133419 E133512 E133513 E133519 E133532 E133533 E133539 E133552 E133553 E133559 E1337X2 E1337X3 E1337X9 Discontinued Diagnosis Codes E08321 E08329 E08331 E09321 E09329 E09331 E10321 E10329 E10331 E11321 E11329 E11331 E13321 E13329 E13331 ICD-10 Special Bulletin, No. 10 E083219 E083319 E083419 E083519 E083539 E083559 E0837X9 E093299 E093399 E093499 E093529 E093549 E093599 E103219 E103319 E103491 E103521 E103541 E103591 E113211 E113311 E113411 E113511 E113531 E113551 E1137X1 E133291 E133391 E133491 E133521 E133541 E133591 R7303 E083291 E083391 E083491 E083521 E083541 E083591 E093211 E093311 E093411 E093511 E093531 E093551 E0937X1 E103291 E103391 E103492 E103522 E103542 E103592 E113212 E113312 E113412 E113512 E113532 E113552 E1137X2 E133292 E133392 E133492 E133522 E133542 E133592 Z7984 E083292 E083392 E083492 E083522 E083542 E083592 E093212 E093312 E093412 E093512 E093532 E093552 E0937X2 E103292 E103392 E103493 E103523 E103543 E103593 E113213 E113313 E113413 E113513 E113533 E113553 E1137X3 E133293 E133393 E133493 E133523 E133543 E133593 E083293 E083393 E083493 E083523 E083543 E083593 E093213 E093313 E093413 E093513 E093533 E093553 E0937X3 E103293 E103393 E103499 E103529 E103549 E103599 E113219 E113319 E113419 E113519 E113539 E113559 E1137X9 E133299 E133399 E133499 E133529 E133549 E133599 E083299 E083399 E083499 E083529 E083549 E083599 E093219 E093319 E093419 E093519 E093539 E093559 E0937X9 E103299 E103411 E103511 E103531 E103551 E1037X1 E113291 E113391 E113491 E113521 E113541 E113591 E133211 E133311 E133411 E133511 E133531 E133551 E1337X1 E08339 E09339 E10339 E11339 E13339 E08341 E09341 E10341 E11341 E13341 E08349 E09349 E10349 E11349 E13349 E08351 E09351 E10351 E11351 E13351 E08359 E09359 E10359 E11359 E13359 15 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Children With Special Health Care Needs (CSHCN) Services Program Providers The combination diagnosis code table has been removed. Each of the paired codes is now listed as a single diagnosis code. Refer to: The current CSHCN Services Program Provider Manual, section 15.2.1, “Glucose Monitor and Supplies” for more information. Echoencephalography The following diagnosis codes may be reimbursed when submitted with procedure code 76506: Added Diagnosis Codes D47Z2 I602 I63523 I69213 I69214 I69215 Discontinued Diagnosis Codes I6020 I6021 I6022 S060X3S S060X4A S060X4D S060X6D S060X6S S0606X8A I63533 I69218 I63543 I69219 I69210 I69211 I69212 S060X2A S060X4S S060X8D S060X2D S060X5A S060X8S S060X2S S060X5D S060X3A S060X5S S060X3D S060X6A Refer to: The current CSHCN Services Program Provider Manual, section 31.2.17, “Echoencephalography,” for more information. Evoked Response Tests and Neuromuscular Procedures The following diagnosis codes may be reimbursed when submitted with Electromyography (EMG) and nerve conduction study (NCS) procedure codes: Added Diagnosis Codes G5603 G5613 G5623 G5713 G5723 G5733 G5793 G6182 K5903 M50120 M50121 M50122 M50320 M50321 M50322 M50920 M50921 M50922 R29703 R29704 R29705 R29711 R29712 R29713 R29719 R29720 R29721 R29727 R29728 R29729 R29735 R29736 R29737 R39191 R39192 R39198 Discontinued Diagnosis Codes M5002 M5012 M5022 G5633 G5743 K5904 M50123 M50323 M50923 R29706 R29714 R29722 R29730 R29738 T85840A G5643 G5753 M50020 M50220 M50820 M6284 R29707 R29715 R29723 R29731 R29739 T85840D G5683 G5763 M50021 M50221 M50821 N39492 R29708 R29716 R29724 R29732 R29740 T85840S M5032 M5082 M5092 G5693 G5773 M50022 M50222 M50822 R29701 R29709 R29717 R29725 R29733 R29741 G5703 G5783 M50023 M50223 M50823 R29702 R29710 R29718 R29726 R29734 R29742 Refer to: The current CSHCN Services Program Provider Manual, section 31.2.19, “Evoked Response Tests and Neuromuscular Procedures,” for more information. ICD-10 Special Bulletin, No. 10 16 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Children With Special Health Care Needs (CSHCN) Services Program Providers Expendable Medical Supplies The following diagnosis codes may be reimbursed when submitted with the appropriate diapers, briefs, pull-ups, or liners procedure code: Added Diagnosis Codes N130 N99115 N99842 N99843 T83021S T83031A T83091D T83091S T83518A T83518D Revised Diagnosis Code N99113 N99523 R9382 T83031D T83092A T83518S N99524 T83011A T83031S T83092D N99533 T83011D T83032A T83092S N99534 T83011S T83032D T83511A N99840 T83021A T83032S T83511D N99841 T83021D T83091A T83511S The combination diagnosis table has been removed. Each of the paired codes is now listed as a single dianosis code. Refer to: The current CSHCN Services Program Provider Manual, section 18.2.1,” Diapers, Briefs, Pull-ups, and Liners,” for more information. Hearing Services The following diagnosis codes may be reimbursed when submitted with procedure code 92568: Added Diagnosis Codes H90A11 H90A12 H93A3 H93A9 H90A21 H90A22 H90A31 H90A32 H93A1 H93A2 Refer to: The current CSHCN Services Program Provider Manual, section 20.2.3.5, “Limitations,” for more information. Neurostimulators and Neuromuscular Stimulators The following diagnosis codes may be considered for prior authorization when submitted with the appropriate dorsal column neurostimulation (DCN), intracranial neurostimulation (ICN), or percutaneous electrical nerve stimulation (PENS) device procedure codes: Added Diagnosis Codes G5773 G5783 G5793 M50121 M50122 M50123 Discontinued Diagnosis Code M5022 M50020 M50220 M50021 M50221 M50022 M50222 M50023 M50223 M50120 Refer to: The current CSHCN Services Program Provider Manual, section 27.2.1, “Dorsal Column Neurostimulation (DCN),” section 27.2.2, “Intracranial Neurostimulation (INS),” and section 27.2.4, “Percutaneous Electrical Nerve Stimulation (PENS),” for more information. ICD-10 Special Bulletin, No. 10 17 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Children With Special Health Care Needs (CSHCN) Services Program Providers Therapeutic Apheresis The following diagnosis codes may be reimbursed when submitted with procedure codes 36511, 36512, 36513, 36514, 36515, and 36516: Added Diagnosis Codes D8940 D8941 D8942 D8943 D8949 E7800 E7801 G6182 Discontinued Diagnosis Code E780 Refer to: The current CSHCN Services Program Provider Manual, section 31.2.40, “Therapeutic Apheresis,” for more information. Vision Services Nonsurgical The following diagnosis codes may be reimbursed when submitted with the appropriate contact lenses and their prescription and fitting procedure codes: Added Diagnosis Codes H53041 H53042 H53043 H53049 Refer to: The current CSHCN Services Program Provider Manual, section 39.2.1.4, “Contact Lenses” for more information. ICD-10 Special Bulletin, No. 10 18 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. All Code Changes: Added, Revised, and Discontinued ALL CODE CHANGES: ADDED, REVISED, AND DISCONTINUED 2017 ICD Diagnosis Code Additions The following is a list of new ICD diagnosis codes: Added Diagnosis Codes A925 C49A0 C49A1 C49A2 C49A9 D47Z2 D49511 D49512 D7832 D7833 D7834 D8940 D8949 E083211 E083212 E083213 E083293 E083299 E083311 E083312 E083392 E083393 E083399 E083411 E083491 E083492 E083493 E083499 E083519 E083521 E083522 E083523 E083533 E083539 E083541 E083542 E083552 E083553 E083559 E083591 E0837X1 E0837X2 E0837X3 E0837X9 E093219 E093291 E093292 E093293 E093313 E093319 E093391 E093392 E093412 E093413 E093419 E093491 E093511 E093512 E093513 E093519 E093529 E093531 E093532 E093533 E093543 E093549 E093551 E093552 E093592 E093593 E093599 E0937X1 E103211 E103212 E103213 E103219 E103299 E103311 E103312 E103313 E103393 E103399 E103411 E103412 E103492 E103493 E103499 E103511 E103521 E103522 E103523 E103529 E103539 E103541 E103542 E103543 E103553 E103559 E103591 E103592 E1037X2 E1037X3 E1037X9 E113211 E113291 E113292 E113293 E113299 E113319 E113391 E113392 E113393 E113413 E113419 E113491 E113492 E113512 E113513 E113519 E113521 E113531 E113532 E113533 E113539 E113549 E113551 E113552 E113553 E113593 E113599 E1137X1 E1137X2 E133212 E133213 E133219 E133291 E133311 E133312 E133313 E133319 ICD-10 Special Bulletin, No. 10 19 C49A3 D49519 D8941 E083219 E083313 E083412 E083511 E083529 E083543 E083592 E093211 E093299 E093393 E093492 E093521 E093539 E093553 E0937X2 E103291 E103319 E103413 E103512 E103531 E103549 E103593 E113212 E113311 E113399 E113493 E113522 E113541 E113559 E1137X3 E133292 E133391 C49A4 D4959 D8942 E083291 E083319 E083413 E083512 E083531 E083549 E083593 E093212 E093311 E093399 E093493 E093522 E093541 E093559 E0937X3 E103292 E103391 E103419 E103513 E103532 E103551 E103599 E113213 E113312 E113411 E113499 E113523 E113542 E113591 E1137X9 E133293 E133392 C49A5 D7831 D8943 E083292 E083391 E083419 E083513 E083532 E083551 E083599 E093213 E093312 E093411 E093499 E093523 E093542 E093591 E0937X9 E103293 E103392 E103491 E103519 E103533 E103552 E1037X1 E113219 E113313 E113412 E113511 E113529 E113543 E113592 E133211 E133299 E133393 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. All Code Changes: Added, Revised, and Discontinued Added Diagnosis Codes E133399 E133411 E133493 E133499 E133522 E133523 E133541 E133542 E133559 E133591 E1337X3 E1337X9 E89823 F3281 F424 F428 G5603 G5613 G5703 G5713 G5773 G5783 G9764 H348110 H348130 H348131 H348311 H348312 H348332 H348390 H353113 H353114 H353130 H353131 H353192 H353193 H353220 H353221 H353233 H353290 H401112 H401113 H401124 H401130 H401191 H401192 H53049 H59331 H59343 H59349 H59362 H59363 H90A31 H90A32 H9552 H9553 I63013 I63033 I63323 I63333 I63513 I63523 I69013 I69014 I69112 I69113 I69211 I69212 I69310 I69311 I69319 I69810 I69818 I69819 I69915 I69918 I7776 I7777 ICD-10 Special Bulletin, No. 10 E133412 E133511 E133529 E133543 E133592 E7800 F3289 F429 G5623 G5723 G5793 H348111 H348132 H348320 H348391 H353120 H353132 H353194 H353222 H353291 H401114 H401131 H401193 H59332 H59351 H59369 H93A1 H9554 I63113 I63343 I63533 I69015 I69114 I69213 I69312 I69811 I69910 I69919 I97620 E133413 E133512 E133531 E133549 E133593 E7801 F3481 F5081 G5633 G5733 G6182 H348112 H348190 H348321 H348392 H353121 H353133 H353210 H353223 H353292 H401120 H401132 H401194 H59333 H59352 H90A11 H93A2 I160 I63133 I63413 I63543 I69018 I69115 I69214 I69313 I69812 I69911 I725 I97621 20 E133419 E133513 E133532 E133551 E133599 E89820 F3489 F5089 G5643 G5743 G9761 H348120 H348191 H348322 H353110 H353122 H353134 H353211 H353230 H353293 H401121 H401133 H53041 H59339 H59353 H90A12 H93A3 I161 I63213 I63423 I69010 I69019 I69118 I69215 I69314 I69813 I69912 I726 I97622 E133491 E133519 E133533 E133552 E1337X1 E89821 F422 F640 G5683 G5753 G9762 H348121 H348192 H348330 H353111 H353123 H353190 H353212 H353231 H401110 H401122 H401134 H53042 H59341 H59359 H90A21 H93A9 I169 I63233 I63433 I69011 I69110 I69119 I69218 I69315 I69814 I69913 I7770 I97630 E133492 E133521 E133539 E133553 E1337X2 E89822 F423 F8082 G5693 G5763 G9763 H348122 H348310 H348331 H353112 H353124 H353191 H353213 H353232 H401111 H401123 H401190 H53043 H59342 H59361 H90A22 H9551 I602 I63313 I63443 I69012 I69111 I69210 I69219 I69318 I69815 I69914 I7775 I97631 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. All Code Changes: Added, Revised, and Discontinued Added Diagnosis Codes I97638 I97640 J95863 J9851 K05213 K05219 K05312 K05313 K063 K0881 K523 K52831 K55019 K55021 K55041 K55042 K55062 K55069 K582 K588 K8501 K8502 K8522 K8530 K8590 K8591 K91870 K91871 L7633 L7634 M21611 M21612 M25542 M25549 M26612 M26613 M26631 M26632 M50023 M50120 M50222 M50223 M50821 M50822 M6284 M84750A M84751A M84751D M84752D M84752G M84753G M84753K M84754K M84754P M84755P M84755S M84756S M84757A M84758A M84758D M84759D M84759G M96842 M96843 M9702XS M9711XA M9721XA M9721XD M9731XD M9731XS M9741XS M9742XA M979XXA M979XXD N4231 N4232 N5089 N5235 ICD-10 Special Bulletin, No. 10 I97641 J9859 K05221 K05319 K0882 K52832 K55022 K55049 K5530 K5903 K8510 K8531 K8592 K91872 L987 M21619 M26601 M26619 M26633 M50121 M50320 M50823 M84750D M84751G M84752K M84753P M84754S M84756A M84757D M84758G M84759K M9701XA M9711XD M9721XS M9732XA M9742XD M979XXS N4239 N5236 I97648 K0401 K05222 K05321 K0889 K52838 K55029 K55051 K5531 K5904 K8511 K8532 K8681 K91873 M041 M21621 M26602 M26621 M26639 M50122 M50321 M50920 M84750G M84751K M84752P M84753S M84755A M84756D M84757G M84758K M84759P M9701XD M9711XS M9722XA M9732XD M9742XS N130 N50811 N5237 21 J95860 K0402 K05223 K05322 K5221 K52839 K55031 K55052 K5532 K5931 K8512 K8580 K8689 L03213 M042 M21622 M26603 M26622 M50020 M50123 M50322 M50921 M84750K M84751P M84752S M84754A M84755D M84756G M84757K M84758P M84759S M9701XS M9712XA M9722XD M9732XS M978XXA N39491 N50812 N610 J95861 K05211 K05229 K05323 K5222 K55011 K55032 K55059 K5533 K5939 K8520 K8581 K9041 L7631 M048 M21629 M26609 M26623 M50021 M50220 M50323 M50922 M84750P M84751S M84753A M84754D M84755G M84756K M84757P M84758S M96840 M9702XA M9712XD M9722XS M9741XA M978XXD N39492 N50819 N611 J95862 K05212 K05311 K05329 K5229 K55012 K55039 K55061 K581 K8500 K8521 K8582 K9049 L7632 M049 M25541 M26611 M26629 M50022 M50221 M50820 M50923 M84750S M84752A M84753D M84754G M84755K M84756P M84757S M84759A M96841 M9702XD M9712XS M9731XA M9741XD M978XXS N4230 N5082 N8300 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. All Code Changes: Added, Revised, and Discontinued Added Diagnosis Codes N8301 N8302 N83209 N83291 N83321 N83322 N8341 N8342 N83529 N9060 N9412 N9419 N99840 N99841 O0011 O0020 O09A0 O09A1 O1205 O1214 O1404 O1405 O1495 O164 O337XX1 O337XX2 O34212 O34219 O4431 O4432 O4450 O4451 O7023 P0509 Q2542 Q2543 Q2549 Q52120 Q6621 Q6622 R29703 R29704 R29710 R29711 R29717 R29718 R29724 R29725 R29731 R29732 R29738 R29739 R39191 R39192 R402413 R402414 R402430 R402431 R402442 R402443 R93421 R93422 S02101B S02101D S02102D S02102G S02109G S02109K S0211AK S0211AS S0211BS S0211CA S0211DA S0211DB S0211EB S0211ED S0211FD S0211FG ICD-10 Special Bulletin, No. 10 N8310 N83292 N83329 N83511 N9061 N99115 N99842 O0021 O09A2 O1215 O1414 O165 O337XX3 O4420 O4433 O4452 P0519 Q2544 Q52121 Q826 R29705 R29712 R29719 R29726 R29733 R29740 R39198 R402420 R402432 R402444 R93429 S02101G S02102K S02109S S0211BA S0211CB S0211DD S0211EG S0211FK N8311 N83299 N83331 N83512 N9069 N99523 N99843 O0080 O09A3 O1224 O1415 O24415 O337XX4 O4421 O4440 O4453 Q2521 Q2545 Q52122 Q8782 R29706 R29713 R29720 R29727 R29734 R29741 R3982 R402421 R402433 R7303 R9349 S02101K S02102S S0211AA S0211BB S0211CD S0211DG S0211EK S0211FS 22 N8312 N83311 N83332 N83519 N931 N99524 O0000 O0081 O114 O1225 O1424 O24425 O337XX5 O4422 O4441 O7020 Q2529 Q2546 Q52123 R29700 R29707 R29714 R29721 R29728 R29735 R29742 R402410 R402422 R402434 R8271 R9720 S02101S S02109A S0211AB S0211BD S0211CG S0211DK S0211ES S0211GA N83201 N83312 N83339 N83521 N9410 N99533 O0001 O0090 O115 O134 O1425 O24435 O337XX9 O4423 O4442 O7021 Q2540 Q2547 Q52124 R29701 R29708 R29715 R29722 R29729 R29736 R3121 R402411 R402423 R402440 R8279 R9721 S02102A S02109B S0211AD S0211BG S0211CK S0211DS S0211FA S0211GB N83202 N83319 N8340 N83522 N9411 N99534 O0010 O0091 O1204 O135 O1494 O337XX0 O34211 O4430 O4443 O7022 Q2541 Q2548 Q52129 R29702 R29709 R29716 R29723 R29730 R29737 R3129 R402412 R402424 R402441 R9341 S02101A S02102B S02109D S0211AG S0211BK S0211CS S0211EA S0211FB S0211GD 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. All Code Changes: Added, Revised, and Discontinued Added Diagnosis Codes S0211GG S0211GK S0211HK S0211HS S0230XS S0231XA S0232XA S0232XB S0240AB S0240AD S0240BD S0240BG S0240CG S0240CK S0240DK S0240DS S0240ES S0240FA S02601A S02601B S02602B S02602D S02610D S02610G S02611G S02611K S02612K S02612S S02620S S02621A S02622A S02622B S02630B S02630D S02631D S02631G S02632G S02632K S02640K S02640S S02641S S02642A S02650A S02650B S02651B S02651D S02652D S02652G S02670G S02670K S02671K S02671S S02672S S0280XA S0281XA S0281XB S0282XB S0282XD S0300XS S0301XA S0303XA S0303XD S0341XD S0341XS S0343XS S92811A S92811S S92812A S92812S S92819A S92819S S99001A S99001S S99002A S99002S S99009A S99009S S99011A ICD-10 Special Bulletin, No. 10 S0211GS S0230XA S0231XB S0232XD S0240AG S0240BK S0240CS S0240EA S0240FB S02601D S02602G S02610K S02611S S02620A S02621B S02622D S02630G S02631K S02632S S02641A S02642B S02650D S02651G S02652K S02670S S02672A S0280XB S0281XD S0282XG S0301XD S0303XS S0342XA S92811B S92812B S92819B S99001B S99002B S99009B S99011B S0211HA S0230XB S0231XD S0232XG S0240AK S0240BS S0240DA S0240EB S0240FD S02601G S02602K S02610S S02612A S02620B S02621D S02622G S02630K S02631S S02640A S02641B S02642D S02650G S02651K S02652S S02671A S02672B S0280XD S0281XG S0282XK S0301XS S0340XA S0342XD S92811D S92812D S92819D S99001D S99002D S99009D S99011D 23 S0211HB S0230XD S0231XG S0232XK S0240AS S0240CA S0240DB S0240ED S0240FG S02601K S02602S S02611A S02612B S02620D S02621G S02622K S02630S S02632A S02640B S02641D S02642G S02650K S02651S S02670A S02671B S02672D S0280XG S0281XK S0282XS S0302XA S0340XD S0342XS S92811G S92812G S92819G S99001G S99002G S99009G S99011G S0211HD S0230XG S0231XK S0232XS S0240BA S0240CB S0240DD S0240EG S0240FK S02601S S02610A S02611B S02612D S02620G S02621K S02622S S02631A S02632B S02640D S02641G S02642K S02650S S02652A S02670B S02671D S02672G S0280XK S0281XS S0300XA S0302XD S0340XS S0343XA S92811K S92812K S92819K S99001K S99002K S99009K S99011K S0211HG S0230XK S0231XS S0240AA S0240BB S0240CD S0240DG S0240EK S0240FS S02602A S02610B S02611D S02612G S02620K S02621S S02630A S02631B S02632D S02640G S02641K S02642S S02651A S02652B S02670D S02671G S02672K S0280XS S0282XA S0300XD S0302XS S0341XA S0343XD S92811P S92812P S92819P S99001P S99002P S99009P S99011P 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. All Code Changes: Added, Revised, and Discontinued Added Diagnosis Codes S99011S S99012A S99012S S99019A S99019S S99021A S99021S S99022A S99022S S99029A S99029S S99031A S99031S S99032A S99032S S99039A S99039S S99041A S99041S S99042A S99042S S99049A S99049S S99091A S99091S S99092A S99092S S99099A S99099S S99101A S99101S S99102A S99102S S99109A S99109S S99111A S99111S S99112A S99112S S99119A S99119S S99121A S99121S S99122A S99122S S99129A S99129S S99131A S99131S S99132A S99132S S99139A S99139S S99141A S99141S S99142A S99142S S99149A S99149S S99191A S99191S S99192A S99192S S99199A S99199S S99201A S99201S S99202A S99202S S99209A S99209S S99211A S99211S S99212A S99212S S99219A S99219S S99221A ICD-10 Special Bulletin, No. 10 S99012B S99019B S99021B S99022B S99029B S99031B S99032B S99039B S99041B S99042B S99049B S99091B S99092B S99099B S99101B S99102B S99109B S99111B S99112B S99119B S99121B S99122B S99129B S99131B S99132B S99139B S99141B S99142B S99149B S99191B S99192B S99199B S99201B S99202B S99209B S99211B S99212B S99219B S99221B S99012D S99019D S99021D S99022D S99029D S99031D S99032D S99039D S99041D S99042D S99049D S99091D S99092D S99099D S99101D S99102D S99109D S99111D S99112D S99119D S99121D S99122D S99129D S99131D S99132D S99139D S99141D S99142D S99149D S99191D S99192D S99199D S99201D S99202D S99209D S99211D S99212D S99219D S99221D 24 S99012G S99019G S99021G S99022G S99029G S99031G S99032G S99039G S99041G S99042G S99049G S99091G S99092G S99099G S99101G S99102G S99109G S99111G S99112G S99119G S99121G S99122G S99129G S99131G S99132G S99139G S99141G S99142G S99149G S99191G S99192G S99199G S99201G S99202G S99209G S99211G S99212G S99219G S99221G S99012K S99019K S99021K S99022K S99029K S99031K S99032K S99039K S99041K S99042K S99049K S99091K S99092K S99099K S99101K S99102K S99109K S99111K S99112K S99119K S99121K S99122K S99129K S99131K S99132K S99139K S99141K S99142K S99149K S99191K S99192K S99199K S99201K S99202K S99209K S99211K S99212K S99219K S99221K S99012P S99019P S99021P S99022P S99029P S99031P S99032P S99039P S99041P S99042P S99049P S99091P S99092P S99099P S99101P S99102P S99109P S99111P S99112P S99119P S99121P S99122P S99129P S99131P S99132P S99139P S99141P S99142P S99149P S99191P S99192P S99199P S99201P S99202P S99209P S99211P S99212P S99219P S99221P 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. All Code Changes: Added, Revised, and Discontinued Added Diagnosis Codes S99221S S99222A S99222S S99229A S99229S S99231A S99231S S99232A S99232S S99239A S99239S S99241A S99241S S99242A S99242S S99249A S99249S S99291A S99291S S99292A S99292S S99299A S99299S T82855A T83011A T83011D T83021D T83021S T83031S T83032A T83092A T83092D T83123D T83123S T8324XS T8325XA T83421A T83421D T83510D T83510S T83512S T83518A T83591A T83591D T83593D T83593S T8361XS T8362XA T83712A T83712D T83714D T83714S T83722S T83723A T83729A T83729D T85113D T85113S T85193S T85615A T85635A T85635D T85730D T85730S T85732S T85733A T85735A T85735D T85810D T85810S T85820S T85828A T85838A T85838D T85848D T85848S T85858S T85860A ICD-10 Special Bulletin, No. 10 S99222B S99229B S99231B S99232B S99239B S99241B S99242B S99249B S99291B S99292B S99299B T82855D T83011S T83022A T83032D T83092S T83193A T8325XD T83421S T83511A T83518D T83591S T83598A T8362XD T83712S T83719A T83723D T83729S T85123A T85615D T85635S T85731A T85733D T85735S T85818A T85828D T85838S T85850A T85860D S99222D S99229D S99231D S99232D S99239D S99241D S99242D S99249D S99291D S99292D S99299D T82855S T83012A T83022D T83032S T83113A T83193D T8325XS T83491A T83511D T83518S T83592A T83598D T8362XS T83713A T83719D T83723S T8379XA T85123D T85615S T85695A T85731D T85733S T85738A T85818D T85828S T85840A T85850D T85860S 25 S99222G S99229G S99231G S99232G S99239G S99241G S99242G S99249G S99291G S99292G S99299G T82856A T83012D T83022S T83091A T83113D T83193S T83411A T83491D T83511S T83590A T83592D T83598S T8369XA T83713D T83719S T83724A T8379XD T85123S T85625A T85695D T85731S T85734A T85738D T85818S T85830A T85840D T85850S T85868A S99222K S99229K S99231K S99232K S99239K S99241K S99242K S99249K S99291K S99292K S99299K T82856D T83012S T83031A T83091D T83113S T8324XA T83411D T83491S T83512A T83590D T83592S T8361XA T8369XD T83713S T83722A T83724D T8379XS T85193A T85625D T85695S T85732A T85734D T85738S T85820A T85830D T85840S T85858A T85868D S99222P S99229P S99231P S99232P S99239P S99241P S99242P S99249P S99291P S99292P S99299P T82856S T83021A T83031D T83091S T83123A T8324XD T83411S T83510A T83512D T83590S T83593A T8361XD T8369XS T83714A T83722D T83724S T85113A T85193D T85625S T85730A T85732D T85734S T85810A T85820D T85830S T85848A T85858D T85868S 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. All Code Changes: Added, Revised, and Discontinued Added Diagnosis Codes T85890A T85890D T8853XD T8853XS V471XXS V473XXA V476XXA V476XXD W262XXD W262XXS W269XXS X500XXA X503XXA X503XXD Z050 Z051 Z055 Z056 Z191 Z192 Z298 Z299 Z3046 Z317 Z5339 Z7984 T85890S V470XXA V473XXD V476XXS W268XXA X500XXD X503XXS Z052 Z0571 Z2911 Z30015 Z333 Z8342 T85898A V470XXD V473XXS V479XXA W268XXD X500XXS X509XXA Z053 Z0572 Z2912 Z30016 Z516 Z8482 T85898D V470XXS V475XXA V479XXD W268XXS X501XXA X509XXD Z0541 Z0573 Z2913 Z30017 Z5331 Z9284 T85898S V471XXA V475XXD V479XXS W269XXA X501XXD X509XXS Z0542 Z058 Z2914 Z3044 Z5332 Z98890 T8853XA V471XXD V475XXS W262XXA W269XXD X501XXS Y9385 Z0543 Z059 Z293 Z3045 Z5333 Z98891 For more information, call the TMHP Contact Center at 1-800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 1-800-568-2413. Discontinued Diagnosis Codes The 2017 ICD discontinued diagnosis codes are no longer valid for claims submitted with dates of service on or after October 1, 2016. The following is a list of diagnosis codes that have been discontinued: Diagnosis Codes D495 E08321 E08329 E08331 E08339 E08341 E08349 E08351 E08359 E09321 E09329 E09331 E09339 E09341 E09349 E09351 E09359 E10321 E10329 E10331 E10339 E10341 E10349 E10351 E10359 E11321 E11329 E11331 E11339 E11341 E11349 E11351 E11359 E13321 E13329 E13331 E13339 E13341 E13349 E13351 E13359 E780 F328 F348 F42 F508 H34811 H34812 H34813 H34819 H34831 H34832 H34833 H34839 H3531 H3532 H4011X0 H4011X1 H4011X2 H4011X3 H4011X4 I6020 I6021 I6022 I6901 I6911 I6921 I6931 I6981 I6991 I9762 J985 K040 K0521 K0522 K0531 K0532 K088 K522 K550 K593 K850 K851 K852 K853 K858 K859 K868 K904 M2660 M2661 M2662 M2663 M5002 M5012 M5022 M5032 M5082 M5092 N423 N508 N61 N830 N831 N8320 N8329 N8331 N8332 N8333 N834 N8351 N8352 N906 N941 O000 O001 O002 O008 O009 O337 O3421 O702 Q252 Q254 Q5212 Q662 ICD-10 Special Bulletin, No. 10 26 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. All Code Changes: Added, Revised, and Discontinued Diagnosis Codes R312 R3919 R934 R972 S0210XS S023XXA S0261XA S0261XB S0262XB S0262XD S0263XD S0263XG S0264XG S0264XK S0265XK S0265XS S0267XS S028XXA S030XXA S030XXD S060X2D S060X2S S060X4S S060X5A S060X7A S060X7D T8351XD T8351XS T836XXS T84040A T84042A T84042D T84048D T84048S T8581XS T8582XA T8584XA T8584XD T8586XD T8586XS V4701XS V4702XA V4712XA V4712XD V4732XD V4732XS V4752XS V4761XA V4791XA V4791XD W451XXD W451XXS Z2252 Z2259 R40241 S0210XA S023XXB S0261XD S0262XG S0263XK S0264XS S0267XA S028XXB S030XXS S060X3A S060X5D S060X7S T8359XA T84040D T84042S T84049A T8582XD T8584XS T8589XA V4702XD V4712XS V4751XA V4761XD V4791XS W452XXA Z9889 R40242 S0210XB S023XXD S0261XG S0262XK S0263XS S0265XA S0267XB S028XXD S034XXA S060X3D S060X5S S060X8A T8359XD T84040S T84043A T84049D T8582XS T8585XA T8589XD V4702XS V4731XA V4751XD V4761XS V4792XA W452XXD R40243 S0210XD S023XXG S0261XK S0262XS S0264XA S0265XB S0267XD S028XXG S034XXD S060X3S S060X6A S060X8D T8359XS T84041A T84043D T84049S T8583XA T8585XD T8589XS V4711XA V4731XD V4751XS V4762XA V4792XD W452XXS R40244 S0210XG S023XXK S0261XS S0263XA S0264XB S0265XD S0267XG S028XXK S034XXS S060X4A S060X6D S060X8S T836XXA T84041D T84043S T8581XA T8583XD T8585XS V4701XA V4711XD V4731XS V4752XA V4762XD V4792XS Z2250 R827 S0210XK S023XXS S0262XA S0263XB S0264XD S0265XG S0267XK S028XXS S060X2A S060X4D S060X6S T8351XA T836XXD T84041S T84048A T8581XD T8583XS T8586XA V4701XD V4711XS V4732XA V4752XD V4762XS W451XXA Z2251 For more information, call the TMHP Contact Center at 1-800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 1-800-568-2413. Diagnosis Code Description Changes Effective for dates of service on or after October 1, 2016, the following diagnosis code descriptions have changed: Revised Diagnosis Codes C7A094 C7A095 C7A096 C8110 C8111 C8112 C8113 C8114 C8115 C8116 C8117 C8118 C8119 C8120 C8121 C8122 C8123 C8124 C8125 C8126 C8127 C8128 C8129 C8130 C8131 C8132 C8133 C8134 C8135 C8136 C8137 C8138 C8139 C8140 C8141 ICD-10 Special Bulletin, No. 10 27 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. All Code Changes: Added, Revised, and Discontinued Revised Diagnosis Codes C8142 C8143 C8149 C8170 C8176 C8177 D7821 D7822 H59311 H59312 H59329 H9541 I97820 I97821 L705 L7621 N401 N5239 N99530 N99531 O0911 O0912 O152 O24011 O24111 O24112 O4401 O4402 P000 P001 P007 P0081 P013 P014 P020 P021 P0260 P0269 P032 P033 P03819 P0389 P0441 P0449 S02110B S02110D S02111D S02111G S02112G S02112K S02118K S02118S S02400S S02401A S02402A S02402B S02600B S02600D S49031G S49031K S49032K S49032P S49039P S49039S S49131S S49132A S49139A S49139D S548X1D S548X1S S548X9S T82817A T82827A T82827D T82837D T82837S T82847S T82848A ICD-10 Special Bulletin, No. 10 C8144 C8171 C8178 E89810 H59313 H9542 J95830 L7622 N99113 N99532 O0913 O24012 O24113 O4403 P002 P0089 P015 P0220 P027 P034 P039 P045 S02110G S02111K S02112S S02400A S02401B S02402D S02600G S49031P S49032S S49131A S49132D S49139G S548X2A T82817D T82827S T82838A T82848D C8145 C8172 C8179 E89811 H59319 I7779 J95831 M96830 N99520 N99538 O1500 O24013 O24119 O4410 P003 P009 P016 P0229 P028 P035 P040 P046 S02110K S02111S S02118A S02400B S02401D S02402G S02600K S49031S S49039A S49131D S49132G S49139K S548X2D T82817S T82828A T82838D T82848S 28 C8146 C8173 D3A094 F641 H59321 I97610 K9161 M96831 N99521 N99820 O1502 O24019 O2412 O4411 P004 P010 P017 P023 P029 P036 P041 P048 S02110S S02112A S02118B S02400D S02401G S02402K S02600S S49032A S49039D S49131G S49132K S49139P S548X2S T82818A T82828D T82838S T82857A C8147 C8174 D3A095 G9751 H59322 I97611 K91840 N10 N99522 N99821 O1503 O2402 O2413 O4412 P005 P011 P018 P024 P030 P03810 P042 P049 S02111A S02112B S02118D S02400G S02401K S02402S S49031A S49032D S49039G S49131K S49132P S49139S S548X9A T82818D T82828S T82847A T82857D C8148 C8175 D3A096 G9752 H59323 I97618 K91841 N400 N99528 O0910 O151 O2403 O4400 O4413 P006 P012 P019 P025 P031 P03811 P043 S02110A S02111B S02112D S02118G S02400K S02401S S02600A S49031D S49032G S49039K S49131P S49132S S548X1A S548X9D T82818S T82837A T82847D T82857S 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. All Code Changes: Added, Revised, and Discontinued Revised Diagnosis Codes T82858A T82858D T82868D T82868S T83028S T83038A T83111A T83111D T83121D T83121S T83191S T83192A T83420A T83420D T83711D T83711S T83721S T83728A T8382XA T8382XD T8384XD T8384XS T8386XS T85110A T85112A T85112D T85121D T85121S T85190S T85191A T85610A T85610D T85630D T85630S T82858S T83018A T83038D T83111S T83122A T83192D T83420S T83718A T83728D T8382XS T8385XA T85110D T85112S T85122A T85191D T85610S T85690A T82867A T83018D T83038S T83112A T83122D T83192S T83490A T83718D T83728S T8383XA T8385XD T85110S T85120A T85122D T85191S T85620A T85690D T82867D T83018S T83098A T83112D T83122S T83410A T83490D T83718S T8381XA T8383XD T8385XS T85111A T85120D T85122S T85192A T85620D T85690S T82867S T83028A T83098D T83112S T83191A T83410D T83490S T83721A T8381XD T8383XS T8386XA T85111D T85120S T85190A T85192D T85620S T82868A T83028D T83098S T83121A T83191D T83410S T83711A T83721D T8381XS T8384XA T8386XD T85111S T85121A T85190D T85192S T85630A For more information, call the TMHP Contact Center at 1-800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 1-800-568-2413. ICD-10 Special Bulletin, No. 10 29 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS INPATIENT HOSPITAL ICD-10-PCS Inpatient Hospital ICD-10-PCS Surgical Procedure Code Updates The ICD-10-PCS procedure codes are inpatient hospital surgical procedure codes and must be submitted, as applicable, only on inpatient hospital claims. Note: For professional and outpatient procedures and services, providers must continue to use the American Medical Association (AMA) Current Procedural Terminology (CPT) manual and the CMS Health Care Common Procedure Coding System (HCPCS) manual. This section lists the ICD-10-PCS inpatient hospital surgical procedure code changes for inpatient hospital providers. Providers should refer to the appropriate copyright holder’s code listing for the new, discontinued, and revised descriptions for the procedure codes indicated below. All discontinued codes will not be reimbursed for dates of service on or after October 1, 2016. The following table lists all of the new, discontinued, and revised surgical procedure codes: Note: These procedure codes are surgical codes used to assign the proper DRG for an inpatient hospital stay and are processed as informational only. Added Procedure Codes 0210083 0210088 0210089 021008C 021008F 021008W 0210483 0210488 0210489 021048C 021048F 021048W 0211083 0211088 0211089 021108C 021108F 021108W 0211483 0211488 0211489 021148C 021148F 021148W 0212083 0212088 0212089 021208C 021208F 021208W 0212483 0212488 0212489 021248C 021248F 021248W 0213083 0213088 0213089 021308C 021308F 021308W 0213483 0213488 0213489 021348C 021348F 021348W 021608P 021608Q 021608R 021648P 021648Q 021648R 021708P 021708Q 021708R 021708S 021708T 021708U 021709S 021709T 021709U 02170AS 02170AT 02170AU 02170JS 02170JT 02170JU 02170KS 02170KT 02170KU 02170ZS 02170ZT 02170ZU 021748P 021748Q 021748R 021748S 021748T 021748U 021749S 021749T 021749U 02174AS 02174AT 02174AU 02174JS 02174JT 02174JU 02174KS 02174KT 02174KU 02174ZS 02174ZT 02174ZU 021K08P 021K08Q 021K08R 021K48P 021K48Q 021K48R 021L08P 021L08Q 021L08R 021L48P 021L48Q 021L48R 021P08A 021P08B 021P08D 021P09A 021P09B 021P09D 021P0AA 021P0AB 021P0AD 021P0JA 021P0JB 021P0JD 021P0KA 021P0KB 021P0KD 021P0ZA 021P0ZB 021P0ZD 021P48A 021P48B 021P48D 021P49A 021P49B 021P49D 021P4AA 021P4AB 021P4AD 021P4JA 021P4JB 021P4JD 021P4KA 021P4KB 021P4KD 021P4ZA 021P4ZB 021P4ZD 021Q08A 021Q08B 021Q08D 021Q09A 021Q09B 021Q09D 021Q0AA 021Q0AB 021Q0AD 021Q0JA 021Q0JB 021Q0JD 021Q0KA 021Q0KB 021Q0KD 021Q0ZA 021Q0ZB ICD-10 Special Bulletin, No. 10 30 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Added Procedure Codes 021Q0ZD 021Q48A 021Q4AA 021Q4AB 021Q4KB 021Q4KD 021R08D 021R09A 021R0JA 021R0JB 021R0ZB 021R0ZD 021R49D 021R4AA 021R4KA 021R4KB 021V08Q 021V08R 021V09U 021V0AS 021V0KS 021V0KT 021V48Q 021V48R 021V49U 021V4AS 021V4KS 021V4KT 021W08D 021W08P 021W48Q 021W48R 021X09B 021X09D 021X0AP 021X0AQ 021X0JR 021X0KB 021X0ZD 021X0ZP 021X48Q 021X48R 021X4AB 021X4AD 021X4JP 021X4JQ 021X4KR 021X4ZB 024F08J 024F0JJ 024J072 024J082 0270056 027005Z 02700EZ 02700F6 0270366 027036Z 02703FZ 02703G6 0270476 027047Z 02704GZ 0271056 02710E6 02710EZ 027135Z 0271366 02713F6 02713FZ 027146Z 0271476 02714G6 02714GZ 027207Z 02720E6 0272356 027235Z ICD-10 Special Bulletin, No. 10 021Q48B 021Q4AD 021Q4ZA 021R09B 021R0JD 021R48A 021R4AB 021R4KD 021V08S 021V0AT 021V0KU 021V48S 021V4AT 021V4KU 021W08Q 021X08B 021X09P 021X0AR 021X0KD 021X0ZQ 021X49B 021X4AP 021X4JR 021X4ZD 024F0KJ 024J0J2 0270066 02700FZ 0270376 02703GZ 02704E6 027105Z 02710F6 027136Z 02713G6 027147Z 0272056 02720EZ 0272366 021Q48D 021Q4JA 021Q4ZB 021R09D 021R0KA 021R48B 021R4AD 021R4ZA 021V08T 021V0AU 021V0ZS 021V48T 021V4AU 021V4ZS 021W08R 021X08D 021X09Q 021X0JB 021X0KP 021X0ZR 021X49D 021X4AQ 021X4KB 021X4ZP 024G072 024J0K2 027006Z 02700G6 027037Z 0270456 02704EZ 0271066 02710FZ 0271376 02713GZ 02714E6 027205Z 02720F6 027236Z 31 021Q49A 021Q4JB 021Q4ZD 021R0AA 021R0KB 021R48D 021R4JA 021R4ZB 021V08U 021V0JS 021V0ZT 021V48U 021V4JS 021V4ZT 021W48B 021X08P 021X09R 021X0JD 021X0KQ 021X48B 021X49P 021X4AR 021X4KD 021X4ZQ 024G082 025X0ZZ 0270076 02700GZ 02703E6 027045Z 02704F6 027106Z 02710G6 027137Z 0271456 02714EZ 0272066 02720FZ 0272376 021Q49B 021Q4JD 021R08A 021R0AB 021R0KD 021R49A 021R4JB 021R4ZD 021V09S 021V0JT 021V0ZU 021V49S 021V4JT 021V4ZU 021W48D 021X08Q 021X0AB 021X0JP 021X0KR 021X48D 021X49Q 021X4JB 021X4KP 021X4ZR 024G0J2 025X3ZZ 027007Z 0270356 02703EZ 0270466 02704FZ 0271076 02710GZ 02713E6 027145Z 02714F6 027206Z 02720G6 027237Z 021Q49D 021Q4KA 021R08B 021R0AD 021R0ZA 021R49B 021R4JD 021V08P 021V09T 021V0JU 021V48P 021V49T 021V4JU 021W08B 021W48P 021X08R 021X0AD 021X0JQ 021X0ZB 021X48P 021X49R 021X4JD 021X4KQ 024F07J 024G0K2 025X4ZZ 02700E6 027035Z 02703F6 027046Z 02704G6 027107Z 0271356 02713EZ 0271466 02714FZ 0272076 02720GZ 02723E6 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Added Procedure Codes 02723EZ 02723F6 0272466 027246Z 02724FZ 02724G6 0273076 027307Z 02730GZ 0273356 02733E6 02733EZ 027345Z 0273466 02734F6 02734FZ 027X34Z 027X3DZ 02BX0ZZ 02BX3ZX 02C04Z6 02C10Z6 02C30Z6 02C33Z6 02H43NZ 02H44NZ 02H74NZ 02HK0NZ 02HX00Z 02HX02Z 02HX3DZ 02HX40Z 02LH0ZZ 02LH3CZ 02NX0ZZ 02NX3ZZ 02QF3ZJ 02QF4ZJ 02QJ4ZG 02QX0ZZ 02RX0KZ 02RX47Z 02SX0ZZ 02UF07J 02UF3JJ 02UF3KJ 02UG08E 02UG0JE 02UG47E 02UG48E 02UJ0KG 02UJ37G 02UJ4JG 02UJ4KG 02UX38Z 02UX3JZ 02VW0EZ 02VW0FZ 02VX0DZ 02VX0EZ 02VX3FZ 02VX3ZZ 02WA0NZ 02WA3NZ 0370066 037006Z 03700F6 03700FZ 037035Z 0370366 03703EZ 03703F6 0370456 037045Z 03704E6 03704EZ 0371046 0371056 ICD-10 Special Bulletin, No. 10 02723FZ 0272476 02724GZ 02730E6 027335Z 02733F6 027346Z 02734G6 027X3ZZ 02BX3ZZ 02C13Z6 02C34Z6 02H60NZ 02HK3NZ 02HX03Z 02HX42Z 02LH3DZ 02NX4ZZ 02QG0ZE 02QX3ZZ 02RX48Z 02UF08J 02UF47J 02UG0KE 02UG4JE 02UJ38G 02UX07Z 02UX3KZ 02VW3EZ 02VX0FZ 02VX4CZ 02WA4NZ 0370076 03700G6 037036Z 03703FZ 0370466 03704F6 037105Z 02723G6 027247Z 0273056 02730EZ 0273366 02733FZ 0273476 02734GZ 027X44Z 02BX4ZX 02C14Z6 02CX0ZZ 02H63NZ 02HK4NZ 02HX0DZ 02HX43Z 02LH3ZZ 02PA0NZ 02QG3ZE 02QX4ZZ 02RX4JZ 02UF0JJ 02UF48J 02UG37E 02UG4KE 02UJ3JG 02UX08Z 02UX47Z 02VW3FZ 02VX0ZZ 02VX4DZ 02WAXNZ 037007Z 03700GZ 0370376 03703G6 037046Z 03704FZ 0371066 32 02723GZ 02724E6 027305Z 02730F6 027336Z 02733G6 027347Z 027X04Z 027X4DZ 02BX4ZZ 02C20Z6 02CX3ZZ 02H64NZ 02HL0NZ 02HX30Z 02HX4DZ 02LH4CZ 02PA3NZ 02QG4ZE 02RX07Z 02RX4KZ 02UF0KJ 02UF4JJ 02UG38E 02UJ07G 02UJ3KG 02UX0JZ 02UX48Z 02VW4EZ 02VX3CZ 02VX4EZ 0370046 03700D6 03700Z6 037037Z 03703GZ 0370476 03704G6 037106Z 0272456 02724EZ 0273066 02730FZ 0273376 02733GZ 02734E6 027X0DZ 027X4ZZ 02C00Z6 02C23Z6 02CX4ZZ 02H70NZ 02HL3NZ 02HX32Z 02LH0CZ 02LH4DZ 02PA4NZ 02QJ0ZG 02RX08Z 02S00ZZ 02UF37J 02UF4KJ 02UG3JE 02UJ08G 02UJ47G 02UX0KZ 02UX4JZ 02VW4FZ 02VX3DZ 02VX4FZ 0370056 03700E6 0370346 03703D6 03703Z6 037047Z 03704GZ 0371076 027245Z 02724F6 027306Z 02730G6 027337Z 0273456 02734EZ 027X0ZZ 02BX0ZX 02C03Z6 02C24Z6 02H40NZ 02H73NZ 02HL4NZ 02HX33Z 02LH0DZ 02LH4ZZ 02QF0ZJ 02QJ3ZG 02RX0JZ 02S10ZZ 02UF38J 02UG07E 02UG3KE 02UJ0JG 02UJ48G 02UX37Z 02UX4KZ 02VX0CZ 02VX3EZ 02VX4ZZ 037005Z 03700EZ 0370356 03703E6 0370446 03704D6 03704Z6 037107Z 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Added Procedure Codes 03710D6 03710E6 03710Z6 0371346 037137Z 03713D6 03713GZ 03713Z6 0371476 037147Z 03714G6 03714GZ 037206Z 0372076 03720FZ 03720G6 0372366 037236Z 03723F6 03723FZ 037245Z 0372466 03724EZ 03724F6 0373056 037305Z 03730E6 03730EZ 0373346 0373356 03733D6 03733E6 03733Z6 0373446 037347Z 03734D6 03734GZ 03734Z6 0374076 037407Z 03740G6 03740GZ 037436Z 0374376 03743FZ 03743G6 0374466 037446Z 03744F6 03744FZ 037505Z 0375066 03750EZ 03750F6 0375356 037535Z 03753E6 03753EZ 0375446 0375456 03754D6 03754E6 03754Z6 0376046 037607Z 03760D6 03760GZ 03760Z6 0376376 037637Z 03763G6 03763GZ 037646Z 0376476 03764FZ 03764G6 0377066 037706Z ICD-10 Special Bulletin, No. 10 03710EZ 0371356 03713E6 0371446 03714D6 03714Z6 037207Z 03720GZ 0372376 03723G6 037246Z 03724FZ 0373066 03730F6 037335Z 03733EZ 0373456 03734E6 0374046 03740D6 03740Z6 037437Z 03743GZ 0374476 03744G6 037506Z 03750FZ 0375366 03753F6 037545Z 03754EZ 0376056 03760E6 0376346 03763D6 03763Z6 037647Z 03764GZ 0377076 03710F6 037135Z 03713EZ 0371456 03714E6 0372046 03720D6 03720Z6 037237Z 03723GZ 0372476 03724G6 037306Z 03730FZ 0373366 03733F6 037345Z 03734EZ 0374056 03740E6 0374346 03743D6 03743Z6 037447Z 03744GZ 0375076 03750G6 037536Z 03753FZ 0375466 03754F6 037605Z 03760EZ 0376356 03763E6 0376446 03764D6 03764Z6 037707Z 33 03710FZ 0371366 03713F6 037145Z 03714EZ 0372056 03720E6 0372346 03723D6 03723Z6 037247Z 03724GZ 0373076 03730G6 037336Z 03733FZ 0373466 03734F6 037405Z 03740EZ 0374356 03743E6 0374446 03744D6 03744Z6 037507Z 03750GZ 0375376 03753G6 037546Z 03754FZ 0376066 03760F6 037635Z 03763EZ 0376456 03764E6 0377046 03770D6 03710G6 037136Z 03713FZ 0371466 03714F6 037205Z 03720EZ 0372356 03723E6 0372446 03724D6 03724Z6 037307Z 03730GZ 0373376 03733G6 037346Z 03734FZ 0374066 03740F6 037435Z 03743EZ 0374456 03744E6 0375046 03750D6 03750Z6 037537Z 03753GZ 0375476 03754G6 037606Z 03760FZ 0376366 03763F6 037645Z 03764EZ 0377056 03770E6 03710GZ 0371376 03713G6 037146Z 03714FZ 0372066 03720F6 037235Z 03723EZ 0372456 03724E6 0373046 03730D6 03730Z6 037337Z 03733GZ 0373476 03734G6 037406Z 03740FZ 0374366 03743F6 037445Z 03744EZ 0375056 03750E6 0375346 03753D6 03753Z6 037547Z 03754GZ 0376076 03760G6 037636Z 03763FZ 0376466 03764F6 037705Z 03770EZ 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Added Procedure Codes 03770F6 03770FZ 037735Z 0377366 03773EZ 03773F6 0377456 037745Z 03774E6 03774EZ 0378046 0378056 03780D6 03780E6 03780Z6 0378346 037837Z 03783D6 03783GZ 03783Z6 0378476 037847Z 03784G6 03784GZ 037906Z 0379076 03790FZ 03790G6 0379366 037936Z 03793F6 03793FZ 037945Z 0379466 03794EZ 03794F6 037A056 037A05Z 037A0E6 037A0EZ 037A346 037A356 037A3D6 037A3E6 037A3Z6 037A446 037A47Z 037A4D6 037A4GZ 037A4Z6 037B076 037B07Z 037B0G6 037B0GZ 037B36Z 037B376 037B3FZ 037B3G6 037B466 037B46Z 037B4F6 037B4FZ 037C05Z 037C066 037C0EZ 037C0F6 037C356 037C35Z 037C3E6 037C3EZ 037C446 037C456 037C4D6 037C4E6 037C4Z6 037D046 037D07Z 037D0D6 ICD-10 Special Bulletin, No. 10 03770G6 037736Z 03773FZ 0377466 03774F6 037805Z 03780EZ 0378356 03783E6 0378446 03784D6 03784Z6 037907Z 03790GZ 0379376 03793G6 037946Z 03794FZ 037A066 037A0F6 037A35Z 037A3EZ 037A456 037A4E6 037B046 037B0D6 037B0Z6 037B37Z 037B3GZ 037B476 037B4G6 037C06Z 037C0FZ 037C366 037C3F6 037C45Z 037C4EZ 037D056 037D0E6 03770GZ 0377376 03773G6 037746Z 03774FZ 0378066 03780F6 037835Z 03783EZ 0378456 03784E6 0379046 03790D6 03790Z6 037937Z 03793GZ 0379476 03794G6 037A06Z 037A0FZ 037A366 037A3F6 037A45Z 037A4EZ 037B056 037B0E6 037B346 037B3D6 037B3Z6 037B47Z 037B4GZ 037C076 037C0G6 037C36Z 037C3FZ 037C466 037C4F6 037D05Z 037D0EZ 34 03770Z6 037737Z 03773GZ 0377476 03774G6 037806Z 03780FZ 0378366 03783F6 037845Z 03784EZ 0379056 03790E6 0379346 03793D6 03793Z6 037947Z 03794GZ 037A076 037A0G6 037A36Z 037A3FZ 037A466 037A4F6 037B05Z 037B0EZ 037B356 037B3E6 037B446 037B4D6 037B4Z6 037C07Z 037C0GZ 037C376 037C3G6 037C46Z 037C4FZ 037D066 037D0F6 0377346 03773D6 03773Z6 037747Z 03774GZ 0378076 03780G6 037836Z 03783FZ 0378466 03784F6 037905Z 03790EZ 0379356 03793E6 0379446 03794D6 03794Z6 037A07Z 037A0GZ 037A376 037A3G6 037A46Z 037A4FZ 037B066 037B0F6 037B35Z 037B3EZ 037B456 037B4E6 037C046 037C0D6 037C0Z6 037C37Z 037C3GZ 037C476 037C4G6 037D06Z 037D0FZ 0377356 03773E6 0377446 03774D6 03774Z6 037807Z 03780GZ 0378376 03783G6 037846Z 03784FZ 0379066 03790F6 037935Z 03793EZ 0379456 03794E6 037A046 037A0D6 037A0Z6 037A37Z 037A3GZ 037A476 037A4G6 037B06Z 037B0FZ 037B366 037B3F6 037B45Z 037B4EZ 037C056 037C0E6 037C346 037C3D6 037C3Z6 037C47Z 037C4GZ 037D076 037D0G6 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Added Procedure Codes 037D0GZ 037D0Z6 037D376 037D37Z 037D3G6 037D3GZ 037D46Z 037D476 037D4FZ 037D4G6 037F066 037F06Z 037F0F6 037F0FZ 037F35Z 037F366 037F3EZ 037F3F6 037F456 037F45Z 037F4E6 037F4EZ 037G046 037G056 037G0D6 037G0E6 037G0Z6 037G346 037G37Z 037G3D6 037G3GZ 037G3Z6 037G476 037G47Z 037G4G6 037G4GZ 037H06Z 037H076 037H0FZ 037H0G6 037H366 037H36Z 037H3F6 037H3FZ 037H45Z 037H466 037H4EZ 037H4F6 037J056 037J05Z 037J0E6 037J0EZ 037J346 037J356 037J3D6 037J3E6 037J3Z6 037J446 037J47Z 037J4D6 037J4GZ 037J4Z6 037K076 037K07Z 037K0G6 037K0GZ 037K36Z 037K376 037K3FZ 037K3G6 037K466 037K46Z 037K4F6 037K4FZ 037L05Z 037L066 037L0EZ 037L0F6 ICD-10 Special Bulletin, No. 10 037D346 037D3D6 037D3Z6 037D47Z 037D4GZ 037F076 037F0G6 037F36Z 037F3FZ 037F466 037F4F6 037G05Z 037G0EZ 037G356 037G3E6 037G446 037G4D6 037G4Z6 037H07Z 037H0GZ 037H376 037H3G6 037H46Z 037H4FZ 037J066 037J0F6 037J35Z 037J3EZ 037J456 037J4E6 037K046 037K0D6 037K0Z6 037K37Z 037K3GZ 037K476 037K4G6 037L06Z 037L0FZ 037D356 037D3E6 037D446 037D4D6 037D4Z6 037F07Z 037F0GZ 037F376 037F3G6 037F46Z 037F4FZ 037G066 037G0F6 037G35Z 037G3EZ 037G456 037G4E6 037H046 037H0D6 037H0Z6 037H37Z 037H3GZ 037H476 037H4G6 037J06Z 037J0FZ 037J366 037J3F6 037J45Z 037J4EZ 037K056 037K0E6 037K346 037K3D6 037K3Z6 037K47Z 037K4GZ 037L076 037L0G6 35 037D35Z 037D3EZ 037D456 037D4E6 037F046 037F0D6 037F0Z6 037F37Z 037F3GZ 037F476 037F4G6 037G06Z 037G0FZ 037G366 037G3F6 037G45Z 037G4EZ 037H056 037H0E6 037H346 037H3D6 037H3Z6 037H47Z 037H4GZ 037J076 037J0G6 037J36Z 037J3FZ 037J466 037J4F6 037K05Z 037K0EZ 037K356 037K3E6 037K446 037K4D6 037K4Z6 037L07Z 037L0GZ 037D366 037D3F6 037D45Z 037D4EZ 037F056 037F0E6 037F346 037F3D6 037F3Z6 037F47Z 037F4GZ 037G076 037G0G6 037G36Z 037G3FZ 037G466 037G4F6 037H05Z 037H0EZ 037H356 037H3E6 037H446 037H4D6 037H4Z6 037J07Z 037J0GZ 037J376 037J3G6 037J46Z 037J4FZ 037K066 037K0F6 037K35Z 037K3EZ 037K456 037K4E6 037L046 037L0D6 037L0Z6 037D36Z 037D3FZ 037D466 037D4F6 037F05Z 037F0EZ 037F356 037F3E6 037F446 037F4D6 037F4Z6 037G07Z 037G0GZ 037G376 037G3G6 037G46Z 037G4FZ 037H066 037H0F6 037H35Z 037H3EZ 037H456 037H4E6 037J046 037J0D6 037J0Z6 037J37Z 037J3GZ 037J476 037J4G6 037K06Z 037K0FZ 037K366 037K3F6 037K45Z 037K4EZ 037L056 037L0E6 037L346 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Added Procedure Codes 037L356 037L35Z 037L3E6 037L3EZ 037L446 037L456 037L4D6 037L4E6 037L4Z6 037M046 037M07Z 037M0D6 037M0GZ 037M0Z6 037M376 037M37Z 037M3G6 037M3GZ 037M46Z 037M476 037M4FZ 037M4G6 037N066 037N06Z 037N0F6 037N0FZ 037N35Z 037N366 037N3EZ 037N3F6 037N456 037N45Z 037N4E6 037N4EZ 037P046 037P056 037P0D6 037P0E6 037P0Z6 037P346 037P37Z 037P3D6 037P3GZ 037P3Z6 037P476 037P47Z 037P4G6 037P4GZ 037Q06Z 037Q076 037Q0FZ 037Q0G6 037Q366 037Q36Z 037Q3F6 037Q3FZ 037Q45Z 037Q466 037Q4EZ 037Q4F6 037R056 037R05Z 037R0E6 037R0EZ 037R346 037R356 037R3D6 037R3E6 037R3Z6 037R446 037R47Z 037R4D6 037R4GZ 037R4Z6 037S076 037S07Z 037S0G6 037S0GZ ICD-10 Special Bulletin, No. 10 037L366 037L3F6 037L45Z 037L4EZ 037M056 037M0E6 037M346 037M3D6 037M3Z6 037M47Z 037M4GZ 037N076 037N0G6 037N36Z 037N3FZ 037N466 037N4F6 037P05Z 037P0EZ 037P356 037P3E6 037P446 037P4D6 037P4Z6 037Q07Z 037Q0GZ 037Q376 037Q3G6 037Q46Z 037Q4FZ 037R066 037R0F6 037R35Z 037R3EZ 037R456 037R4E6 037S046 037S0D6 037S0Z6 037L36Z 037L3FZ 037L466 037L4F6 037M05Z 037M0EZ 037M356 037M3E6 037M446 037M4D6 037M4Z6 037N07Z 037N0GZ 037N376 037N3G6 037N46Z 037N4FZ 037P066 037P0F6 037P35Z 037P3EZ 037P456 037P4E6 037Q046 037Q0D6 037Q0Z6 037Q37Z 037Q3GZ 037Q476 037Q4G6 037R06Z 037R0FZ 037R366 037R3F6 037R45Z 037R4EZ 037S056 037S0E6 037S346 36 037L376 037L3G6 037L46Z 037L4FZ 037M066 037M0F6 037M35Z 037M3EZ 037M456 037M4E6 037N046 037N0D6 037N0Z6 037N37Z 037N3GZ 037N476 037N4G6 037P06Z 037P0FZ 037P366 037P3F6 037P45Z 037P4EZ 037Q056 037Q0E6 037Q346 037Q3D6 037Q3Z6 037Q47Z 037Q4GZ 037R076 037R0G6 037R36Z 037R3FZ 037R466 037R4F6 037S05Z 037S0EZ 037S356 037L37Z 037L3GZ 037L476 037L4G6 037M06Z 037M0FZ 037M366 037M3F6 037M45Z 037M4EZ 037N056 037N0E6 037N346 037N3D6 037N3Z6 037N47Z 037N4GZ 037P076 037P0G6 037P36Z 037P3FZ 037P466 037P4F6 037Q05Z 037Q0EZ 037Q356 037Q3E6 037Q446 037Q4D6 037Q4Z6 037R07Z 037R0GZ 037R376 037R3G6 037R46Z 037R4FZ 037S066 037S0F6 037S35Z 037L3D6 037L3Z6 037L47Z 037L4GZ 037M076 037M0G6 037M36Z 037M3FZ 037M466 037M4F6 037N05Z 037N0EZ 037N356 037N3E6 037N446 037N4D6 037N4Z6 037P07Z 037P0GZ 037P376 037P3G6 037P46Z 037P4FZ 037Q066 037Q0F6 037Q35Z 037Q3EZ 037Q456 037Q4E6 037R046 037R0D6 037R0Z6 037R37Z 037R3GZ 037R476 037R4G6 037S06Z 037S0FZ 037S366 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Added Procedure Codes 037S36Z 037S376 037S3FZ 037S3G6 037S466 037S46Z 037S4F6 037S4FZ 037T05Z 037T066 037T0EZ 037T0F6 037T356 037T35Z 037T3E6 037T3EZ 037T446 037T456 037T4D6 037T4E6 037T4Z6 037U046 037U07Z 037U0D6 037U0GZ 037U0Z6 037U376 037U37Z 037U3G6 037U3GZ 037U46Z 037U476 037U4FZ 037U4G6 037V066 037V06Z 037V0F6 037V0FZ 037V35Z 037V366 037V3EZ 037V3F6 037V456 037V45Z 037V4E6 037V4EZ 037Y046 037Y056 037Y0D6 037Y0E6 037Y0Z6 037Y346 037Y37Z 037Y3D6 037Y3GZ 037Y3Z6 037Y476 037Y47Z 037Y4G6 037Y4GZ 03C13Z6 03C14Z6 03C34Z6 03C40Z6 03C60Z6 03C63Z6 03C83Z6 03C84Z6 03CA4Z6 03CB0Z6 03CD0Z6 03CD3Z6 03CG3Z6 03CG4Z6 03CJ4Z6 03CK0Z6 03CM0Z6 03CM3Z6 ICD-10 Special Bulletin, No. 10 037S37Z 037S3GZ 037S476 037S4G6 037T06Z 037T0FZ 037T366 037T3F6 037T45Z 037T4EZ 037U056 037U0E6 037U346 037U3D6 037U3Z6 037U47Z 037U4GZ 037V076 037V0G6 037V36Z 037V3FZ 037V466 037V4F6 037Y05Z 037Y0EZ 037Y356 037Y3E6 037Y446 037Y4D6 037Y4Z6 03C20Z6 03C43Z6 03C64Z6 03C90Z6 03CB3Z6 03CD4Z6 03CH0Z6 03CK3Z6 03CM4Z6 037S3D6 037S3Z6 037S47Z 037S4GZ 037T076 037T0G6 037T36Z 037T3FZ 037T466 037T4F6 037U05Z 037U0EZ 037U356 037U3E6 037U446 037U4D6 037U4Z6 037V07Z 037V0GZ 037V376 037V3G6 037V46Z 037V4FZ 037Y066 037Y0F6 037Y35Z 037Y3EZ 037Y456 037Y4E6 03C00Z6 03C23Z6 03C44Z6 03C70Z6 03C93Z6 03CB4Z6 03CF0Z6 03CH3Z6 03CK4Z6 03CN0Z6 37 037S3E6 037S446 037S4D6 037S4Z6 037T07Z 037T0GZ 037T376 037T3G6 037T46Z 037T4FZ 037U066 037U0F6 037U35Z 037U3EZ 037U456 037U4E6 037V046 037V0D6 037V0Z6 037V37Z 037V3GZ 037V476 037V4G6 037Y06Z 037Y0FZ 037Y366 037Y3F6 037Y45Z 037Y4EZ 03C03Z6 03C24Z6 03C50Z6 03C73Z6 03C94Z6 03CC0Z6 03CF3Z6 03CH4Z6 03CL0Z6 03CN3Z6 037S3EZ 037S456 037S4E6 037T046 037T0D6 037T0Z6 037T37Z 037T3GZ 037T476 037T4G6 037U06Z 037U0FZ 037U366 037U3F6 037U45Z 037U4EZ 037V056 037V0E6 037V346 037V3D6 037V3Z6 037V47Z 037V4GZ 037Y076 037Y0G6 037Y36Z 037Y3FZ 037Y466 037Y4F6 03C04Z6 03C30Z6 03C53Z6 03C74Z6 03CA0Z6 03CC3Z6 03CF4Z6 03CJ0Z6 03CL3Z6 03CN4Z6 037S3F6 037S45Z 037S4EZ 037T056 037T0E6 037T346 037T3D6 037T3Z6 037T47Z 037T4GZ 037U076 037U0G6 037U36Z 037U3FZ 037U466 037U4F6 037V05Z 037V0EZ 037V356 037V3E6 037V446 037V4D6 037V4Z6 037Y07Z 037Y0GZ 037Y376 037Y3G6 037Y46Z 037Y4FZ 03C10Z6 03C33Z6 03C54Z6 03C80Z6 03CA3Z6 03CC4Z6 03CG0Z6 03CJ3Z6 03CL4Z6 03CP0Z6 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Added Procedure Codes 03CP3Z6 03CP4Z6 03CR4Z6 03CS0Z6 03CU0Z6 03CU3Z6 03CY3Z6 03CY4Z6 0470076 047007Z 04700G6 04700GZ 047036Z 0470376 04703FZ 04703G6 0470466 047046Z 04704F6 04704FZ 047105Z 0471066 04710EZ 04710F6 0471356 047135Z 04713E6 04713EZ 0471446 0471456 04714D6 04714E6 04714Z6 0472046 047207Z 04720D6 04720GZ 04720Z6 0472376 047237Z 04723G6 04723GZ 047246Z 0472476 04724FZ 04724G6 0473066 047306Z 04730F6 04730FZ 047335Z 0473366 04733EZ 04733F6 0473456 047345Z 04734E6 04734EZ 0474046 0474056 04740D6 04740E6 04740Z6 0474346 047437Z 04743D6 04743GZ 04743Z6 0474476 047447Z 04744G6 04744GZ 047506Z 0475076 04750FZ 04750G6 0475366 047536Z ICD-10 Special Bulletin, No. 10 03CQ0Z6 03CS3Z6 03CU4Z6 0470046 04700D6 04700Z6 047037Z 04703GZ 0470476 04704G6 047106Z 04710FZ 0471366 04713F6 047145Z 04714EZ 0472056 04720E6 0472346 04723D6 04723Z6 047247Z 04724GZ 0473076 04730G6 047336Z 04733FZ 0473466 04734F6 047405Z 04740EZ 0474356 04743E6 0474446 04744D6 04744Z6 047507Z 04750GZ 0475376 03CQ3Z6 03CS4Z6 03CV0Z6 0470056 04700E6 0470346 04703D6 04703Z6 047047Z 04704GZ 0471076 04710G6 047136Z 04713FZ 0471466 04714F6 047205Z 04720EZ 0472356 04723E6 0472446 04724D6 04724Z6 047307Z 04730GZ 0473376 04733G6 047346Z 04734FZ 0474066 04740F6 047435Z 04743EZ 0474456 04744E6 0475046 04750D6 04750Z6 047537Z 38 03CQ4Z6 03CT0Z6 03CV3Z6 047005Z 04700EZ 0470356 04703E6 0470446 04704D6 04704Z6 047107Z 04710GZ 0471376 04713G6 047146Z 04714FZ 0472066 04720F6 047235Z 04723EZ 0472456 04724E6 0473046 04730D6 04730Z6 047337Z 04733GZ 0473476 04734G6 047406Z 04740FZ 0474366 04743F6 047445Z 04744EZ 0475056 04750E6 0475346 04753D6 03CR0Z6 03CT3Z6 03CV4Z6 0470066 04700F6 047035Z 04703EZ 0470456 04704E6 0471046 04710D6 04710Z6 047137Z 04713GZ 0471476 04714G6 047206Z 04720FZ 0472366 04723F6 047245Z 04724EZ 0473056 04730E6 0473346 04733D6 04733Z6 047347Z 04734GZ 0474076 04740G6 047436Z 04743FZ 0474466 04744F6 047505Z 04750EZ 0475356 04753E6 03CR3Z6 03CT4Z6 03CY0Z6 047006Z 04700FZ 0470366 04703F6 047045Z 04704EZ 0471056 04710E6 0471346 04713D6 04713Z6 047147Z 04714GZ 0472076 04720G6 047236Z 04723FZ 0472466 04724F6 047305Z 04730EZ 0473356 04733E6 0473446 04734D6 04734Z6 047407Z 04740GZ 0474376 04743G6 047446Z 04744FZ 0475066 04750F6 047535Z 04753EZ 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Added Procedure Codes 04753F6 04753FZ 047545Z 0475466 04754EZ 04754F6 0476056 047605Z 04760E6 04760EZ 0476346 0476356 04763D6 04763E6 04763Z6 0476446 047647Z 04764D6 04764GZ 04764Z6 0477076 047707Z 04770G6 04770GZ 047736Z 0477376 04773FZ 04773G6 0477466 047746Z 04774F6 04774FZ 047805Z 0478066 04780EZ 04780F6 0478356 047835Z 04783E6 04783EZ 0478446 0478456 04784D6 04784E6 04784Z6 0479046 047907Z 04790D6 04790GZ 04790Z6 0479376 047937Z 04793G6 04793GZ 047946Z 0479476 04794FZ 04794G6 047A066 047A06Z 047A0F6 047A0FZ 047A35Z 047A366 047A3EZ 047A3F6 047A456 047A45Z 047A4E6 047A4EZ 047B046 047B056 047B0D6 047B0E6 047B0Z6 047B346 047B37Z 047B3D6 ICD-10 Special Bulletin, No. 10 04753G6 047546Z 04754FZ 0476066 04760F6 047635Z 04763EZ 0476456 04764E6 0477046 04770D6 04770Z6 047737Z 04773GZ 0477476 04774G6 047806Z 04780FZ 0478366 04783F6 047845Z 04784EZ 0479056 04790E6 0479346 04793D6 04793Z6 047947Z 04794GZ 047A076 047A0G6 047A36Z 047A3FZ 047A466 047A4F6 047B05Z 047B0EZ 047B356 047B3E6 04753GZ 0475476 04754G6 047606Z 04760FZ 0476366 04763F6 047645Z 04764EZ 0477056 04770E6 0477346 04773D6 04773Z6 047747Z 04774GZ 0478076 04780G6 047836Z 04783FZ 0478466 04784F6 047905Z 04790EZ 0479356 04793E6 0479446 04794D6 04794Z6 047A07Z 047A0GZ 047A376 047A3G6 047A46Z 047A4FZ 047B066 047B0F6 047B35Z 047B3EZ 39 04753Z6 047547Z 04754GZ 0476076 04760G6 047636Z 04763FZ 0476466 04764F6 047705Z 04770EZ 0477356 04773E6 0477446 04774D6 04774Z6 047807Z 04780GZ 0478376 04783G6 047846Z 04784FZ 0479066 04790F6 047935Z 04793EZ 0479456 04794E6 047A046 047A0D6 047A0Z6 047A37Z 047A3GZ 047A476 047A4G6 047B06Z 047B0FZ 047B366 047B3F6 0475446 04754D6 04754Z6 047607Z 04760GZ 0476376 04763G6 047646Z 04764FZ 0477066 04770F6 047735Z 04773EZ 0477456 04774E6 0478046 04780D6 04780Z6 047837Z 04783GZ 0478476 04784G6 047906Z 04790FZ 0479366 04793F6 047945Z 04794EZ 047A056 047A0E6 047A346 047A3D6 047A3Z6 047A47Z 047A4GZ 047B076 047B0G6 047B36Z 047B3FZ 0475456 04754E6 0476046 04760D6 04760Z6 047637Z 04763GZ 0476476 04764G6 047706Z 04770FZ 0477366 04773F6 047745Z 04774EZ 0478056 04780E6 0478346 04783D6 04783Z6 047847Z 04784GZ 0479076 04790G6 047936Z 04793FZ 0479466 04794F6 047A05Z 047A0EZ 047A356 047A3E6 047A446 047A4D6 047A4Z6 047B07Z 047B0GZ 047B376 047B3G6 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Added Procedure Codes 047B3GZ 047B3Z6 047B476 047B47Z 047B4G6 047B4GZ 047C06Z 047C076 047C0FZ 047C0G6 047C366 047C36Z 047C3F6 047C3FZ 047C45Z 047C466 047C4EZ 047C4F6 047D056 047D05Z 047D0E6 047D0EZ 047D346 047D356 047D3D6 047D3E6 047D3Z6 047D446 047D47Z 047D4D6 047D4GZ 047D4Z6 047E076 047E07Z 047E0G6 047E0GZ 047E36Z 047E376 047E3FZ 047E3G6 047E466 047E46Z 047E4F6 047E4FZ 047F05Z 047F066 047F0EZ 047F0F6 047F356 047F35Z 047F3E6 047F3EZ 047F446 047F456 047F4D6 047F4E6 047F4Z6 047H046 047H07Z 047H0D6 047H0GZ 047H0Z6 047H376 047H37Z 047H3G6 047H3GZ 047H46Z 047H476 047H4FZ 047H4G6 047J066 047J06Z 047J0F6 047J0FZ 047J35Z 047J366 047J3EZ 047J3F6 ICD-10 Special Bulletin, No. 10 047B446 047B4D6 047B4Z6 047C07Z 047C0GZ 047C376 047C3G6 047C46Z 047C4FZ 047D066 047D0F6 047D35Z 047D3EZ 047D456 047D4E6 047E046 047E0D6 047E0Z6 047E37Z 047E3GZ 047E476 047E4G6 047F06Z 047F0FZ 047F366 047F3F6 047F45Z 047F4EZ 047H056 047H0E6 047H346 047H3D6 047H3Z6 047H47Z 047H4GZ 047J076 047J0G6 047J36Z 047J3FZ 047B456 047B4E6 047C046 047C0D6 047C0Z6 047C37Z 047C3GZ 047C476 047C4G6 047D06Z 047D0FZ 047D366 047D3F6 047D45Z 047D4EZ 047E056 047E0E6 047E346 047E3D6 047E3Z6 047E47Z 047E4GZ 047F076 047F0G6 047F36Z 047F3FZ 047F466 047F4F6 047H05Z 047H0EZ 047H356 047H3E6 047H446 047H4D6 047H4Z6 047J07Z 047J0GZ 047J376 047J3G6 40 047B45Z 047B4EZ 047C056 047C0E6 047C346 047C3D6 047C3Z6 047C47Z 047C4GZ 047D076 047D0G6 047D36Z 047D3FZ 047D466 047D4F6 047E05Z 047E0EZ 047E356 047E3E6 047E446 047E4D6 047E4Z6 047F07Z 047F0GZ 047F376 047F3G6 047F46Z 047F4FZ 047H066 047H0F6 047H35Z 047H3EZ 047H456 047H4E6 047J046 047J0D6 047J0Z6 047J37Z 047J3GZ 047B466 047B4F6 047C05Z 047C0EZ 047C356 047C3E6 047C446 047C4D6 047C4Z6 047D07Z 047D0GZ 047D376 047D3G6 047D46Z 047D4FZ 047E066 047E0F6 047E35Z 047E3EZ 047E456 047E4E6 047F046 047F0D6 047F0Z6 047F37Z 047F3GZ 047F476 047F4G6 047H06Z 047H0FZ 047H366 047H3F6 047H45Z 047H4EZ 047J056 047J0E6 047J346 047J3D6 047J3Z6 047B46Z 047B4FZ 047C066 047C0F6 047C35Z 047C3EZ 047C456 047C4E6 047D046 047D0D6 047D0Z6 047D37Z 047D3GZ 047D476 047D4G6 047E06Z 047E0FZ 047E366 047E3F6 047E45Z 047E4EZ 047F056 047F0E6 047F346 047F3D6 047F3Z6 047F47Z 047F4GZ 047H076 047H0G6 047H36Z 047H3FZ 047H466 047H4F6 047J05Z 047J0EZ 047J356 047J3E6 047J446 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Added Procedure Codes 047J456 047J45Z 047J4E6 047J4EZ 047K046 047K056 047K0D6 047K0E6 047K0Z6 047K346 047K37Z 047K3D6 047K3GZ 047K3Z6 047K476 047K47Z 047K4G6 047K4GZ 047L06Z 047L076 047L0FZ 047L0G6 047L366 047L36Z 047L3F6 047L3FZ 047L45Z 047L466 047L4EZ 047L4F6 047M056 047M05Z 047M0E6 047M0EZ 047M346 047M356 047M3D6 047M3E6 047M3Z6 047M446 047M47Z 047M4D6 047M4GZ 047M4Z6 047N076 047N07Z 047N0G6 047N0GZ 047N36Z 047N376 047N3FZ 047N3G6 047N466 047N46Z 047N4F6 047N4FZ 047P05Z 047P066 047P0EZ 047P0F6 047P356 047P35Z 047P3E6 047P3EZ 047P446 047P456 047P4D6 047P4E6 047P4Z6 047Q046 047Q07Z 047Q0D6 047Q0GZ 047Q0Z6 047Q376 047Q37Z 047Q3G6 047Q3GZ ICD-10 Special Bulletin, No. 10 047J466 047J4F6 047K05Z 047K0EZ 047K356 047K3E6 047K446 047K4D6 047K4Z6 047L07Z 047L0GZ 047L376 047L3G6 047L46Z 047L4FZ 047M066 047M0F6 047M35Z 047M3EZ 047M456 047M4E6 047N046 047N0D6 047N0Z6 047N37Z 047N3GZ 047N476 047N4G6 047P06Z 047P0FZ 047P366 047P3F6 047P45Z 047P4EZ 047Q056 047Q0E6 047Q346 047Q3D6 047Q3Z6 047J46Z 047J4FZ 047K066 047K0F6 047K35Z 047K3EZ 047K456 047K4E6 047L046 047L0D6 047L0Z6 047L37Z 047L3GZ 047L476 047L4G6 047M06Z 047M0FZ 047M366 047M3F6 047M45Z 047M4EZ 047N056 047N0E6 047N346 047N3D6 047N3Z6 047N47Z 047N4GZ 047P076 047P0G6 047P36Z 047P3FZ 047P466 047P4F6 047Q05Z 047Q0EZ 047Q356 047Q3E6 047Q446 41 047J476 047J4G6 047K06Z 047K0FZ 047K366 047K3F6 047K45Z 047K4EZ 047L056 047L0E6 047L346 047L3D6 047L3Z6 047L47Z 047L4GZ 047M076 047M0G6 047M36Z 047M3FZ 047M466 047M4F6 047N05Z 047N0EZ 047N356 047N3E6 047N446 047N4D6 047N4Z6 047P07Z 047P0GZ 047P376 047P3G6 047P46Z 047P4FZ 047Q066 047Q0F6 047Q35Z 047Q3EZ 047Q456 047J47Z 047J4GZ 047K076 047K0G6 047K36Z 047K3FZ 047K466 047K4F6 047L05Z 047L0EZ 047L356 047L3E6 047L446 047L4D6 047L4Z6 047M07Z 047M0GZ 047M376 047M3G6 047M46Z 047M4FZ 047N066 047N0F6 047N35Z 047N3EZ 047N456 047N4E6 047P046 047P0D6 047P0Z6 047P37Z 047P3GZ 047P476 047P4G6 047Q06Z 047Q0FZ 047Q366 047Q3F6 047Q45Z 047J4D6 047J4Z6 047K07Z 047K0GZ 047K376 047K3G6 047K46Z 047K4FZ 047L066 047L0F6 047L35Z 047L3EZ 047L456 047L4E6 047M046 047M0D6 047M0Z6 047M37Z 047M3GZ 047M476 047M4G6 047N06Z 047N0FZ 047N366 047N3F6 047N45Z 047N4EZ 047P056 047P0E6 047P346 047P3D6 047P3Z6 047P47Z 047P4GZ 047Q076 047Q0G6 047Q36Z 047Q3FZ 047Q466 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Added Procedure Codes 047Q46Z 047Q476 047Q4FZ 047Q4G6 047R066 047R06Z 047R0F6 047R0FZ 047R35Z 047R366 047R3EZ 047R3F6 047R456 047R45Z 047R4E6 047R4EZ 047S046 047S056 047S0D6 047S0E6 047S0Z6 047S346 047S37Z 047S3D6 047S3GZ 047S3Z6 047S476 047S47Z 047S4G6 047S4GZ 047T06Z 047T076 047T0FZ 047T0G6 047T366 047T36Z 047T3F6 047T3FZ 047T45Z 047T466 047T4EZ 047T4F6 047U056 047U05Z 047U0E6 047U0EZ 047U346 047U356 047U3D6 047U3E6 047U3Z6 047U446 047U47Z 047U4D6 047U4GZ 047U4Z6 047V076 047V07Z 047V0G6 047V0GZ 047V36Z 047V376 047V3FZ 047V3G6 047V466 047V46Z 047V4F6 047V4FZ 047W05Z 047W066 047W0EZ 047W0F6 047W356 047W35Z 047W3E6 047W3EZ 047W446 047W456 ICD-10 Special Bulletin, No. 10 047Q47Z 047Q4GZ 047R076 047R0G6 047R36Z 047R3FZ 047R466 047R4F6 047S05Z 047S0EZ 047S356 047S3E6 047S446 047S4D6 047S4Z6 047T07Z 047T0GZ 047T376 047T3G6 047T46Z 047T4FZ 047U066 047U0F6 047U35Z 047U3EZ 047U456 047U4E6 047V046 047V0D6 047V0Z6 047V37Z 047V3GZ 047V476 047V4G6 047W06Z 047W0FZ 047W366 047W3F6 047W45Z 047Q4D6 047Q4Z6 047R07Z 047R0GZ 047R376 047R3G6 047R46Z 047R4FZ 047S066 047S0F6 047S35Z 047S3EZ 047S456 047S4E6 047T046 047T0D6 047T0Z6 047T37Z 047T3GZ 047T476 047T4G6 047U06Z 047U0FZ 047U366 047U3F6 047U45Z 047U4EZ 047V056 047V0E6 047V346 047V3D6 047V3Z6 047V47Z 047V4GZ 047W076 047W0G6 047W36Z 047W3FZ 047W466 42 047Q4E6 047R046 047R0D6 047R0Z6 047R37Z 047R3GZ 047R476 047R4G6 047S06Z 047S0FZ 047S366 047S3F6 047S45Z 047S4EZ 047T056 047T0E6 047T346 047T3D6 047T3Z6 047T47Z 047T4GZ 047U076 047U0G6 047U36Z 047U3FZ 047U466 047U4F6 047V05Z 047V0EZ 047V356 047V3E6 047V446 047V4D6 047V4Z6 047W07Z 047W0GZ 047W376 047W3G6 047W46Z 047Q4EZ 047R056 047R0E6 047R346 047R3D6 047R3Z6 047R47Z 047R4GZ 047S076 047S0G6 047S36Z 047S3FZ 047S466 047S4F6 047T05Z 047T0EZ 047T356 047T3E6 047T446 047T4D6 047T4Z6 047U07Z 047U0GZ 047U376 047U3G6 047U46Z 047U4FZ 047V066 047V0F6 047V35Z 047V3EZ 047V456 047V4E6 047W046 047W0D6 047W0Z6 047W37Z 047W3GZ 047W476 047Q4F6 047R05Z 047R0EZ 047R356 047R3E6 047R446 047R4D6 047R4Z6 047S07Z 047S0GZ 047S376 047S3G6 047S46Z 047S4FZ 047T066 047T0F6 047T35Z 047T3EZ 047T456 047T4E6 047U046 047U0D6 047U0Z6 047U37Z 047U3GZ 047U476 047U4G6 047V06Z 047V0FZ 047V366 047V3F6 047V45Z 047V4EZ 047W056 047W0E6 047W346 047W3D6 047W3Z6 047W47Z 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Added Procedure Codes 047W4D6 047W4E6 047W4Z6 047Y046 047Y07Z 047Y0D6 047Y0GZ 047Y0Z6 047Y376 047Y37Z 047Y3G6 047Y3GZ 047Y46Z 047Y476 047Y4FZ 047Y4G6 04C10Z6 04C13Z6 04C33Z6 04C34Z6 04C54Z6 04C60Z6 04C80Z6 04C83Z6 04CA3Z6 04CA4Z6 04CC4Z6 04CD0Z6 04CF0Z6 04CF3Z6 04CJ3Z6 04CJ4Z6 04CL4Z6 04CM0Z6 04CP0Z6 04CP3Z6 04CR3Z6 04CR4Z6 04CT4Z6 04CU0Z6 04CW0Z6 04CW3Z6 04V00D6 04V00E6 04V03D6 04V03E6 04V04D6 04V04E6 04VC0FZ 04VC3EZ 04VD3EZ 04VD3FZ 05H03MZ 05H042Z 05H43MZ 05H44MZ 05P04MZ 05P0X2Z 05P40MZ 05P43MZ 05W03MZ 05W042Z 05W34MZ 05W3XMZ 0SPA3JZ 0SPA4JZ 0SPD4JC 0SPE0JZ 0SPS0JZ 0SPS3JZ 0SPU3JZ 0SPU4JZ 0SPW4JZ 0SRC0L9 0SWA0JZ 0SWA3JZ 0SWCXJC 0SWD0JC ICD-10 Special Bulletin, No. 10 047W4EZ 047Y056 047Y0E6 047Y346 047Y3D6 047Y3Z6 047Y47Z 047Y4GZ 04C14Z6 04C40Z6 04C63Z6 04C84Z6 04CB0Z6 04CD3Z6 04CF4Z6 04CK0Z6 04CM3Z6 04CP4Z6 04CS0Z6 04CU3Z6 04CW4Z6 04V00EZ 04V03EZ 04V04EZ 04VC3FZ 04VD4EZ 05H04MZ 05P002Z 05P0XMZ 05P44MZ 05W04MZ 05W40MZ 0SPC0JC 0SPE3JZ 0SPS4JZ 0SPV0JZ 0SRC0LA 0SWA4JZ 0SWD3JC 047W4F6 047Y05Z 047Y0EZ 047Y356 047Y3E6 047Y446 047Y4D6 047Y4Z6 04C20Z6 04C43Z6 04C64Z6 04C90Z6 04CB3Z6 04CD4Z6 04CH0Z6 04CK3Z6 04CM4Z6 04CQ0Z6 04CS3Z6 04CU4Z6 04CY0Z6 04V00F6 04V03F6 04V04F6 04VC4EZ 04VD4FZ 05H30MZ 05P00MZ 05P30MZ 05P4XMZ 05W0X2Z 05W43MZ 0SPC3JC 0SPE4JZ 0SPT0JZ 0SPV3JZ 0SRC0LZ 0SWAXJZ 0SWD4JC 43 047W4FZ 047Y066 047Y0F6 047Y35Z 047Y3EZ 047Y456 047Y4E6 04C00Z6 04C23Z6 04C44Z6 04C70Z6 04C93Z6 04CB4Z6 04CE0Z6 04CH3Z6 04CK4Z6 04CN0Z6 04CQ3Z6 04CS4Z6 04CV0Z6 04CY3Z6 04V00FZ 04V03FZ 04V04FZ 04VC4FZ 05H002Z 05H33MZ 05P032Z 05P33MZ 05W002Z 05W0XMZ 05W44MZ 0SPC4JC 0SPR0JZ 0SPT3JZ 0SPV4JZ 0SRD0L9 0SWC0JC 0SWDXJC 047W4G6 047Y06Z 047Y0FZ 047Y366 047Y3F6 047Y45Z 047Y4EZ 04C03Z6 04C24Z6 04C50Z6 04C73Z6 04C94Z6 04CC0Z6 04CE3Z6 04CH4Z6 04CL0Z6 04CN3Z6 04CQ4Z6 04CT0Z6 04CV3Z6 04CY4Z6 04V00Z6 04V03Z6 04V04Z6 04VD0EZ 05H00MZ 05H34MZ 05P03MZ 05P34MZ 05W00MZ 05W30MZ 05W4XMZ 0SPD0JC 0SPR3JZ 0SPT4JZ 0SPW0JZ 0SRD0LA 0SWC3JC 0SWE0JZ 047W4GZ 047Y076 047Y0G6 047Y36Z 047Y3FZ 047Y466 047Y4F6 04C04Z6 04C30Z6 04C53Z6 04C74Z6 04CA0Z6 04CC3Z6 04CE4Z6 04CJ0Z6 04CL3Z6 04CN4Z6 04CR0Z6 04CT3Z6 04CV4Z6 04V00C6 04V03C6 04V04C6 04VC0EZ 04VD0FZ 05H032Z 05H40MZ 05P042Z 05P3XMZ 05W032Z 05W33MZ 0SPA0JZ 0SPD3JC 0SPR4JZ 0SPU0JZ 0SPW3JZ 0SRD0LZ 0SWC4JC 0SWE3JZ 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Added Procedure Codes 0SWE4JZ 0SWEXJZ 0SWS3JZ 0SWS4JZ 0SWU0JZ 0SWU3JZ 0SWVXJZ 0SWW0JZ 0XYJ0Z0 0XYJ0Z1 30230X2 30230X3 30233G3 30233G4 30233Y4 30240G2 30240Y2 30240Y3 30243X3 30243X4 3E0Q00M 3E0Q028 3E0Q0GC 3E0Q0HZ 4A1BXSH 4A1GXSH X2RF032 X2RF332 XNS3432 XNS4032 XRG6092 XRG7092 XW03372 XW03392 0SWR3JZ 0SWT0JZ 0SWUXJZ 0SWW4JZ 0XYK0Z1 30230Y2 30233X3 30240G4 30243G2 30243Y3 3E0Q03Z 3E0Q0NZ 6ABB0BZ XHRPXL2 XRG0092 XRGA092 XW04392 0SWR4JZ 0SWT3JZ 0SWV0JZ 0SWWXJZ 30230G2 30230Y3 30233X4 30240X2 30243G3 30243Y4 3E0Q06Z 3E0Q0SF 6ABF0BZ XNS0032 XRG1092 XRGB092 XW0DX82 0SWRXJZ 0SWT4JZ 0SWV3JZ 0WY20Z0 30230G3 30230Y4 30233Y2 30240X3 30243G4 3E0Q004 3E0Q07Z 3E0Q0TZ 6ABT0BZ XNS0432 XRG2092 XRGC092 0SWS0JZ 0SWTXJZ 0SWV4JZ 0WY20Z1 30230G4 30233G2 30233Y3 30240X4 30243X2 3E0Q005 3E0Q0BZ 4A12XSH X2A5312 XNS3032 XRG4092 XRGD092 Discontinued Procedure Codes 30230G1 30230X1 30230Y1 30240X1 30240Y1 30243G1 30233G1 30243X1 30233X1 30243Y1 30233Y1 30240G1 Revised Procedure Codes 0210093 0210098 02100A8 02100A9 02100J9 02100JC 02100KC 02100KF 02100ZF 0210344 021049C 021049F 02104AF 02104AW 02104JF 02104JW 02104KW 02104Z3 0211098 0211099 02110A9 02110AC 02110JC 02110JF 02110KF 02110KW 0211344 02113D4 021149F 021149W 02114AW 02114D4 02114JW 02114K3 02114Z3 02114Z8 021009C 02100AF 02100JW 02100Z3 0210444 02104A3 02104J3 02104K8 02104Z9 021109F 02110AW 02110K3 02110Z8 0211493 02114A8 02114J8 02114K9 02114ZC 021009F 02100AW 02100K3 02100Z8 0210493 02104A8 02104J8 02104K9 02104ZC 021109W 02110J3 02110K8 02110Z9 0211498 02114A9 02114J9 02114KC 02114ZF 021009W 02100J3 02100K8 02100Z9 0210498 02104A9 02104J9 02104KC 02104ZF 02110A3 02110J8 02110K9 02110ZC 0211499 02114AC 02114JC 02114KF 0212093 02100A3 02100J8 02100K9 02100ZC 0210499 02104AC 02104JC 02104KF 0211093 02110A8 02110J9 02110KC 02110ZF 021149C 02114AF 02114JF 02114KW 0212098 ICD-10 Special Bulletin, No. 10 0SWR0JZ 0SWSXJZ 0SWU4JZ 0SWW3JZ 0XYK0Z0 30230X4 30233X2 30240G3 30240Y4 30243Y2 3E0Q029 3E0Q0KZ 6AB50BZ X2RF432 XNS4432 XRG8092 XW04372 0210099 02100AC 02100JF 02100KW 02103D4 021049W 02104D4 02104K3 02104Z8 021109C 02110AF 02110JW 02110Z3 0211444 02114A3 02114J3 02114K8 02114Z9 44 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Revised Procedure Codes 0212099 021209C 02120AC 02120AF 02120JF 02120JW 02120KW 02120Z3 02123D4 0212444 021249W 02124A3 02124D4 02124J3 02124K3 02124K8 02124Z8 02124Z9 021309C 021309F 02130AF 02130AW 02130JW 02130K3 02130Z3 02130Z8 0213444 0213493 02134A3 02134A8 02134J3 02134J8 02134K8 02134K9 02134Z9 02134ZC 021W09R 021W0AB 021W0JD 021W0JP 021W0KQ 021W0KR 021W49B 021W49D 021W4AP 021W4AQ 021W4JR 021W4KB 021W4ZD 021W4ZP 0270046 027004Z 02700ZZ 0270346 02703Z6 02703ZZ 02704TZ 02704Z6 02710T6 02710TZ 02713DZ 02713T6 02714D6 02714DZ 027204Z 02720D6 0272346 027234Z 02723ZZ 0272446 02724Z6 02724ZZ 02730TZ 02730Z6 02733T6 02733TZ 02734DZ 02734T6 ICD-10 Special Bulletin, No. 10 021209F 02120AW 02120K3 02120Z8 0212493 02124A8 02124J8 02124K9 02124ZC 021309W 02130J3 02130K8 02130Z9 0213498 02134A9 02134J9 02134KC 02134ZF 021W0AD 021W0JQ 021W0ZB 021W49P 021W4AR 021W4KD 021W4ZQ 02700D6 027034Z 0270446 02704ZZ 02710Z6 02713TZ 02714T6 02720DZ 02723D6 027244Z 0273046 02730ZZ 02733Z6 02734TZ 021209W 02120J3 02120K8 02120Z9 0212498 02124A9 02124J9 02124KC 02124ZF 02130A3 02130J8 02130K9 02130ZC 0213499 02134AC 02134JC 02134KF 021W09B 021W0AP 021W0JR 021W0ZD 021W49Q 021W4JB 021W4KP 021W4ZR 02700DZ 02703D6 027044Z 0271046 02710ZZ 02713Z6 02714TZ 02720T6 02723DZ 02724D6 027304Z 0273346 02733ZZ 02734Z6 45 02120A3 02120J8 02120K9 02120ZC 0212499 02124AC 02124JC 02124KF 0213093 02130A8 02130J9 02130KC 02130ZF 021349C 02134AF 02134JF 02134KW 021W09D 021W0AQ 021W0KB 021W0ZP 021W49R 021W4JD 021W4KQ 025W0ZZ 02700T6 02703DZ 02704D6 027104Z 0271346 02713ZZ 02714Z6 02720TZ 02723T6 02724DZ 02730D6 027334Z 0273446 02734ZZ 02120A8 02120J9 02120KC 02120ZF 021249C 02124AF 02124JF 02124KW 0213098 02130A9 02130JC 02130KF 0213344 021349F 02134AW 02134JW 02134Z3 021W09P 021W0AR 021W0KD 021W0ZQ 021W4AB 021W4JP 021W4KR 025W3ZZ 02700TZ 02703T6 02704DZ 02710D6 027134Z 0271446 02714ZZ 02720Z6 02723TZ 02724T6 02730DZ 02733D6 027344Z 027F04Z 02120A9 02120JC 02120KF 0212344 021249F 02124AW 02124JW 02124Z3 0213099 02130AC 02130JF 02130KW 02133D4 021349W 02134D4 02134K3 02134Z8 021W09Q 021W0JB 021W0KP 021W0ZR 021W4AD 021W4JQ 021W4ZB 025W4ZZ 02700Z6 02703TZ 02704T6 02710DZ 02713D6 027144Z 0272046 02720ZZ 02723Z6 02724TZ 02730T6 02733DZ 02734D6 027F34Z 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Revised Procedure Codes 027F44Z 027F4DZ 027H44Z 027J04Z 027P04Z 027P34Z 027R04Z 027R34T 027S44Z 027T04Z 027W04Z 027W0DZ 027W4DZ 027W4ZZ 02BW4ZZ 02C00ZZ 02C20ZZ 02C23ZZ 02CW3ZZ 02CW4ZZ 02HW32Z 02HW33Z 02NW0ZZ 02NW3ZZ 02Q13ZZ 02Q14ZZ 02Q34ZZ 02QW0ZZ 02RF3KH 02RF47Z 02RW0JZ 02RW0KZ 02UW07Z 02UW08Z 02UW3KZ 02UW47Z 02VW0ZZ 02VW3CZ 02WF07Z 02WF0JZ 037004Z 037034Z 037234Z 037244Z 037444Z 037504Z 037704Z 037734Z 037934Z 037944Z 037B44Z 037C04Z 037F04Z 037F34Z 037H34Z 037H44Z 037K44Z 037L04Z 037N04Z 037N34Z 037Q34Z 037Q44Z 037S44Z 037T04Z 037V04Z 037V34Z 047034Z 047044Z 047244Z 047304Z 047504Z 047534Z 047734Z 047744Z 047944Z 047A04Z ICD-10 Special Bulletin, No. 10 027G04Z 027J34Z 027P44Z 027R34Z 027T34Z 027W0ZZ 02BW0ZX 02C03ZZ 02C24ZZ 02HW00Z 02HW3DZ 02NW4ZZ 02Q20ZZ 02QW3ZZ 02RF48Z 02RW47Z 02UW0JZ 02UW48Z 02VW3DZ 02WF0KZ 037044Z 037304Z 037534Z 037744Z 037A04Z 037C34Z 037F44Z 037J04Z 037L34Z 037N44Z 037R04Z 037T34Z 037V44Z 047104Z 047334Z 047544Z 047804Z 047A34Z 027G34Z 027J44Z 027Q04Z 027R44T 027T44Z 027W34Z 02BW0ZZ 02C04ZZ 02C30ZZ 02HW02Z 02HW40Z 02Q00ZZ 02Q23ZZ 02QW4ZZ 02RF4JZ 02RW48Z 02UW0KZ 02UW4JZ 02VW3ZZ 02WF47Z 037104Z 037334Z 037544Z 037804Z 037A34Z 037C44Z 037G04Z 037J34Z 037L44Z 037P04Z 037R34Z 037T44Z 037Y04Z 047134Z 047344Z 047604Z 047834Z 047A44Z 46 027G44Z 027K04Z 027Q34Z 027R44Z 027V04Z 027W3DZ 02BW3ZX 02C10ZZ 02C33ZZ 02HW03Z 02HW42Z 02Q03ZZ 02Q24ZZ 02RF37H 02RF4KZ 02RW4JZ 02UW37Z 02UW4KZ 02VW4CZ 02WF48Z 037134Z 037344Z 037604Z 037834Z 037A44Z 037D04Z 037G34Z 037J44Z 037M04Z 037P34Z 037R44Z 037U04Z 037Y34Z 047144Z 047404Z 047634Z 047844Z 047B04Z 027H04Z 027K34Z 027Q44Z 027S04Z 027V34Z 027W3ZZ 02BW3ZZ 02C13ZZ 02C34ZZ 02HW0DZ 02HW43Z 02Q04ZZ 02Q30ZZ 02RF38H 02RW07Z 02RW4KZ 02UW38Z 02VW0CZ 02VW4DZ 02WF4JZ 037144Z 037404Z 037634Z 037844Z 037B04Z 037D34Z 037G44Z 037K04Z 037M34Z 037P44Z 037S04Z 037U34Z 037Y44Z 047204Z 047434Z 047644Z 047904Z 047B34Z 027H34Z 027K44Z 027R04T 027S34Z 027V44Z 027W44Z 02BW4ZX 02C14ZZ 02CW0ZZ 02HW30Z 02HW4DZ 02Q10ZZ 02Q33ZZ 02RF3JH 02RW08Z 02SW0ZZ 02UW3JZ 02VW0DZ 02VW4ZZ 02WF4KZ 037204Z 037434Z 037644Z 037904Z 037B34Z 037D44Z 037H04Z 037K34Z 037M44Z 037Q04Z 037S34Z 037U44Z 047004Z 047234Z 047444Z 047704Z 047934Z 047B44Z 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved. Inpatient Hospital ICD-10-PCS Revised Procedure Codes 047C04Z 047C34Z 047E34Z 047E44Z 047H44Z 047J04Z 047K34Z 047K441 047L441 047L44Z 047M44Z 047N041 047P04Z 047P34Z 047R34Z 047R44Z 047T44Z 047U04Z 047W04Z 047W34Z X2C1361 X2C2361 047C44Z 047F04Z 047J34Z 047K44Z 047M041 047N04Z 047P44Z 047S04Z 047U34Z 047W44Z X2C3361 047D04Z 047F34Z 047J44Z 047L041 047M04Z 047N341 047Q04Z 047S34Z 047U44Z 047Y04Z ICD-10 Special Bulletin, No. 10 47 047D34Z 047F44Z 047K041 047L04Z 047M341 047N34Z 047Q34Z 047S44Z 047V04Z 047Y34Z 047D44Z 047H04Z 047K04Z 047L341 047M34Z 047N441 047Q44Z 047T04Z 047V34Z 047Y44Z 047E04Z 047H34Z 047K341 047L34Z 047M441 047N44Z 047R04Z 047T34Z 047V44Z X2C0361 2016 Texas Medicaid CPT only copyright 2015 American Medical Association. All rights reserved.
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