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Care360® EHR’s Clinical Decision Support

Acceptable Codes – Quality Measures Reference Guide

CORE
Hypertension: Blood Pressure Measurement (NQF 0013) (CORE)
Definition: Percentage of patient visits for patients aged 18 years and older with a diagnosis of hypertension who have been seen for at least 2 office visits, with blood pressure recorded. Diagnosis - Hypertension ICD-9 Definition 401.0 Malignant Essential Hypertension 401.1 Benign Essential Hypertension 401.9 Unspecified Essential Hypertension 402.00 Malignant Hypertensive Heart Disease Without Heart Failure 402.01 Malignant Hypertensive Heart Disease With Heart Failure 402.10 Benign Hypertensive Heart Disease Without Heart Failure 402.11 Benign Hypertensive Heart Disease With Heart Failure 402.90 Unspecified Hypertensive Heart Disease Without Heart Failure 402.91 Unspecified Hypertensive Heart Disease With Heart Failure 403.00 Hypertensive Chronic Kidney Disease, Malignant, With Chronic Kidney Disease Stage I (One) Through Stage IV (Four), Or Unspecified 403.01 Hypertensive Chronic Kidney Disease, Malignant, With Chronic Kidney Disease Stage V (Five) Or End Stage Renal Disease 403.10 Hypertensive Chronic Kidney Disease, Benign, With Chronic Kidney Disease Stage I (One) Through Stage IV (Four), Or Unspecified 403.11 Hypertensive Chronic Kidney Disease, Benign, With Chronic Kidney Disease Stage V (Five) Or End Stage Renal Disease 403.90 Hypertensive Chronic Kidney Disease, Unspecified, With Chronic Kidney Disease Stage I (One) Through Stage IV (Four), Or Unspecified 403.91 Hypertensive Chronic Kidney Disease, Unspecified, With Chronic Kidney Disease Stage V (Five) Or End Stage Renal Disease 404.00 Hypertensive Heart And Chronic Kidney Disease, Malignant, Without Heart Failure And With Chronic Kidney Disease Stage I (One) Through Stage IV (Four), Or Unspecified 404.01 Hypertensive Heart And Chronic Kidney Disease, Malignant, With Heart Failure And With Chronic Kidney Disease Stage I (One) Through Stage IV (Four), Or Unspecified 404.02 Hypertensive Heart And Chronic Kidney Disease, Malignant, Without Heart Failure And With Chronic Kidney Disease Stage V (Five) Or End Stage Renal Disease 404.03 Hypertensive Heart And Chronic Kidney Disease, Malignant, With Heart Failure And With Chronic Kidney Disease Stage V (Five) Or End Stage Renal Disease 404.10 Hypertensive Heart And Chronic Kidney Disease, Benign, Without Heart Failure And With Chronic Kidney Disease Stage I (One) Through Stage IV (Four), Or Unspecified 404.11 Hypertensive Heart And Chronic Kidney Disease, Benign, With Heart Failure Or 1

404.12 404.13 404.90

404.91

404.92

404.93

And With Chronic Kidney Disease Stage I (One) Through Stage IV (Four), Or Unspecified Hypertensive Heart And Chronic Kidney Disease, Benign, Without Heart Failure And With Chronic Kidney Disease Stage V (Five) Or End Stage Renal Disease Hypertensive Heart And Chronic Kidney Disease, Benign, With Heart Failure And Chronic Kidney Disease Stage V (Five) Or End Stage Renal Disease Hypertensive Heart And Chronic Kidney Disease, Unspecified, Without Heart Failure And With Chronic Kidney Disease Stage I (One) Through Stage IV (Four), Or Unspecified Hypertensive Heart And Chronic Kidney Disease, Unspecified, With Heart Failure And With Chronic Kidney Disease Stage I (One) Through Stage IV (Four), Or Unspecified Hypertensive Heart And Chronic Kidney Disease, Unspecified, Without Heart Failure And With Chronic Kidney Disease Stage V (Five) Or End Stage Renal Disease Hypertensive Heart And Chronic Kidney Disease, Unspecified, With Heart Failure And Chronic Kidney Disease Stage V (Five) Or End Stage Renal Disease

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Preventative Care and Screening Measure Pair: Tobacco Use Assessment and Tobacco Cessation Intervention (NQF 0028) (CORE)
Description: Percentage of patients aged 18 years or older who have been seen for at least 2 office visits, who were queried about tobacco use one or more times within 24 months. Percentage of patients aged 18 years and older identified as tobacco users within the past 24 months who and have been seen for at least 2 office visits, who received cessation intervention. Procedures - Enter in SOAP note or past medical History CPT Description 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES 99407 TOBACCO USE CESSATION INTENSIVE >10 MINUTES Advised to quit and given medication - Enter in procedures in SOAP note 4001F TOBACCO USE CESSATION IVNTJ PHARMACOLOGIC THER Medication RxNorm Descripition 105075 16 HR Nicotine 0.313 MG/HR Transdermal Patch 198029 24 HR Nicotine 0.583 MG/HR Transdermal Patch 198030 24 HR Nicotine 0.875 MG/HR Transdermal Patch 198031 24 HR Nicotine 0.292 MG/HR Transdermal Patch 198406 16 HR Nicotine 0.625 MG/HR Transdermal Patch 198407 16 HR Nicotine 0.938 MG/HR Transdermal Patch 227177 Nicotine 2 MG Sublingual Tablet 250983 Nicotine 4 MG/ACTUAT Inhalant Solution 311975 Nicotine 4 MG Chewing Gum 314119 Nicotine 2 MG Chewing Gum 359817 Nicotine 2 MG Lozenge 359818 Nicotine 4 MG Lozenge 388082 Nicotine 1 MG Lozenge Encounters: Health and behavior assessment CPT 96150 96152 Descripition HLTH&BEHAVIOR ASSMT EA 15 MIN F2F W/PT 1ST ASSMT HLTH&BEHAVIOR IVNTJ EA 15 MIN F2F INDIV

Occupational therapy CPT 97003 97004 Descripition OCCUPATIONAL THER EVAL OCCUPATIONAL THER RE-EVAL

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Psychiatric & psychologic CPT 90801 90802 90804 90805 90806 90807 90808 90809 90810 90811 90812 90813 90814 90815 90845 90862 Descripition PSYC DX INTERVIEW XM INTERACTIVE PSYCHIATRIC DX EXAM, USING PLAY EQUIPMENT/PX DEVICES/LANGUAGE INTERPRETER/OTHER IPI-OB-M/S OFFICE 20-30 MIN PSYTX, OFF, 20-30 MIN W/E&M PSYTX, OFF, 45-50 MIN IPI-OB-M/S OFFICE 45-50 MIN MEDICAL E/M IPI-OB-M/S OFFICE 75-80 MIN IPI-OB-M/S OFFICE 75-80 MIN MEDICAL E/M INDIV PSYCTX IA 20-30 MIN INDIV PSYCTX IA 20-30 MIN MEDICAL E/M INDIV PSYCTX IA 45-50 MIN INDIV PSYCTX IA 45-50 MIN MEDICAL E/M INDIV PSYCTX IA 45-50 MIN MEDICAL E/M INDIV PSYCTX IA 75-80 MIN MEDICAL E/M PSYCHOALYS PHARMACOLOGIC MGMT MIN MEDICAL PSYCTX

Individual counseling CPT 99401 99401 99402 99403 99404 Descripition PREVENTIVE MEDICINE COUNSELING, INDIV; 15 MIN PREVENTIVE MEDICINE COUNSELING, INDIV; 15 MIN PREVENTIVE MEDICINE COUNSELING, INDIV; 30 MIN PREVENTIVE MEDICINE COUNSELING, INDIV; 45 MIN 'PREV MED CNSL INDIV SPX 60 MIN

Group counseling CPT 99411 99411 99412 Descripition PREV MED CNSL GRP SPX 30 MIN PREV MED CNSL GRP SPX 30 MIN PREV MED CNSL GRP SPX 60 MIN

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Other preventive medical services quality CPT 99420 99420 99429 Descripition ADMN&INTERPJ HLTH RISK ASSMT INSTRUMENT ADMN&INTERPJ HLTH RISK ASSMT INSTRUMENT UNLIS PREV MED SVC

Advised to quit and given Counseling - Enter in SOAP note or past medical history CPT Descripition 4000F- TOBACCO USE CESSATION IVNTJ COUNSELING Active users of tobacco products 171055003 Smoking in pregnancy education 185792005 Stop smoking monitoring first letter 185793000 Stop smoking monitoring second letter 185794006 Stop smoking monitoring third letter 185795007 Stop smoking monitoring verbal invite 185796008 Stop smoking monitoring telephone invite 225323000 Smoking cessation education 225324006 Smoking effects education 310429001 Smoking monitoring invitation 315232003 Referral to stop-smoking clinic 384742004 Smoking cessation assistance

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84 Young multigravida V23.2 Pregnant State.49 Supervision Of High-risk Pregnancy With other poor obstetric history V23.5 Supervision Of High-risk Pregnancy With Other Poor Reproductive History V23.3 Supervision Of High-risk Pregnancy With Grand Multiparity V23.7 Supervision Of High-risk Pregnancy With Insufficient Prenatal Care V23.0 Supervision Of High-risk Pregnancy With History Of Infertility V23.1 Supervision Of High-risk Pregnancy With History Of Trophoblastic Disease V23. Labor.1 Encounter for antenatal screening for raised alpha-fetoprotein levels in amniotic fluid of mother V28. Incidental V23.82 Elderly multigravida V23. The likelihood of being asked about diet or physical activity during a routine checkup declined with age (Real-Time and Prospective Rule).1 Supervision Of Other Normal Pregnancy V22.2 Supervision Of High-risk Pregnancy With History Of Abortion V23.41 Supervision Of High-risk Pregnancy With history of pre-term labor V23.86 Pregnancy with history of in utero procedure during previous pregnancy V23.4 Encounter for antenatal screening for fetal growth retardation using ultrasonics of mother 6 . Diagnosis Active – pregnancy ICD-9-CM Description 630…633 Ectopic and Molar Pregnancy 634…639 Other Pregnancy with Abortive Outcome 640…649 Complications Mainly Related to Pregnancy Normal Delivery and other Indications for care in Pregnancy.2 Encounter for other antenatal screening based on amniocentesis of mother V28.83 Young primigravida V23.85 Pregnancy resulting from assisted reproductive technology V23.Adult Weight Screening and Follow-up (NQF 0421) (CORE) Description: Of the Medicare population. and 650…659 Delivery 660…669 Complications Occurring Mainly in the Course of Labor and Delivery 670…677 Complications of the Puerperium V22.0 Encounter for antenatal screening for chromosomal anomalies by amniocentesis of mother V28.89 Other high-risk pregnancy V23.81 Elderly primigravida V23. 37% are overweight and 18% are obese.0 Supervision Of Normal First Pregnancy V22.9 Supervision of unspecified high-risk pregnancy V28.3 Encounter for routine antenatal screening for malformation using ultrasonics of mother V28.

82 V28.89 V28.V28.81 V28.5 V28.3 Dietary surveillance and counseling Care Plan . without gastric bypass.follow-up plan_BMI management CPT Description 43644 LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y <150 CM 43645 LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ 43770 LAPS GASTRIC RESTRICTIVE PROCEDURE PLACE DEVICE 43771 LAPS GASTRIC RESTRICTIVE PX REVISION DEVICE 43772 LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE 43773 LAPS GASTRIC RESTRICTIVE PX REMOVE&RPLCMT DEVICE 43774 LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE &PORT 43842 GSTR RSTCV W/O BYP VER-BANDED GSTP Gastric restrictive procedure.follow-up plan_BMI management SNOMEDCT Description 169411000 Vitamin/diet support therapy 170795002 Follow-up obesity assessment 225171007 Weight and body mass assessment procedure 268523001 Target weight discussed 275919002 Weight loss advised 305849009 Seen by dietetics . for morbid obesity.service 307818003 Weight monitoring 7 .follow-up plan_BMI management ICD-9CM Description V65.6 V28.9 Encounter for antenatal screening for isoimmunization of mother Encounter for antenatal screening for Streptococcus B of mother Encounter for fetal anatomic survey Encounter for screening for risk of pre-term labor Other specified antenatal screening Encounter for unspecified antenatal screening of mother Care Plan . other 43843 than vertical-banded gastroplasty 43845 GSTR RSTCV W/PRTL GSTRCT 50-100 CM 43846 GSTR RSTCV W/BYP W/SHORT LIMB 150 CM/< 43847 GSTR RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ 43848 REVISION OPEN GASTRIC RESTRICTIVE PX NOT DEVICE 97804 MED NUTR THER GRP2/> INDIV EA 30 MIN 98961 EDUCAJ&TRAINJ F/PT SELF-MGMT BY NONPHYS 2-4 PT 98962 EDUCAJ&TRAINJ F/PT SELF-MGMT BY NONPHYS 5-8 PTS 99078 PHYS EDUCATIONAL SVCS RENDERED PTS GRP SETTING Care Plan .

early stage 162608008 Terminal illness .late stage 300936002 Terminal disease Encounter – encounter_outpatient_CPT_with clinician CPT Description 90801 PSYC DX INTERVIEW XM 90802 IA PSYC DX INTERVIEW XM W/PLAY 90804 IPI-OB-M/S OFFICE 20-30 MIN 90805 IPI-OB-M/S OFFICE 20-30 MIN MEDICAL E/M 90806 IPI-OB-M/S OFFICE 45-50 MIN 90807 IPI-OB-M/S OFFICE 45-50 MIN MEDICAL E/M 90808 IPI-OB-M/S OFFICE 75-80 MIN 90809 IPI-OB-M/S OFFICE 75-80 MIN MEDICAL E/M 97001 PHYSICAL THER EVAL 97003 OCCUPATIONAL THER EVAL 97802 MED NUTR THER 1ST ASSMT&IVNTJ INDIV EA 15 MIN 97803 MED NUTR THER RE-ASSMT&IVNTJ INDIV EA 15 MIN 98960 EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT 99201 OFFICE OUTPT NEW 10 MIN 99202 OFFICE OUTPT NEW 20 MINUTES 99203 OFFICE OUTPT NEW 30 MIN 99204 OFFICE OUTPT NEW 45 MIN 99205 OFFICE OUTPT NEW 60 MIN 99211 OFFICE O/P EST 5 MIN 99212 OFFICE OUTPT EST 10 MIN 99213 OFFICE OUTPT EST15 MIN 99214 OFFICE OUTPT EST 25 MIN 99215 OFFICE OUTPT EST 40 MIN 99324 DOM/R-HOME LW SEVERITY 8 .401003006 Weight loss from baseline weight Communication provider to provider .dietary consultation order SNOMEDCT Description 103699006 Patient referral to dietitian 306163007 Referral to dietetics service 408289007 Refer to weight management program Patient characteristic – terminal illness SNOMEDCT Description 162607003 Terminal illness .

99325 99326 99327 99328 99334 99335 99336 99337 99341 99342 99343 99344 99345 99347 99348 99349 99350 DOM/R-HOME E/M NEW PT MOD SEVERITY DOM/R-HOME E/M NEW PT MOD HI SEVERITY DOM/R-HOME E/M NEW PT HI SEVERITY DOM/R-HOME E/M NEW PT SIGNIFICANT NEW PROBLEM DOM/R-HOME E/M EST PT SELF-LMTD/MINOR DOM/R-HOME E/M EST PT LW MOD SEVERITY DOM/R-HOME E/M EST PT MOD HI SEVERITY DOM/R-HOME E/M EST PT SIGNIFICANT NEW PROBLEM HOME VST NEW PT LOW SEVERITY HOME VST NEW PT MOD SEVERITY HOME VST NEW PT MOD TO HI SEVERITY HOME VST NEW PT HI SEVERITY HOME VST NEW PT UNSTABLE/SIGNIFICANT NEW PROBLEM HOME VST EST PT SELF LIMITED/MINOR HOME VST EST PT LOW TO MOD SEVERITY HOME VST EST PT MOD TO HI SEVERITY HOME VST EST PT UNSTABLE/SIGNIFICANT NEW PROBLEM 9 .

5 V23.9 V28.1 V23. Active diagnosis of pregnancy ICD-9 Descripition 630.659 Delivery 660..0 Supervision Of Normal First Pregnancy V22. Incidental Supervision Of High-risk Pregnancy With History Of Infertility Supervision Of High-risk Pregnancy With History Of Trophoblastic Disease Supervision Of High-risk Pregnancy With History Of Abortion Supervision Of High-risk Pregnancy With Grand Multiparity Supervision Of High-risk Pregnancy With history of pre-term labor Supervision Of High-risk Pregnancy With other poor obstetric history Supervision Of High-risk Pregnancy With Other Poor Reproductive History Supervision Of High-risk Pregnancy With Insufficient Prenatal Care Elderly primigravida Elderly multigravida Young primigravida Young multigravida Pregnancy resulting from assisted reproductive technology Pregnancy with history of in utero procedure during previous pregnancy Other high-risk pregnancy Supervision of unspecified high-risk pregnancy Encounter for antenatal screening for chromosomal anomalies by amniocentesis of mother Encounter for antenatal screening for raised alpha-fetoprotein levels in amniotic fluid of mother 10 .ALTERNATE CORE Weight Assessment and Counseling for Children and Adolescents (NQF 0024) (Alternate CORE) Description: The percentage of patients 2‐17 years of age who had an outpatient visit with a PCP or OB/GYN and who had evidence of BMI percentile documentation..84 V23..49 V23...83 V23.677 Complications of the Puerperium V22..633 Ectopic and Molar Pregnancy 634..669 Complications Occurring Mainly in the Course of Labor and Delivery 670.89 V23.2 V23.82 V23.649 Complications Mainly Related to Pregnancy Normal Delivery and other Indications for care in Pregnancy.41 V23.1 V22.3 V23.81 V23.2 V23.7 V23.639 Other Pregnancy with Abortive Outcome 640. and 650... counseling for nutrition and counseling for physical activity during the measurement year.85 V23.86 V23..1 Supervision Of Other Normal Pregnancy Pregnant State. Labor...0 V23.0 V28.

41 Exercise counseling OB/GYN Encounter.7 Other unwanted pregnancy V69.Enter in procedures 97802 MED NUTR THER 1ST ASSMT&IVNTJ INDIV EA 15 MIN 97803 MED NUTR THER RE-ASSMT&IVNTJ INDIV EA 15 MIN 97804 Medical nutrition therapy. group (2 or more individual(s)).9 Encounter for other antenatal screening based on amniocentesis of mother Encounter for routine antenatal screening for malformation using ultrasonics of mother Encounter for antenatal screening for fetal growth retardation using ultrasonics of mother Encounter for antenatal screening for isoimmunization of mother Encounter for antenatal screening for Streptococcus B of mother Encounter for fetal anatomic survey Encounter for screening for risk of pre-term labor Other specified antenatal screening Encounter for unspecified antenatal screening of mother BMI measurements – enter height and weight in vitals Counseling for nutrition.2 V28.5 Presence of contraceptive device V61.Enter in procedures ICD-9 Descripition V65.6 V28.89 V28.CPT codes.ICD-9 code .81 V28.6 Illegitimacy or illegitimate pregnancy V61. each 30 minutes V65.3 Special investigations and examinations .5 V28.82 V28.4 Pregnancy examination or test 11 .4 V28.3 V28.3 Dietary surveillance and counseling Counseling for physicial activity.V28.Gynecological examination V72.5 Multiparity V61.2 High-risk sexual behavior V72.Enter in past medical history ICD9 Description V24 Postpartum care and examination V25 Encounter for contraceptive management V26 Procreative management V27 Outcome of delivery V28 Encounter for antenatal screening of mother V45.

tetanus and acellular pertussis (DTaP). two H influenza type B (HiB). The measure calculates a rate for each vaccine and two separate combination rates. one measles.51 Encephalitis and encephalomyelitis following immunization procedures SNOMED 230363006 Progressive neuronal degeneration of childhood 292925004 Streptomycin adverse reaction 292927007 Neomycin adverse reaction 292992006 Polymyxin B adverse reaction Diagnosis (active or resolved) of measles ICD-9 Description 55 Measles Diagnosis of HIV.Childhood Immunization Status (NQF 0038) (Alternate CORE) Description: The percentage of children 2 years of age who had four diphtheria. two hepatitis A (Hep A). immunodeficiency. one chicken pox (VZV). mumps and rubella (MMR). four pneumococcal conjugate (PCV). three hepatitis B (Hep B). two or three rotavirus (RV). or cancer of lymphoreticular or histiocytic tissue ICD-9 42 V08 201 202 203 200 202 204 205 206 207 208 279 203 Description Human immunodeficiency virus [HIV] disease Asymptomatic human immunodeficiency virus [HIV] infection status Hodgkin's disease Other malignant neoplasms of lymphoid and histiocytic tissue Multiple myeloma and immunoproliferative neoplasms Lymphosarcoma and reticulosarcoma and other specified malignant tumors of lymphatic tissue Other malignant neoplasms of lymphoid and histiocytic tissue Lymphoid leukemia Myeloid leukemia Monocytic leukemia Other specified leukemia Leukemia of unspecified cell type Disorders involving the immune mechanism Multiple myeloma and immunoproliferative neoplasms 12 . and two influenza (flu) vaccines by their second birthday. three polio (IPV). leukemia. multiple myeloma. Diagnosis of encephalopathy or progressive neurological disorder ICD-9 Description 323.

05 MG/ML / Haemophilus capsular oligosaccharide 0.0 Viral hepatitis A with hepatic coma 070.936 MG/ML / Diphtheria Toxoid Vaccine 13.2 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Injectable Suspension Diphtheria Toxoid Vaccine 13.2 Viral hepatitis B with hepatic coma 070.Diagnosis (active or resolved) of Hepatitis B ICD-9 Description 070.036 MG/ML / Haemophilus capsular oligosaccharide 0.5 ML Acellular Pertussis Vaccine 0. capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / Inactivated Polioviruses Type 798347 802049 805375 13 .61 Hepatitis B carrier Diagnosis (active or resolved) of varicella (chicken pox) ICD-9 Description 052 Chickenpox 053 Herpes zoster Diagnosis (resolved) of hepatitis A ICD-9 Description 070.02 MG/ML Injectable Suspension Acellular Pertussis Vaccine 0.2 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Injectable Suspension Acellular Pertussis Vaccine 96 UNT/ML / Diphtheria Toxoid Vaccine 30 UNT/ML / Haemophilus influenzae b.4 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Injectable Solution Acellular Pertussis Vaccine 0.4 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Injectable Suspension Diphtheria Toxoid Vaccine 13.0936 MG/ML / Diphtheria Toxoid Vaccine 13.08 MG/ML / Diphtheria Toxoid Vaccine 15 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Injectable Suspension Acellular Pertussis Vaccine 8 UNT/ML / Diphtheria Toxoid Vaccine 13.1 Viral hepatitis A without mention of hepatic coma RxNORM Description Diphtheria Toxoid 30 UNT/ML / Tetanus Toxoid 20 UNT/ML Injectable 204525 Suspension 205257 205259 260122 562372 795926 795930 795938 795939 795942 798309 Diphtheria Toxoid 4 UNT/ML / Tetanus Toxoid 20 UNT/ML Injectable Suspension Diphtheria Toxoid Vaccine 4 UNT/ML / Tetanus Toxoid Vaccine 4 UNT/ML Injectable Suspension Diphtheria Toxoid 0.3 Viral hepatitis B without mention of hepatic coma V02.4 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Injectable Suspension 0.936 UNT/ML / Diphtheria Toxoid Vaccine 13.05 MG/ML Injectable Solution Acellular Pertussis Vaccine 0.4 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Injectable Suspension Diphtheria Toxoid Vaccine 0.08 MG/ML / Diphtheria Toxoid Vaccine 30 UNT/ML / Tetanus Toxoid Vaccine 12 UNT/ML Injectable Suspension Acellular Pertussis Vaccine 0.

037 MG/ML / Diphtheria Toxoid Vaccine 5 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Prefilled Syringe Diphtheria Toxoid Vaccine 4 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Injectable Suspension Acellular Pertussis Vaccine 8 UNT/ML / Diphtheria Toxoid Vaccine 25 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Injectable Suspension Acellular Pertussis Vaccine 50 UNT/ML / Diphtheria Toxoid Vaccine 50 UNT/ML / Tetanus Toxoid Vaccine 20 UNT/ML Injectable Suspension Acellular Pertussis Vaccine 0. type 2 (MEF-1) 16 UNT/ML / Poliovirus vaccine inactivated.046 MG/ML / Diphtheria Toxoid Vaccine 30 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Injectable Suspension IPV = Inactivated Polio Vaccine RxNORM Description 763103 Poliovirus vaccine inactivated. type 3 (Saukett) 64 UNT/ML / Tetanus Toxoid Vaccine 20 UNT/ML Prefilled Syringe Acellular Pertussis Vaccine 0. type 1 (Mahoney) 80 UNT/ML / Poliovirus vaccine inactivated.116 MG/ML / Diphtheria Toxoid Vaccine 50 UNT/ML / Poliovirus vaccine inactivated. type 2 (MEF-1) 16 UNT/ML / Poliovirus vaccine inactivated.5 ML Acellular Pertussis Vaccine 0. type 1 (Mahoney) 80 UNT/ML / Poliovirus 14 .4 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Injectable Suspension Acellular Pertussis Vaccine 0.02 MG/ML / Poliovirus vaccine inactivated. Mahoney strain vaccine 80 UNT/ML / Inactivated Polioviruses Type 2.116 MG/ML / Diphtheria Toxoid Vaccine 50 UNT/ML / Hepatitis B Surface Antigen Vaccine 0.116 MG/ML / Diphtheria Toxoid Vaccine 50 UNT/ML / Poliovirus vaccine inactivated.805379 806587 806593 807277 807415 824542 829894 829971 829987 830518 830549 830555 830893 835879 1.02 MG/ML / Poliovirus vaccine inactivated.5 ML Acellular Pertussis Vaccine 0.037 MG/ML / Diphtheria Toxoid Vaccine 5 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Injectable Suspension 0. type 3 (Saukett) 64 UNT/ML / Tetanus Toxoid Vaccine 20 UNT/ML Injectable Suspension 0. type 3 (Saukett) 64 UNT/ML / Tetanus Toxoid Vaccine 20 UNT/ML Prefilled Syringe Acellular Pertussis Vaccine 0.116 MG/ML / Diphtheria Toxoid Vaccine 50 UNT/ML / Tetanus Toxoid Vaccine 20 UNT/ML Injectable Suspension Acellular Pertussis Vaccine 0. type 1 (Mahoney) 80 UNT/ML / Poliovirus vaccine inactivated.031 MG/ML / Diphtheria Toxoid Vaccine 4 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Injectable Suspension Acellular Pertussis Vaccine 0. type 1 (Mahoney) 80 UNT/ML / Poliovirus vaccine inactivated. Saukett strain vaccine 64 UNT/ML / Tetanus Toxoid Vaccine 20 UNT/ML Injectable Suspension Diphtheria Toxoid Vaccine 13.5 ML Acellular Pertussis Vaccine 0. type 2 (MEF-1) 16 UNT/ML / Poliovirus vaccine inactivated. type 1 (Mahoney) 80 UNT/ML / Poliovirus vaccine inactivated.116 MG/ML / Diphtheria Toxoid Vaccine 50 UNT/ML / Hepatitis B Surface Antigen Vaccine 0.08 MG/ML / Diphtheria Toxoid Vaccine 18 UNT/ML / Tetanus Toxoid Vaccine 10 UNT/ML Injectable Suspension Acellular Pertussis Vaccine 0. type 3 (Saukett) 64 UNT/ML / Tetanus Toxoid Vaccine 20 UNT/ML Injectable Suspension 0. type 2 (MEF-1) 16 UNT/ML / Poliovirus vaccine inactivated. MEF-1 strain vaccine 16 UNT/ML / Inactivated Polioviruses Type 3.

048 MG/ML Injectable Solution Haemophilus influenzae b. type 2 (MEF-1) 16 UNT/ML / Poliovirus vaccine inactivated.LIVE ATTENUATED 2000 UNT/ML Injectable Solution Measles Vaccine 2000 UNT/ML Injectable Solution Measles Virus Vaccine Live. Jeryl Lynn Strain 40000 UNT/ML / Rubella Virus Vaccine Live (Wistar RA 27-3 Strain) 2000 UNT/ML Injectable Solution Measles RxNORM 346512 547240 804183 805494 Rubella RxNORM 762820 Description MEASLES VIRUS VACCINE. Jeryl Lynn Strain 25000 UNT/ML / Rubella Virus Vaccine Live (Wistar RA 27-3 Strain) 2000 UNT/ML Injectable Solution Measles Virus Vaccine Live. Jeryl Lynn Strain 40000 UNT/ML Injectable Solution Mumps Virus Vaccine Live. Mumps.068 MG/ML Injectable Solution 15 .068 MG/ML Injectable Solution 0. and Rubella (German Measles) RxNORM Description Rubella Virus Vaccine Live (Wistar RA 27-3 Strain) 2000 UNT/ML Injectable 762820 Solution Mumps Virus Vaccine Live.866820 vaccine inactivated. capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 0. Enders' attenuated Edmonston strain 2000 UNT/ML / Mumps Virus Vaccine Live. type 3 (Saukett) 64 UNT/ML Injectable Solution 0. Enders' attenuated Edmonston strain 2000 UNT/ML / Mumps Virus Vaccine Live. type 2 (MEF-1) 16 UNT/ML / Poliovirus vaccine inactivated.5 ML Poliovirus vaccine inactivated.02 MG/ML / Tetanus Toxoid 0.5 ML Haemophilus influenzae b. capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 0. type 1 (Mahoney) 80 UNT/ML / Poliovirus vaccine inactivated. Jeryl Lynn Strain 40000 UNT/ML / Rubella Virus Vaccine Live (Wistar RA 27-3 Strain) 2000 UNT/ML / Varicella Virus Vaccine Live (Oka-Merck) strain 20000 UNT/ML Injectable Solution Description Rubella Virus Vaccine Live (Wistar RA 27-3 Strain) 2000 UNT/ML Injectable Solution H influenza type B = HiB = meningitis vaccine RxNORM Description 260123 798282 798348 Haemophilus capsular oligosaccharide 0. type 3 (Saukett) 64 UNT/ML Prefilled Syringe MMR = Measles. Jeryl Lynn Strain 40000 UNT/ML / Rubella Virus 805077 Vaccine Live (Wistar RA 27-3 Strain) 2000 UNT/ML Injectable Solution Mumps RxNORM 798375 805077 Description Mumps Virus Vaccine Live.

05 MG/ML 854947 pneumococcal capsular polysaccharide type 19A vaccine 0.5 ML Hepatitis B Vaccine 0.01 MG/ML Injectable Suspension Haemophilus influenzae b (Ross strain) capsular polysaccharide Meningococcal Protein Conjugate Vaccine 0.02 MG/ML Prefilled Syringe Chicken pox vaccine (VZV) = varicella RxNORM Description 106483 varicella-zoster immune globulin 50 MG/ML Injectable Solution 252016 varicella-zoster immune globulin 100 UNT/ML Injectable Solution 646808 varicella-zoster immune globulin 50 UNT/ML Injectable Solution Pneumococcal conjugate = pneumonia vaccine RxNORM Description 854931 pneumococcal capsular polysaccharide type 1 vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 23F vaccine 0.04 MG/ML Injectable Suspension Hepatitis A Vaccine.02 MG/ML Injectable Suspension 0.02 MG/ML Injectable Suspension HEPATITIS B VACCINE (RECOMBINANT) 0.05 MG/ML pneumococcal capsular polysaccharide type 3 vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 33F vaccine 0.265 MG/ML Injectable Suspension haemophilus b polysaccharide vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 22F vaccine 0.02 MG/ML Description HEPATITIS B VACCINE (RECOMBINANT) 0.05 MG/ML 854941 pneumococcal capsular polysaccharide type 15B vaccine 0.01 MG/ML Injectable Suspension HEPATITIS B VACCINE (RECOMBINANT) 0.05 MG/ML 854939 pneumococcal capsular polysaccharide type 14 vaccine 0.05 MG/ML 854943 pneumococcal capsular polysaccharide type 17F vaccine 0.05 MG/ML 854951 pneumococcal capsular polysaccharide type 2 vaccine 0.05 MG/ML 854945 pneumococcal capsular polysaccharide type 18C vaccine 0.05 MG/ML 854949 pneumococcal capsular polysaccharide type 19F vaccine 0.05 MG/ML .05 MG/ML 854933 pneumococcal capsular polysaccharide type 10A vaccine 0.265 MG/ML / Hepatitis B Surface Antigen Vaccine 0.05 MG/ML 854937 pneumococcal capsular polysaccharide type 12F vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 5 vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 4 vaccine 0. Inactivated 720 UNT/ML / Hepatitis B Vaccine 0.05 MG/ML 854953 854955 854957 854959 854961 854963 854965 16 pneumococcal capsular polysaccharide type 20 vaccine 0.05 MG/ML 854935 pneumococcal capsular polysaccharide type 11A vaccine 0.798440 798447 860904 Hepatitis B RxNORM 310752 310753 310756 606375 763313 Haemophilus influenzae b (Ross strain) capsular polysaccharide Meningococcal Protein Conjugate Vaccine 0.

05 MG/ML pneumococcal capsular polysaccharide type 7F vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 12F vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 9V vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 5 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 22F vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 9N vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 15B vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 9N vaccine 0.02 MG/ML Injectable Suspension 1 ML Hepatitis A Vaccine (Inactivated) Strain HM175 720 UNT/ML / Hepatitis B Surface Antigen Vaccine 0.5 ML Hepatitis A Vaccine (Inactivated) Strain HM175 1440 UNT/ML Prefilled Syringe Hepatitis A Vaccine (Inactivated) Strain HM175 720 UNT/ML / Hepatitis B Surface Antigen Vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 6B vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 18C vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 20 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 9V vaccine 0.854967 854969 854971 854973 854975 854977 pneumococcal capsular polysaccharide type 6B vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 11A vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 2 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 3 vaccine 0.02 MG/ML Prefilled Syringe Rotavirus vaccine RxNORM Description 17 .05 MG/ML / pneumococcal capsular polysaccharide type 17F vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 10A vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 7F vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 33F vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 4 vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 1 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 19A vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 19F vaccine 0.05 MG/ML Injectable Solution Hepatitis A RxNORM Description Hepatitis A Vaccine (Inactivated) Strain HM175 1440 UNT/ML Injectable 798364 Suspension 1 ML Hepatitis A Vaccine (Inactivated) Strain HM175 1440 UNT/ML Prefilled 798477 Syringe 798481 803364 803369 0.05 MG/ML pneumococcal capsular polysaccharide type 8 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 8 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 14 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 23F vaccine 0.

Inactivated A-Brisbane-59-2007. Inactivated A-Brisbane-59-2007.03 MG/ML / Influenza Virus Vaccine. Inactivated A-Brisbane-59-2007 (H1N1) strain 0. IVR-148 (H1N1) strain 0. G1P[8] Human 89-12 strain 1000000 UNT/ML Oral Suspension Influenza vaccine RxNORM Description Influenza Virus Vaccine.03 MG/ML / Influenza Virus Vaccine. A-South Dakota-6-2007 (H1N1) (A-Brisbane-59-2007-like) strain 158000000 UNT/ML / Influenza Virus Vaccine. Inactivated A-Brisbane-59-2007 (H1N1)-like virus (A-Brisbane-592007 IVR-148) strain 0. Inactivated AUruguay-716-2007. Inactivated B-Brisbane-60-2008 strain 0. B-Florida-4-2006 strain 158000000 UNT/ML Nasal Spray 0. Inactivated A-Uruguay-7162007. Inactivated. Inactivated B-Brisbane-60-2008 strain 0.03 MG/ML Prefilled Syringe Influenza Virus Vaccine. Inactivated B-Brisbane-60-2008 strain 0.25 ML Influenza Virus Vaccine. Live Attenuated.03 MG/ML / Influenza Virus Vaccine.5 ML Influenza Virus Vaccine. IVR-148 (H1N1) strain 0.03 MG/ML Injectable Suspension 0.03 MG/ML Prefilled Syringe Influenza Virus Vaccine.5 ML Influenza Virus Vaccine. NYMC X-175C (H3N2) strain 0. NYMC X-175C (H3N2) strain 0.03 MG/ML / Influenza Virus Vaccine. Inactivated A-Brisbane-59-2007.798297 805576 Human-Bovine Reassortant Rotavirus Strain G1 Vaccine 1100000 UNT/ML / Human-Bovine Reassortant Rotavirus Strain G2 Vaccine 1400000 UNT/ML / Human-Bovine Reassortant Rotavirus Strain G3 Vaccine 1100000 UNT/ML / Human-Bovine Reassortant Rotavirus Strain G4 Vaccine 1000000 UNT/ML / Human-Bovine Reassortant Rotavirus Strain P1A[8] Vaccine 1150000 UNT/ML Oral Suspension Rotavirus Vaccine. Inactivated.03 MG/ML / Influenza Virus Vaccine.03 MG/ML / Influenza Virus Vaccine.03 MG/ML / Influenza Virus Vaccine.03 MG/ML Prefilled Syringe 0. Inactivated A-Brisbane-59-2007 (H1N1)-like virus (ABrisbane-59-2007 IVR-148) strain 0. IVR-148 (H1N1) strain 0. Inactivated B-Florida-4-2006 strain 0. Live Attenuated. NYMC X-175C (H3N2) strain 0. Inactivated A-Uruguay-7162007 (H3N2) (A-Brisbane-10-2007-like) strain 0.03 MG/ML / Influenza Virus Vaccine.03 MG/ML / Influenza Virus Vaccine. Live Attenuated.25 ML Influenza Virus Vaccine. B-Florida-4-2006-like virus (B-Florida-4-2006) strain 0. A-Uruguay -716-2007 (H3N2) (A-Brisbane-102007-like) strain 158000000 UNT/ML / Influenza Virus Vaccine.03 MG/ML / Influenza Virus Vaccine. BFlorida-4-2006-like virus (B-Florida-4-2006) strain 0. Live Attenuated. Inactivated A-Brisbane-10-2007 (H3N2)-like virus (A-Uruguay-716-2007 NYMC X-175C) strain 0.03 MG/ML Injectable Suspension 0.25 ML influenza A-California-7-2009-(H1N1)v-like virus vaccine 0.03 MG/ML Prefilled Syringe 0. Inactivated A-Brisbane-10-2007 (H3N2)-like virus (A-Uruguay-716-2007 NYMC X-175C) strain 0. Inactivated AUruguay-716-2007.03 MG/ML / Influenza Virus Vaccine.03 MG/ML Prefilled Syringe 805527 805533 805544 805571 857924 857942 857965 864781 18 .03 MG/ML / Influenza Virus Vaccine.

2 ML influenza A-California-7-2009-(H1N1)v-like virus vaccine 158000000 UNT/ML Nasal Spray 19 .864797 864814 0.03 MG/ML Prefilled Syringe 0.5 ML influenza A-California-7-2009-(H1N1)v-like virus vaccine 0.

03 MG/ML / Influenza Virus Vaccine. NYMC X-175C (H3N2) strain 0. Inactivated A-Brisbane-59-2007. IVR-148 (H1N1) strain 0.03 MG/ML / Influenza Virus Vaccine.03 MG/ML / Influenza Virus Vaccine.5 ML Influenza Virus Vaccine. IVR-148 (H1N1) strain 0. Inactivated A-Brisbane-59-2007.Preventative Care and Screening: Influenza Immunization for Patients >50 Years Old (NQF 0041) (Alternate CORE) Description: Percentage of patients aged 50 years and older who received an influenza immunization during the flu season (September through February). IVR-148 (H1N1) strain 0.25 ML Influenza Virus Vaccine. Inactivated A-Brisbane-59-2007. Inactivated A-Uruguay716-2007. Inactivated B-Brisbane-60-2008 strain 0.03 MG/ML / Influenza Virus Vaccine.03 MG/ML Injectable Suspension 0.03 MG/ML / Influenza Virus Vaccine.03 MG/ML Prefilled 857924 Syringe Influenza Virus Vaccine.03 MG/ML / Influenza Virus Vaccine. Inactivated A-Uruguay716-2007. 857942 Inactivated B-Brisbane-60-2008 strain 0.03 MG/ML Prefilled 857965 Syringe Encounter Nursing Facility CPT 99304 99305 99306 99307 99308 99309 99310 Description 1ST NF CARE PR D E/M LW SEVERITY 1ST NF CARE PR D E/M MOD SEVERITY 1ST NF CARE PR D E/M HI SEVERITY SBSQ NF CARE PR D E/M STABLE SBSQ NF CARE PR D E/M MINOR COMPLCTJ SBSQ NF CARE PR D E/M NEW PROBLEM SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM Encounter Nursing Discharge CPT 99315 99316 Description NF DSCHRG D MGMT 30 MIN/< NF DSCHRG D MGMT > 30 MIN Encounter Prev Med 40 and Older CPT 99386 99387 Description 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 40-64YRS 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 65YRS&> 20 . NYMC X-175C (H3N2) strain 0. NYMC X-175C (H3N2) strain 0. Inactivated B-Brisbane-60-2008 strain 0. Influenza Immunization – Add Immunization to Administered Meds or as Reported Med RxNorm Description 0. Inactivated A-Uruguay-7162007.

30 MIN PREVENTIVE MEDICINE COUNSELING.99395 99396 99397 PERIODIC COMPREHENSIVE PREVENTIVE MEDICINE E&M W/HX/EXAM. INDIV. INDIV. EST PT. INDIV. 18-39 YR PERIODIC COMPREHENSIVE PREVENTIVE MEDICINE E&M W/HX/EXAM. 40-64 YR PERIODIC COMPREHENSIVE PREVENTIVE MEDICINE E&M W/HX/EXAM. 65+ YR Encounter Prev Med-Individual counseling CPT 99401 99402 99403 99404 Description PREVENTIVE MEDICINE COUNSELING. EST PT. 15 MIN PREVENTIVE MEDICINE COUNSELING. 45 MIN 'PREV MED CNSL INDIV SPX 60 MIN Encounter Prev Med Group Counseling CPT 99411 99412 Description PREV MED CNSL GRP SPX 30 MIN PREV MED CNSL GRP SPX 60 MIN Encounter Prev Med Other Services CPT 99420 99429 Description ADMN&INTERPJ HLTH RISK ASSMT INSTRUMENT UNLIS PREV MED SVC 21 . EST PT.

9 Asthma.81 Exercise induced bronchospasm 493. with (acute) exacerbation 493.91 Asthma. with status asthmaticus 493. unspecified type. unspecified 493.1 Intrinsic asthma 493.21 Chronic obstructive asthma. with (acute) exacerbation 493. Diagnosis .92 Asthma.11 Intrinsic asthma with status asthmaticus 493. with (acute) exacerbation 493.02 Extrinsic asthma.Asthma ICD9 Description 493 Asthma 493.22 Chronic obstructive asthma. with status asthmaticus 493.2 Chronic obstructive asthma 493.ADDITIONAL MEASURES Asthma Assessment (NQF 0001) (Additional Measure . unspecified with (acute) exacerbation Daytime and nighttime symptoms of asthma assessed and quantified SNO-MED Description 370202007 Asthma causes daytime symptoms 1 to 2 times per month 370203002 Asthma causes daytime symptoms 1 to 2 times per week 370208006 Asthma never causes daytime symptoms 170635006 Asthma not disturbing sleep 170636007 Asthma never disturbs sleep 370205009 Asthma causes night symptoms 1 to 2 times per month Active daytime and nighttime symptoms of asthma in quantifiable form SNO-MED Description 370204008 Asthma causes daytime symptoms most days 373899003 Asthma daytime symptoms 170631002 Asthma disturbing sleep 170632009 Asthma causing night waking 170633004 Asthma disturbs sleep weekly 170634005 Asthma disturbs sleep frequently 395022009 Asthma night-time symptoms Evidence of asthma symptom assessment tool SNO-MED Description 401011001 Peak expiratory flow rate monitoring using diary 22 . which were evaluated during at least one office visit within 12 months for the frequency (numeric) of daytime and nocturnal asthma symptoms.MENU) Description: Percentage of patients aged 5 through 40 years with a diagnosis of asthma and who have been seen for at least 2 office visits.01 Extrinsic asthma with status asthmaticus 493.12 Intrinsic asthma.82 Cough variant asthma 493.

(Retrospective Rule).0 462 463 Description Streptococcal sore throat Acute pharyngitis Acute tonsillitis CPT 87070 87071 87081 87430 87650 87651 87652 87880 Description CUL BACT XCPT URINE BLD/STL AERC ISOL CUL BACT QUAN AERC ISOL XCPT UR BLD/STOOL CUL PRSMPTV PTHGNC ORGANISMS SCR IAAD EIA STREPTOCOCCUS GRP IADNA STREPTOCOCCUS GRP DIR PRB IADNA STREPTOCOCCUS GRP AMP PRB IADNA STREPTOCOCCUS GRP QUAN IAADIADOO STREPTOCOCCUS GRP Lab test performed: Group A Streptococcus Test LOINC Description Streptococcus pyogenes [Presence] in Throat by 11268-0 Organism specific culture Streptococcus pyogenes [Presence] in Unspecified 17656-0 specimen by Organism specific culture 18481-2 Streptococcus pyogenes Ag [Presence] in Throat Streptococcus pyogenes Ag [Presence] in 31971-5 Unspecified specimen Streptococcus pyogenes DNA [Identifier] in Unspecified specimen by Probe & target 49610-9 amplification method Streptococcus pyogenes rRNA [Presence] in 5036-9 Unspecified specimen by DNA probe 23 . Diagnosis.Enter in SOAP note ICD-9 034.Pharyngitis .Testing for Children with Pharyngitis (NQF 0002) (Additional Measure MENU) Description: This measure is important because it requires initial antigen screening to ensure accurate diagnosis and promotes judicious use of antibiotics and reduction of antibiotic use.

ordered.626-2 Bacteria identified in Throat by Culture Streptococcus pyogenes Ag [Presence] in Throat by 6556-5 Immunoassay Streptococcus pyogenes Ag [Presence] in 6558-1 Unspecified specimen by Immunoassay Streptococcus pyogenes Ag [Presence] in 6559-9 Unspecified specimen by Immunofluorescence Medication .Pharyngitis antibiotics active. or dispensed (reported med does not qualify) RXNorm Description Ampicillin 167 MG/ML / Floxacillin 167 MG/ML 105134 Injectable Solution 105152 Amoxicillin 60 MG/ML Oral Suspension 199693 Amoxicillin 400 MG/ML Injectable Solution 199694 Amoxicillin 167 MG/ML Injectable Solution 199928 Amoxicillin 200 MG/ML Injectable Solution 199997 sparfloxacin 200 MG Oral Tablet Ampicillin 30 MG/ML / Sulbactam 15 MG/ML 239187 Injectable Solution 239191 Amoxicillin 50 MG/ML Oral Suspension Ampicillin 100 MG/ML / Sulbactam 50 MG/ML 240984 Injectable Solution 246282 Amoxicillin 100 MG/ML Oral Suspension 250463 Ampicillin 250 MG / Floxacillin 250 MG Oral Capsule 308177 Amoxicillin 125 MG Chewable Tablet 308181 Amoxicillin 200 MG Chewable Tablet 308182 Amoxicillin 250 MG Oral Capsule 308183 Amoxicillin 250 MG Oral Tablet 308188 Amoxicillin 400 MG Chewable Tablet 24 .

308189 Amoxicillin 80 MG/ML Oral Suspension 308191 Amoxicillin 500 MG Oral Capsule 308192 Amoxicillin 500 MG Oral Tablet 308194 Amoxicillin 875 MG Oral Tablet Amphotericin B 50 MG / Tetracycline 250 MG Oral 308206 Capsule 308207 Ampicillin 125 MG/ML Injectable Solution Ampicillin 250 MG/ML / Sulbactam 125 MG/ML 308208 Injectable Solution 308209 308210 308212 313797 313798 313799 313800 313801 313819 313850 346892 392151 392152 403945 476299 562255 562256 598025 746669 756252 789980 791939 791947 802550 846994 852904 RXNorm Ampicillin 100 MG/ML Oral Suspension Ampicillin 50 MG/ML Oral Suspension Ampicillin 500 MG Oral Capsule Amoxicillin 25 MG/ML Oral Suspension Amoxicillin 10 MG/ML Oral Suspension Ampicillin 25 MG/ML Oral Suspension Ampicillin 250 MG Oral Capsule Ampicillin 389 MG / Probenecid 111 MG Oral Capsule Ampicillin 250 MG/ML Injectable Solution Amoxicillin 40 MG/ML Oral Suspension Amoxicillin 125 MG/ML Oral Suspension Amoxicillin 200 MG Oral Tablet Amoxicillin 400 MG Oral Tablet Amoxicillin 20 MG/ML Oral Suspension Amoxicillin trihydrate 600 MG Disintegrating Tablet Ampicillin 25 MG/ML Oral Solution Ampicillin 50 MG/ML Oral Solution Amoxicillin 250 MG Chewable Tablet Ampicillin 125 MG/ML Oral Suspension Ampicillin 25 MG/ML / Floxacillin 25 MG/ML Oral Solution Ampicillin 100 MG/ML Injectable Solution Amoxicillin 100 MG Oral Tablet Amoxicillin 50 MG Oral Tablet Amoxicillin 775 MG Extended Release Tablet Amoxicillin 150 MG Oral Tablet Amoxicillin 200 MG Oral Capsule Beta-Lactamase inhibitors 25 .

2 MG Chewable 562253 Tablet Amoxicillin 875 MG / Clavulanate 125 MG Oral 562508 Tablet Amoxicillin 5 MG/ML / Clavulanate 2.58 MG/ML 617993 Oral Suspension 12 HR Amoxicillin 1000 MG / Clavulanate 62.5 MG/ML Oral 617293 Solution Amoxicillin 50 MG/ML / Clavulanate 10 MG/ML 617295 Injectable Solution Amoxicillin 500 MG / Clavulanate 125 MG Oral 617296 Tablet Amoxicillin 25 MG/ML / Clavulanate 6.7 MG/ML Oral 617423 Suspension Amoxicillin 80 MG/ML / Clavulanate 11.5 MG 617995 Extended Release Tablet Amoxicillin 800 MG / Clavulanate 125 MG Oral 617996 Tablet Amoxicillin 200 MG/ML / Clavulanate 28 MG/ML Oral 645806 Suspension 26 .5 MG/ML 617322 Oral Suspension Amoxicillin 40 MG/ML / Clavulanate 5.5 MG Chewable 617304 Tablet Amoxicillin 200 MG / Clavulanate 28.5 MG 617989 Extended Release Tablet Amoxicillin 120 MG/ML / Clavulanate 8.25 MG/ML 617302 Oral Suspension Amoxicillin 250 MG / Clavulanate 62.5 MG Chewable 617981 Tablet Amoxicillin 1000 MG / Clavulanate 62.4 MG/ML 617430 Oral Suspension Amoxicillin 25 MG/ML / Clavulanate 25 MG/ML Oral 617975 Suspension Amoxicillin 50 MG/ML / Clavulanate 25 MG/ML Oral 617976 Suspension Amoxicillin 400 MG / Clavulanate 28.Amoxicillin 250 MG / Clavulanate 125 MG Oral 562251 Tablet Amoxicillin 125 MG / Clavulanate 31.5 MG Chewable 617309 Tablet Amoxicillin 400 MG / Clavulanate 57 MG Chewable 617316 Tablet Amoxicillin 50 MG/ML / Clavulanate 12.

RXNorm First generation cephalosporins 105170 Cefadroxil 25 MG/ML Oral Suspension 105171 Cefadroxil 100 MG/ML Oral Suspension 197454 Cephalexin 500 MG Oral Tablet 197455 Cephradine 250 MG Oral Capsule 197456 Cephradine 500 MG Oral Capsule 242794 Cephradine 250 MG/ML Injectable Solution 250582 Cephalexin 100 MG/ML Oral Suspension 309046 Cefadroxil 250 MG Oral Capsule 309047 Cefadroxil 1000 MG Oral Tablet 309048 Cefadroxil 50 MG/ML Oral Suspension 309049 Cefadroxil 500 MG Oral Capsule 309051 Cefazolin 10 MG/ML Injectable Solution 309052 Cefazolin 20 MG/ML Injectable Solution 309053 Cefazolin 225 MG/ML Injectable Solution 309110 Cephalexin 25 MG/ML Oral Suspension 309111 Cephalexin 1000 MG Oral Tablet 309112 Cephalexin 250 MG Oral Capsule 309113 Cephalexin 50 MG/ML Oral Suspension 309114 Cephalexin 500 MG Oral Capsule 309115 Cephalexin 250 MG Oral Tablet 27 .

309121 Cephradine 25 MG/ML Oral Suspension 313889 Cephradine 50 MG/ML Oral Suspension 313920 Cefazolin 200 MG/ML Injectable Solution 313929 Cefazolin 330 MG/ML Injectable Solution 347996 Cephalexin 250 MG/ML Oral Suspension 406696 Cephalexin 125 MG Disintegrating Tablet 476193 Cephalexin 250 MG Disintegrating Tablet 562062 Cefazolin 250 MG/ML Injectable Solution 562641 Cefadroxil 25 MG/ML Oral Solution 637173 Cephalexin 750 MG Oral Capsule 645617 Cephalexin 333 MG Oral Capsule 755615 Cephalexin 100 MG/ML Oral Solution 755616 Cephalexin 25 MG/ML Oral Solution 755617 Cephalexin 50 MG/ML Oral Solution 796301 Cefazolin 100 MG/ML Injectable Solution 854220 Cefazolin 40 MG/ML Injectable Solution RXNorm Folate antagonist 108449 Trimethoprim 10 MG/ML Oral Suspension 141843 Trimethoprim 20 MG/ML Injectable Solution 198332 Trimethoprim 100 MG Oral Tablet 198333 Trimethoprim 200 MG Oral Tablet 28 .

Polymyxin B 10000 UNT/ML / Trimethoprim 1 244967 MG/ML Ophthalmic Solution 562707 Trimethoprim 10 MG/ML Oral Solution RXNorm Lincomycin derivatives 141970 Clindamycin 20 MG/ML Topical Cream 197518 Clindamycin 150 MG Oral Capsule 197519 Clindamycin 10 MG/ML Topical Lotion 205964 Clindamycin 150 MG/ML Injectable Solution 259233 Clindamycin 100 MG Vaginal Suppository 284215 Clindamycin 300 MG Oral Capsule 309329 Clindamycin 75 MG Oral Capsule 309332 Clindamycin 0.05 MG/MG / Clindamycin 0.01 358917 MG/MG Topical Gel 392275 Clindamycin 75 MG/ML Oral Suspension 477451 Clindamycin 10 MG/ML Topical Foam 29 .01 MG/MG Topical Gel 309333 Clindamycin 10 MG/ML Topical Solution 309335 Clindamycin 12 MG/ML Injectable Solution 309336 Clindamycin 18 MG/ML Injectable Solution 309337 Clindamycin 20 MG/ML Vaginal Cream 309338 Clindamycin 2 MG/ML Injectable Solution 309339 Clindamycin 6 MG/ML Injectable Solution 309340 Clindamycin 9 MG/ML Injectable Solution Benzoyl Peroxide 0.

00025 MG/MG Topical Gel Benzoyl Peroxide 0.012 MG/MG Topical Gel 890921 5000 MG Clindamycin 20 MG/ML Prefilled Applicator 900391 Clindamycin 25 MG Oral Tablet 900424 Clindamycin 25 MG/ML Oral Solution 900460 Clindamycin 75 MG Oral Tablet RXNorm Macrolides 141962 Azithromycin 250 MG Oral Capsule 141963 Azithromycin 40 MG/ML Oral Suspension 197516 Clarithromycin 250 MG Oral Tablet 197517 Clarithromycin 500 MG Oral Tablet 197650 Erythromycin 500 MG Oral Tablet 206085 Erythromycin Estolate 333 MG Oral Tablet 240741 Clarithromycin 25 MG/ML Oral Suspension 251854 Clarithromycin 50 MG/ML Injectable Suspension 259543 Clarithromycin 500 MG Extended Release Tablet 308459 Azithromycin 20 MG/ML Oral Suspension 30 .025 MG/MG / clindamycin-2885131 phosphate 0.012 MG/MG / Tretinoin 882548 0.562266 Clindamycin 15 MG/ML Oral Solution 745483 Penicillin G Potassium 800000 UNT Oral Tablet 797274 Clindamycin 10 MG/ML Medicated Pad 853019 Clindamycin 25 MG Oral Capsule clindamycin-2-phosphate 0.

308460 Azithromycin 250 MG Oral Tablet 308461 Azithromycin 100 MG/ML Injectable Solution 309321 Clarithromycin 37.3 MG/ML Oral Suspension Azithromycin 33.5 MG/ML Oral Suspension 309322 Clarithromycin 50 MG/ML Oral Suspension 310157 Erythromycin 500 MG Enteric Coated Tablet 310160 Erythromycin Estolate 125 MG Oral Capsule 310161 Erythromycin Estolate 125 MG Chewable Tablet 310162 Erythromycin Estolate 250 MG Chewable Tablet 310165 Erythromycin Estolate 250 MG Oral Tablet 346618 Clarithromycin 250 MG Extended Release Tablet 24 HR Clarithromycin 500 MG Extended Release 359385 Tablet 486912 Erythromycin Estolate 500 MG Oral Tablet 486955 Erythromycin Estolate 250 MG Oral Capsule 486960 Erythromycin Estolate 25 MG/ML Oral Suspension 487129 Erythromycin Estolate 100 MG/ML Oral Suspension 577162 Azithromycin 33.3 MG/ML Extended Release 577378 Suspension 597193 Erythromycin 50 MG/ML Oral Suspension 597194 Erythromycin Estolate 50 MG/ML Oral Suspension erythromycin lactobionate 50 MG/ML Injectable 597298 Solution 597455 Clarithromycin 1000 MG Extended Release Tablet 31 .

7 MG/ML Oral Suspension RXNorm Natural penicillins 105078 Penicillin G 375 MG/ML Injectable Solution Penicillin G Potassium 40000 UNT/ML Injectable 204466 Solution Penicillin G Potassium 20000 UNT/ML Injectable 207390 Solution Penicillin G Potassium 60000 UNT/ML Injectable 207391 Solution 312260 Penicillin G 250000 UNT Oral Tablet 312263 Penicillin G 400000 UNT Oral Tablet 312266 Penicillin G 500000 UNT Oral Tablet 32 .597455 Clarithromycin 1000 MG Extended Release Tablet Erythromycin Ethylsuccinate 200 MG Chewable 686350 Tablet Erythromycin Gluceptate 1 MG/ML Injectable 686354 Solution 686355 erythromycin stearate 250 MG Oral Tablet Erythromycin Ethylsuccinate 40 MG/ML / 686383 Sulfisoxazole 120 MG/ML Oral Suspension Erythromycin Ethylsuccinate 40 MG/ML Oral 686400 Suspension 686405 Erythromycin Ethylsuccinate 400 MG Oral Tablet 686406 erythromycin stearate 500 MG Oral Tablet Erythromycin Ethylsuccinate 80 MG/ML Oral 686418 Suspension Erythromycin Gluceptate 50 MG/ML Injectable 686447 Solution 750151 60 ML Azithromycin 16.7 MG/ML Oral Suspension 751864 erythromycin stearate 250 MG Enteric Coated Tablet 861416 Azithromycin 16.

312270 Penicillin G 300000 UNT/ML Injectable Suspension 617857 Penicillin G 10000 UNT/ML Injectable Solution 617881 Penicillin G 100000 UNT/ML Injectable Solution penicillin G benzathine 300000 UNT/ML / penicillin G 623677 procaine 300000 UNT/ML Injectable Suspension penicillin G benzathine 150000 UNT/ML / penicillin G 623695 procaine 150000 UNT/ML Injectable Suspension 2 ML penicillin G benzathine 300000 UNT/ML / penicillin G procaine 300000 UNT/ML Prefilled 731538 Syringe 1 ML penicillin G benzathine 300000 UNT/ML / penicillin G procaine 300000 UNT/ML Prefilled 731558 Syringe penicillin G benzathine 150000 UNT/ML / penicillin G 731560 procaine 150000 UNT/ML Injectable Solution 1 ML penicillin G benzathine 600000 UNT/ML 731564 Prefilled Syringe 2 ML penicillin G benzathine 600000 UNT/ML 731567 Prefilled Syringe 4 ML penicillin G benzathine 600000 UNT/ML 731570 Prefilled Syringe penicillin G benzathine 600000 UNT/ML Injectable 731572 Suspension penicillin G benzathine 300000 UNT/ML Injectable 731575 Suspension 4 ML penicillin G benzathine 300000 UNT/ML / penicillin G procaine 300000 UNT/ML Prefilled 731590 Syringe 745047 Penicillin G Potassium 156 MG Oral Tablet 745051 Penicillin G Potassium 200000 UNT Oral Tablet 745053 Penicillin G Potassium 25 MG/ML Oral Suspension 745276 Penicillin G Potassium 50 MG/ML Oral Suspension 745278 Penicillin G Potassium 313 MG Oral Tablet 745280 Penicillin G Potassium 125 MG Oral Tablet 33 .

745282 Penicillin G Potassium 250 MG Oral Tablet Penicillin G Potassium 500000 UNT/ML Oral 745284 Solution 745286 Penicillin G Potassium 250000 UNT Oral Tablet 745292 Penicillin G Potassium 400000 UNT Oral Tablet Penicillin G Potassium 50000 UNT/ML Oral 745296 Suspension Penicillin G Potassium 100000 UNT/ML Injectable 745300 Solution Penicillin G Sodium 100000 UNT/ML Injectable 745302 Solution penicillin G procaine 300000 UNT/ML Injectable 745303 Suspension 2 ML penicillin G procaine 600000 UNT/ML Prefilled 745462 Syringe Penicillin G Potassium 10000 UNT/ML Injectable 745464 Solution penicillin G benzathine 900000 UNT/ML / penicillin G 745477 procaine 300000 UNT/ML Injectable Suspension 745479 Penicillin G Potassium 500000 UNT Oral Tablet 745483 Penicillin G Potassium 800000 UNT Oral Tablet 745519 Penicillin G Potassium 500 MG Oral Tablet 1 ML penicillin G procaine 600000 UNT/ML Prefilled 745560 Syringe penicillin G procaine 600000 UNT/ML Injectable 745561 Suspension 745585 Penicillin G Potassium 31.3 MG/ML Oral Suspension 2 ML penicillin G benzathine 600000 UNT/ML / penicillin G procaine 600000 UNT/ML Prefilled 824584 Syringe 834040 Penicillin V Potassium 50 MG/ML Oral Solution 834046 Penicillin V Potassium 25 MG/ML Oral Solution 34 .

834061 Penicillin V Potassium 250 MG Oral Tablet 834102 Penicillin V Potassium 500 MG Oral Tablet 834179 Penicillin V Potassium 125 MG Oral Tablet 834182 Penicillin V Potassium 3 MG/ML Ophthalmic Solution 2 ML penicillin G benzathine 450000 UNT/ML / penicillin G procaine 150000 UNT/ML Prefilled 836306 Syringe Penicillin G Potassium 1000000 UNT/ML Injectable 863538 Solution RXNorm Penicillinase-resistant penicillins 197595 Dicloxacillin 250 MG Oral Capsule 197596 Dicloxacillin 500 MG Oral Capsule 309860 Dicloxacillin 125 MG Oral Capsule 313945 Dicloxacillin 12.5 MG/ML Oral Suspension 406366 Dicloxacillin 500 MG Oral Tablet RXNorm Quinolones 197511 Ciprofloxacin 250 MG Oral Tablet 197512 Ciprofloxacin 750 MG Oral Tablet 198044 Norfloxacin 400 MG Oral Tablet 198048 Ofloxacin 200 MG Oral Tablet 198049 Ofloxacin 300 MG Oral Tablet 198050 Ofloxacin 400 MG Oral Tablet 199370 Ciprofloxacin 100 MG Oral Tablet 35 .

6 MG/ML Injectable Solution 24 HR Ciprofloxacin 500 MG Extended Release 359383 Tablet 24 HR Ciprofloxacin 1000 MG Extended Release 403921 Tablet 477391 Levofloxacin 25 MG/ML Oral Solution 36 .199886 Levofloxacin 5 MG/ML Injectable Solution 240639 Ofloxacin 20 MG/ML Injectable Solution 240640 Ofloxacin 40 MG/ML Injectable Solution 250095 Ofloxacin 2 MG/ML Injectable Solution 259311 gatifloxacin 2 MG/ML Injectable Solution 309304 Ciprofloxacin 2 MG/ML Injectable Solution 309308 Ciprofloxacin 50 MG/ML Oral Suspension 309309 Ciprofloxacin 500 MG Oral Tablet 309310 Ciprofloxacin 100 MG/ML Oral Suspension 310445 gatifloxacin 200 MG Oral Tablet 311296 Levofloxacin 750 MG Oral Tablet 311364 lomefloxacin 400 MG Oral Tablet 311787 moxifloxacin 400 MG Oral Tablet 313522 trovafloxacin 100 MG Oral Tablet 313523 trovafloxacin 200 MG Oral Tablet 314009 gatifloxacin 400 MG Oral Tablet 315065 Ofloxacin 4 MG/ML Injectable Solution 351156 moxifloxacin 1.

5 MG/ML Oral Suspension 197449 Cefaclor 500 MG Oral Capsule 197452 cefprozil 250 MG Oral Tablet 197453 cefprozil 500 MG Oral Tablet 197898 loracarbef 200 MG Oral Capsule 197899 loracarbef 400 MG Oral Capsule 204929 Cefuroxime 15 MG/ML Injectable Solution 245239 Cefuroxime 250 MG/ML Injectable Suspension 309040 Cefaclor 37.597446 Ciprofloxacin 1000 MG Extended Release Tablet 637560 gemifloxacin 320 MG Oral Tablet 644541 gatifloxacin 40 MG/ML Oral Suspension 794769 Ciprofloxacin 500 MG Extended Release Tablet 877486 Ofloxacin 600 MG Oral Tablet RXNorm Second generation cephalosporins 105189 Cefuroxime 12.4 MG/ML Oral Suspension 309041 12 HR Cefaclor 375 MG Extended Release Tablet 309042 Cefaclor 75 MG/ML Oral Suspension 309043 12 HR Cefaclor 500 MG Extended Release Tablet 309044 Cefaclor 25 MG/ML Oral Suspension 309045 Cefaclor 250 MG Oral Capsule 309080 cefprozil 25 MG/ML Oral Suspension 37 .

309081 cefprozil 50 MG/ML Oral Suspension 309095 Cefuroxime 125 MG Oral Tablet 309096 Cefuroxime 25 MG/ML Oral Suspension 309097 Cefuroxime 250 MG Oral Tablet 309098 Cefuroxime 500 MG Oral Tablet 309099 Cefuroxime 90 MG/ML Injectable Solution 309100 Cefuroxime 30 MG/ML Injectable Solution 309101 Cefuroxime 95 MG/ML Injectable Solution 309103 Cefuroxime 220 MG/ML Injectable Suspension 311370 loracarbef 20 MG/ML Oral Suspension 311371 loracarbef 40 MG/ML Oral Suspension 313888 Cefaclor 50 MG/ML Oral Suspension 313926 Cefuroxime 50 MG/ML Oral Suspension 349507 Cefaclor 375 MG Extended Release Tablet 349508 Cefaclor 500 MG Extended Release Tablet 387065 Cefuroxime 50 MG/ML Injectable Solution 387066 Cefuroxime 60 MG/ML Injectable Solution 476322 Cefaclor 125 MG Chewable Tablet 476325 Cefaclor 187 MG Chewable Tablet 476327 Cefaclor 250 MG Chewable Tablet 476623 Cefaclor 375 MG Chewable Tablet 38 .

333 MG/MG / Trimethoprim 0.RXNorm Sulfonamides Sulfamethoxazole 100 MG / Trimethoprim 20 MG 142118 Oral Tablet 198235 Sulfisoxazole 500 MG Oral Tablet Sulfamethoxazole 400 MG / Trimethoprim 80 MG 198334 Oral Tablet Sulfamethoxazole 800 MG / Trimethoprim 160 MG 198335 Oral Tablet 198420 Sulfisoxazole 100 MG/ML Oral Suspension Sulfamethoxazole 80 MG/ML / Trimethoprim 16 246252 MG/ML Oral Suspension Phenazopyridine 50 MG / Sulfisoxazole 500 MG Oral 312340 Tablet Sulfamethoxazole 40 MG/ML / Trimethoprim 8 313134 MG/ML Oral Suspension Sulfamethoxazole 80 MG/ML / Trimethoprim 16 313137 MG/ML Injectable Solution 315219 Sulfisoxazole 200 MG/ML Oral Suspension 413716 Sulfisoxazole 400 MG/ML Injectable Solution Phenazopyridine 200 MG / Sulfamethoxazole 800 648254 MG / Trimethoprim 160 MG Oral Tablet Erythromycin Ethylsuccinate 40 MG/ML / 686383 Sulfisoxazole 120 MG/ML Oral Suspension 756189 Sulfisoxazole 100 MG/ML Oral Solution Sulfadiazine 0.067 894883 MG/MG Oral Powder RXNorm Tetracycline 105227 Minocycline 100 MG Extended Release Capsule 197633 Doxycycline 100 MG Oral Tablet 197984 Minocycline 100 MG Oral Capsule 197985 Minocycline 50 MG Oral Capsule 39 .

198249 Tetracycline 100 MG Oral Capsule 198250 Tetracycline 250 MG Oral Capsule 198252 Tetracycline 500 MG Oral Capsule 199026 Doxycycline 100 MG Oral Capsule 199027 Doxycycline 50 MG Oral Capsule 207362 Minocycline 50 MG Oral Tablet 207364 Minocycline 100 MG Oral Tablet 242807 Minocycline 10 MG/ML Oral Suspension Amphotericin B 5 MG/ML / Tetracycline 25 MG/ML 242814 Oral Solution 283535 Doxycycline 20 MG Oral Tablet 310026 Doxycycline 10 MG/ML Oral Suspension 310027 Doxycycline 10 MG/ML Injectable Solution 310028 Doxycycline 20 MG Oral Capsule 310029 Doxycycline 50 MG Oral Tablet 310030 Doxycycline 5 MG/ML Oral Suspension 313251 Tetracycline 25 MG/ML Oral Suspension 313252 Tetracycline 250 MG Oral Tablet 313253 Tetracycline 250 MG/ML Injectable Solution 313254 Tetracycline 500 MG Oral Tablet 314108 Minocycline 75 MG Oral Capsule 317127 Minocycline 20 MG/ML Injectable Solution 40 .

348869 Doxycycline 100 MG Enteric Coated Capsule 348870 Doxycycline 75 MG Enteric Coated Capsule 349114 Doxycycline 109 MG Oral Tablet 349115 Doxycycline 109 MG Oral Capsule 349116 Doxycycline 54.4 MG Oral Capsule 351121 Minocycline 1 MG Oral Powder 359465 Doxycycline 75 MG Oral Tablet 403840 Minocycline 75 MG Oral Tablet 406524 Doxycycline 75 MG Enteric Coated Tablet 434018 Doxycycline 100 MG Enteric Coated Tablet 597520 Doxycycline 100 MG Disintegrating Tablet 597521 Doxycycline 75 MG Disintegrating Tablet 597808 Doxycycline 150 MG Oral Tablet 24 HR Minocycline 135 MG Extended Release 629695 Tablet 629697 24 HR Minocycline 45 MG Extended Release Tablet 629699 24 HR Minocycline 90 MG Extended Release Tablet 630819 Minocycline 135 MG Extended Release Tablet 630824 Minocycline 45 MG Extended Release Tablet 630827 Minocycline 90 MG Extended Release Tablet 645613 Minocycline 135 MG Extended Release Capsule 645614 Minocycline 45 MG Extended Release Capsule 41 .

645619 Minocycline 90 MG Extended Release Capsule Bismuth biskalcitrate 140 MG / Metronidazole 125 687231 MG / Tetracycline 125 MG Oral Capsule 700408 Doxycycline 75 MG Oral Capsule bismuth subcitrate 140 MG / Metronidazole 125 MG / 705861 Tetracycline 125 MG Oral Capsule 728207 Doxycycline 150 MG Oral Capsule 756134 Minocycline 10 MG/ML Oral Solution 756192 Tetracycline 25 MG/ML Oral Solution 799048 Doxycycline 150 MG Enteric Coated Tablet 24 HR Minocycline 115 MG Extended Release 858062 Tablet 858065 Minocycline 115 MG Extended Release Tablet 858372 24 HR Minocycline 65 MG Extended Release Tablet 858375 Minocycline 65 MG Extended Release Tablet RXNorm Third generation cephalosporins 197450 Cefixime 200 MG Oral Tablet 197451 Cefixime 400 MG Oral Tablet 200346 cefdinir 300 MG Oral Capsule 204871 Ceftriaxone 350 MG/ML Injectable Solution 250156 cefpodoxime 8 MG/ML Oral Suspension 309054 cefdinir 25 MG/ML Oral Suspension 309058 Cefixime 20 MG/ML Oral Suspension 309076 cefpodoxime 100 MG Oral Tablet 42 .

ED .Enter in Past Medical History CPT 99281 99282 99283 99284 99285 Description EMER DEPT SELF LIMITED/MINOR EMER DEPT LOW TO MODERATE SEVERITY EMER DEPT MODERATE SEVERITY EMER DEPT HI SEVERITY&URGENT EVAL EMER DEPT HIGH SEVERITY&THREAT FUNCJ 43 .309077 cefpodoxime 20 MG/ML Oral Suspension 309078 cefpodoxime 200 MG Oral Tablet 309079 cefpodoxime 10 MG/ML Oral Suspension 309085 ceftibuten 36 MG/ML Oral Suspension 309086 ceftibuten 400 MG Oral Capsule 309087 ceftibuten 18 MG/ML Oral Suspension 309090 Ceftriaxone 100 MG/ML Injectable Solution 309091 Ceftriaxone 20 MG/ML Injectable Solution 309092 Ceftriaxone 250 MG/ML Injectable Solution 309093 Ceftriaxone 40 MG/ML Injectable Solution 351127 cefditoren pivoxil 200 MG Oral Tablet 419849 Cefixime 40 MG/ML Oral Suspension 476576 cefdinir 50 MG/ML Oral Suspension 746671 cefdinir 250 MG/ML Oral Suspension 847360 cefditoren pivoxil 400 MG Oral Tablet Encounters.

83 Drug-induced persisting amnestic disorder 292.9 Unspecified alcohol-induced mental disorders 292 Drug-induced mental disorders 292.1 Alcohol-induced persisting amnestic disorder 291.00 Acute alcoholic intoxication in alcoholism.02 Acute alcoholic intoxication in alcoholism.12 Drug-induced psychotic disorder with hallucinations 292. episodic drinking behavior 304. continuous use 44 .82 Drug-induced persisting dementia 292.82 Alcohol induced sleep disorders 291.Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: (a) Initiation (b) Engagement (NQF 0004) (Additional Measure MENU) Description: This measure is designed to ensure that treatment is initiated once the need has been identified and will permit comparison of effectiveness in initiating care (Retrospective Rule).2 Alcohol-induced persisting dementia 291.00 Opioid type dependence.89 Other specified drug-induced mental disorders 292.5 Alcohol-induced psychotic disorder with delusions 291. unspecified drinking behavior 303. episodic drinking behavior 303.8 Other specified alcohol-induced mental disorders 291.85 Drug induced sleep disorders 292.81 Alcohol withdrawal 291. continuous drinking behavior 303.4 Idiosyncratic alcohol intoxication 291.11 Drug-induced psychotic disorder with delusions 292.0 Drug withdrawal 292. Active diagnosis of alcohol or drug dependence ICD9 Description 291 Alcohol-induced mental disorders 291.92 Other and unspecified alcohol dependence. unspecified use 304.3 Alcohol-induced psychotic disorder with hallucinations 291. continuous drinking behavior 303. unspecified drinking behavior 303.2 Pathological drug intoxication 292.91 Other and unspecified alcohol dependence.00 no result 291.84 Drug-induced mood disorder 292.90 Other and unspecified alcohol dependence.81 Drug-induced delirium 292.01 Opioid type dependence.89 Other specified alcohol-induced mental disorders 291.01 Acute alcoholic intoxication in alcoholism.8 Other specified drug-induced mental disorders 292.9 Unspecified drug-induced mental disorder 303.

unspecified use Combinations of drug dependence excluding opioid type drug. hypnotic or anxiolytic abuse.20 305. continuous use Cannabis dependence.92 305.91 304. unspecified use Cannabis dependence. episodic drinking behavior Cannabis abuse.62 304. episodic use Alcohol abuse.20 304. episodic use Sedative. continuous use Combinations of opioid type drug with any other drug dependence. continuous use Cocaine dependence. episodic use Cannabis dependence. episodic use Combinations of opioid type drug with any other drug dependence. episodic Cocaine dependence.32 305.32 304. continuous use Hallucinogen dependence.40 304.72 304.41 304. unspecified use Hallucinogen dependence. unspecified use Other specified drug dependence. continuous use Hallucinogen abuse. unspecified use Amphetamine and other psychostimulant dependence. episodic use Sedative. unspecified use Unspecified drug dependence.42 304. continuous drinking behavior Alcohol abuse. hypnotic or anxiolytic dependence.304. unspecified use Hallucinogen abuse.01 305.22 305. hypnotic or anxiolytic abuse.31 305.40 305. unspecified Sedative.02 304. unspecified use Cannabis abuse.82 304.31 304.50 304.80 304. unspecified Sedative. continuous use Amphetamine and other psychostimulant dependence. continuous .00 305. episodic use Hallucinogen abuse.02 305.51 304. continuous Sedative.21 305.22 304.90 304.71 304. hypnotic or anxiolytic dependence. continuous use Other specified drug dependence. hypnotic or anxiolytic dependence.60 304. episodic use Other specified drug dependence.61 304.10 304. episodic use Unspecified drug dependence.81 304.30 305. continuous use Unspecified drug dependence. episodic use Amphetamine and other psychostimulant dependence.11 304.70 304.12 304. unspecified use Cocaine dependence. episodic use Hallucinogen dependence. continuous use Combinations of drug dependence excluding opioid type drug.21 304. unspecified drinking behavior Alcohol abuse. episodic use Combinations of drug dependence excluding opioid type drug.41 45 Opioid type dependence.52 304. continuous use Cannabis abuse. unspecified use Combinations of opioid type drug with any other drug dependence.30 304.

50 305. continuous use Other.72 305. or unspecified drug abuse.305. unspecified use Opioid abuse. unspecified use Amphetamine or related acting sympathomimetic abuse.62 305.3 535.70 305.30 535. unspecified use Antidepressant type abuse. episodic use Alcoholic gastritis Alcoholic gastritis. hypnotic or anxiolytic abuse.1 Sedative. or unspecified drug abuse. episodic use Cocaine abuse. unspecified use Other.90 305.52 305. continuous use Cocaine abuse.60 305. drug rehab and detox interventions SNOMEDCT Description 20093000 Alcohol rehabilitation and detoxification 23915005 Combined alcohol and drug rehabilitation and detoxification 35637008 Alcohol rehabilitation 52052004 Rehabilitation therapy 56876005 Drug rehabilitation and detoxification 62213004 Combined alcohol and drug rehabilitation 78092008 Drug rehabilitation Procedure performed for detoxification interventions SNOMEDCT Description 67516001 Detoxication therapy Encounter – acute inpatient CPT Description 99221 1ST HOSP CARE PR D 30 MIN 99222 1ST HOSP CARE PR D 50 MIN 99223 1ST HOSP CARE PR D 70 MIN 99231 SBSQ HOSP CARE PR D 15 MIN 99232 SBSQ HOSP CARE PR D 25 MIN 99233 SBSQ HOSP CARE PR D 35 MIN 46 . mixed. unspecified use Cocaine abuse. episodic use Other.71 305. episodic use Amphetamine or related acting sympathomimetic abuse.42 305. continuous use Antidepressant type abuse.82 305. mixed.51 305. episodic Opioid abuse. episodic use Antidepressant type abuse.61 305.92 535. continuous use Amphetamine or related acting sympathomimetic abuse. without mention of hemorrhage Alcoholic gastritis. mixed.31 571.91 305. with hemorrhage Acute alcoholic hepatitis Procedure performed for alcohol.81 305.80 305. or unspecified drug abuse. continuous use Opioid abuse.

99238 99239 99251 99252 99253 99254 99255 99291 HOSP DSCHRG D MGMT 30 MIN/< HOSP DSCHRG D MGMT > 30 MIN 1ST INPT CONSLTJ 20 MIN 1ST INPT CONSLTJ 40 MIN 1ST INPT CONSLTJ 55 MIN 1ST INPT CONSLTJ 80 MIN 1ST INPT CONSLTJ 110 MIN CC E/M CRITICALLY ILL/INJURED 1ST 30-74 MIN Encounter – ED CPT Description 99281 EMER DEPT SELF LIMITED/MINOR 99282 EMER DEPT LOW TO MODERATE SEVERITY 99283 EMER DEPT MODERATE SEVERITY 99284 EMER DEPT HI SEVERITY&URGENT EVAL 99285 EMER DEPT HIGH SEVERITY&THREAT FUNCJ Encounter – non-acute inpatient CPT Description 99304 1ST NF CARE PR D E/M LW SEVERITY 99305 1ST NF CARE PR D E/M MOD SEVERITY 99306 1ST NF CARE PR D E/M HI SEVERITY 99307 SBSQ NF CARE PR D E/M STABLE 99308 SBSQ NF CARE PR D E/M MINOR COMPLCTJ 99309 SBSQ NF CARE PR D E/M NEW PROBLEM 99310 SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM 99315 NF DSCHRG D MGMT 30 MIN/< 99316 NF DSCHRG D MGMT > 30 MIN 99318 E/M PT INVG ANNUAL NF ASSMT 99324 DOM/R-HOME LW SEVERITY 99325 DOM/R-HOME E/M NEW PT MOD SEVERITY 99326 DOM/R-HOME E/M NEW PT MOD HI SEVERITY 99327 DOM/R-HOME E/M NEW PT HI SEVERITY 99328 DOM/R-HOME E/M NEW PT SIGNIFICANT NEW PROBLEM 99334 DOM/R-HOME E/M EST PT SELF-LMTD/MINOR 99335 DOM/R-HOME E/M EST PT LW MOD SEVERITY 99337 DOM/R-HOME E/M EST PT SIGNIFICANT NEW PROBLEM Encounter – outpatient BH CPT Description 90804 IPI-OB-M/S OFFICE 20-30 MIN 90805 IPI-OB-M/S OFFICE 20-30 MIN MEDICAL E/M 90806 IPI-OB-M/S OFFICE 45-50 MIN 90807 IPI-OB-M/S OFFICE 45-50 MIN MEDICAL E/M 90808 IPI-OB-M/S OFFICE 75-80 MIN 47 .

90809 90810 90811 90812 90813 90814 90815 98960 98961 98962 99078 99201 99202 99203 99204 99205 99211 99212 99213 99214 99215 99217 99218 99219 99220 99241 99242 99243 99244 99245 99341 99342 99343 99344 99345 99347 99348 99349 99350 99384 99385 99386 99387 48 IPI-OB-M/S OFFICE 75-80 MIN MEDICAL E/M INDIV PSYCTX IA 20-30 MIN INDIV PSYCTX IA 20-30 MIN MEDICAL E/M INDIV PSYCTX IA 45-50 MIN INDIV PSYCTX IA 45-50 MIN MEDICAL E/M INDIV PSYCTX IA 75-80 MIN INDIV PSYCTX IA 75-80 MIN MEDICAL E/M EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT EDUCATION&TRAINING SELF-MGMT NONPHYS 2-4 PTS EDUCATION&TRAINING SELF-MGMT NONPHYS 5-8 PTS PHYS EDUCATIONAL SVCS RENDERED PTS GRP SETTING OFFICE OUTPT NEW 10 MIN OFFICE OUTPT NEW 20 MINUTES OFFICE OUTPT NEW 30 MIN OFFICE OUTPT NEW 45 MIN OFFICE OUTPT NEW 60 MIN OFFICE O/P EST 5 MIN OFFICE OUTPT EST 10 MIN OFFICE OUTPT EST15 MIN OFFICE OUTPT EST 25 MIN OFFICE OUTPT EST 40 MIN OBS CARE DSCHRG D MGMT 1ST OBS CARE PR D LOW SEVERITY 1ST OBS CARE PR D MODERATE SEVERITY 1ST OBS CARE PR D HIGH SEVERITY OFFICE CONSLTJ 15 MIN OFFICE CONSLTJ 30 MIN OFFICE CONSLTJ 40 MIN OFFICE CONSLTJ 60 MIN OFFICE CONSLTJ 80 MIN HOME VST NEW PT LOW SEVERITY HOME VST NEW PT MOD SEVERITY HOME VST NEW PT MOD TO HI SEVERITY HOME VST NEW PT HI SEVERITY HOME VST NEW PT UNSTABLE/SIGNIFICANT NEW PROBLEM HOME VST EST PT SELF LIMITED/MINOR HOME VST EST PT LOW TO MOD SEVERITY HOME VST EST PT MOD TO HI SEVERITY HOME VST EST PT UNSTABLE/SIGNIFICANT NEW PROBLEM 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 12-17 YR 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 18-39YRS 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 40-64YRS 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 65YRS&> .

99394 99395 99396 99397 99401 99402 99403 99404 99408 99409 99411 99412 99510 PERIODIC PREVENTIVE MED EST PATIENT AGE 12-17YRS PERIODIC PREVENTIVE MED EST PATIENT AGE 18-39YRS PERIODIC PREVENTIVE MED EST PATIENT AGE 40-64YRS PERIODIC PREVENTIVE MED EST PATIENT AGE 65YRS&> PREV MED CNSL INDIV SPX 15 MIN PREV MED CNSL INDIV SPX 30 MIN PREV MED CNSL INDIV SPX 45 MIN PREV MED CNSL INDIV SPX 60 MIN ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN ALCOHOL/SUBSTANCE SCREEN & INTERVEN >30 MIN PREV MED CNSL GRP SPX 30 MIN PREV MED CNSL GRP SPX 60 MIN HOME VST INDIV FAM/MARRIAGE CNSL 49 .

who gave birth during a 12-month period who were screened for HIV infection during the first or second prenatal visit. regardless of age. Active diagnosis of delivery live births ICD9 Description 640…649 Complications Mainly Related to Pregnancy Normal Delivery and other indications for care in Pregnancy.Prenatal Care: Screening for Human Immunodeficiency Virus (HIV) (NQF 0012) (Additional Measure . Labor and 650…659 Delivery 660…669 Complications Occurring Mainly in the Course of Labor and Delivery Active or inactive diagnosis of HIV ICD9 Description 042 Human immunodeficiency virus [HIV] disease V08 Asymptomatic human immunodeficiency virus [HIV] infection status Procedure performed for delivery of live births .MENU) Description: Percentage of patients.Enter past medical history CPT Description 59400 OB CARE ANTEPARTUM VAG DLVR&POSTPARTUM 59409 VAG DLVR ONLY 59410 VAG DLVR ONLY POSTPARTUM CARE 59425 ANTEPARTUM CARE ONLY 4-6 VSTS 59426 ANTEPARTUM CARE ONLY 7+ VSTS 59510 OB ANTEPARTUM CARE C DLVR&POSTPARTUM 59514 CESAREAN DELIVERY ONLY 59515 C DLVR ONLY W/POSTPARTUM CARE 59610 OB ANTEPARTUM VAG DLVR&POSTPARTUM AFTER C DLVR 59612 VAG DLVR AFTER C DLVR 59614 VAG DLVR AFTER C DLVR POSTPARTUM CARE 59618 ANTEPARTUM C DLVR&POSTPARTUM FA V AP C DLVER 59620 C DLVR ONLY FA V AP C DLVER 59622 C DLVR ONLY FA V AP C DLVER W/POSTPARTUM CARE Lab test for HIV Screening LOINC Descripition 35437-3 HIV 1 Ab [Presence] in Saliva by Immunoassay 35438-1 HIV 1 Ab [Units/volume] in Saliva by Immunoassay 35439-9 HIV 1 Ab [Presence] in Saliva by Immunoblot (IB) 35440-7 HIV 1 gp160 Ab [Presence] in Saliva by Immunoblot (IB) 35441-5 HIV 1 gp120 Ab [Presence] in Saliva by Immunoblot (IB) 35442-3 HIV 1 p66 Ab [Presence] in Saliva by Immunoblot (IB) 35443-1 HIV 1 p65 Ab [Presence] in Saliva by Immunoblot (IB) 35444-9 HIV 1 p55 Ab [Presence] in Saliva by Immunoblot (IB) 35445-6 HIV 1 p51 Ab [Presence] in Saliva by Immunoblot (IB) 50 .

35446-4 35447-2 35448-0 35449-8 35450-6 35452-2 35564-4 35565-1 38998-1 40437-6 40438-4 40439-2 40732-0 40733-8 41143-9 41144-7 41145-4 41290-8 41497-9 41498-7 41513-3 41514-1 41515-8 41516-6 42339-2 42600-7 42627-0 42768-2 42917-5 43008-2 43009-0 43010-8 43011-6 HIV 1 gp41 Ab [Presence] in Saliva by Immunoblot (IB) HIV 1 p31 Ab [Presence] in Saliva by Immunoblot (IB) HIV 1 p24 Ab [Presence] in Saliva by Immunoblot (IB) HIV 1 p17 Ab [Presence] in Saliva by Immunoblot (IB) HIV 1 P18 AB:ACNC:PT:SALIVA:ORD:IB HIV 1 gp40 Ab [Presence] in Serum by Immunoblot (IB) HIV 1 p31+p32 Ab [Presence] in Serum by Immunoblot (IB) HIV 1 p40 Ab [Presence] in Serum by Immunoblot (IB) HIV 1+Hepatitis C virus RNA [Presence] in Serum or Plasma from Blood product unit by Probe & target amplification method HIV 1 p24 Ab [Presence] in Serum by Immunoassay HIV 1 gp41 Ab [Presence] in Serum by Immunoassay HIV 1 gp120+gp160 Ab [Presence] in Serum by Immunoassay HIV 1 IgG Ab [Presence] in Serum by Immunoblot (IB) HIV 1+2 IgG Ab [Presence] in Serum by Immunoassay HIV 1 Ab [Units/volume] in Saliva HIV 1 Ab [Presence] in Saliva HIV 1 Ab [Presence] in Capillary blood HIV 1+2 IgM Ab [Units/volume] in Serum by Immunoassay HIV 1 RNA [Log #/volume] in Cerebral spinal fluid by Probe & target amplification method HIV 1 RNA [#/volume] in Cerebral spinal fluid by Probe & target amplification method HIV 1 RNA [#/volume] in Serum or Plasma by Probe with amplification detection limit = 400 copies/mL HIV 1 RNA [Log #/volume] in Serum or Plasma by Probe with amplification detection limit = 2.9 log copies/mL HIV 1 p24 Ag [Mass/volume] in Serum by Immunoassay HIV 1+2 Ab [Presence] in Unspecified specimen by Immunoassay HIV 1 Ab [Presence] in Cerebral spinal fluid by Immunofluorescence HIV 1 & 2 Ab [interpretation] in Serum Narrative HIV 1 RNA [Presence] in Cerebral spinal fluid by Probe & target amplification method HIV 1+2 IgM Ab [Units/volume] in Serum HIV 1+2 IgG Ab [Presence] in Serum HIV 1+2 Ab [Presence] in Unspecified specimen HIV 1 p24 Ab [Presence] in Serum 51 .6 log copies/mL HIV 1 RNA [#/volume] in Serum or Plasma by Probe with amplification detection limit = 75 copies/mL HIV 1 RNA [Log #/volume] in Serum or Plasma by Probe with amplification detection limit = 1.

43012-4 43013-2 5017-9 5018-7 5220-9 5221-7 5222-5 5223-3 5224-1 5225-8 7917-8 7918-6 7919-4 9660-2 9661-0 9662-8 9663-6 9664-4 9665-1 9666-9 9667-7 9668-5 9669-3 9821-0 9836-8 9837-6 HIV 1 gp41 Ab [Presence] in Serum HIV 1 gp120+gp160 Ab [Presence] in Serum HIV 1 RNA [Presence] in Blood by Probe & target amplification method HIV 1 RNA [Presence] in Unspecified specimen by Probe & target amplification method HIV 1 Ab [Units/volume] in Serum by Immunoassay HIV 1 Ab [Presence] in Serum by Immunoblot (IB) HIV 1 Ag [Presence] in Serum by Immunoassay HIV 1+2 Ab [Units/volume] in Serum by Immunoassay HIV 2 Ab [Units/volume] in Serum by Immunoassay HIV 2 Ab [Presence] in Serum by Immunoblot (IB) HIV 1 Ab [Presence] in Serum HIV 1+2 Ab [Presence] in Serum HIV 2 Ab [Presence] in Serum HIV 1 gp160 Ab [Presence] in Serum by Immunoblot (IB) HIV 1 gp120 Ab [Presence] in Serum by Immunoblot (IB) HIV 1 gp41 Ab [Presence] in Serum by Immunoblot (IB) HIV 1 p17 Ab [Presence] in Serum by Immunoblot (IB) HIV 1 p24 Ab [Presence] in Serum by Immunoblot (IB) HIV 1 p24 Ag [Units/volume] in Serum HIV 1 p31 Ab [Presence] in Serum by Immunoblot (IB) HIV 1 p51 Ab [Presence] in Serum by Immunoblot (IB) HIV 1 p55 Ab [Presence] in Serum by Immunoblot (IB) HIV 1 p66 Ab [Presence] in Serum by Immunoblot (IB) HIV 1 p24 Ag [Presence] in Serum HIV DNA [Presence] in Blood by Probe with amplification HIV 1 DNA [Presence] in Blood by Probe with amplification Prenatal encounter visit.0 Supervision of normal first pregnancy V22.enter in past medical history ICD9 Description V22.2 Pregnant state. incidental 52 .1 Supervision of other normal pregnancy V22.

1 Rhesus isoimmunization affecting management of mother Rhesus isoimmunization affecting management of mother. who gave birth during a 12-month period who received anti-D immune globuline at 26-30 weeks gestation. Labor and 650…659 Delivery 660…669 Complications Occurring Mainly in the Course of Labor and Delivery Active diagnosis of D(Rh) negative ICD-9 Descripition 656. unsensitized patients. with or 656.11 without mention of antepartum condition Active diagnosis of primagravida SNO-MED Description 127364007 Primigravida 199719009 Elderly primigravida with antenatal problem 29399001 Elderly primigravida Active diagnosis of multigravida SNO-MED Description 102876002 Multigravida 127365008 Gravida 2 127366009 Gravida 3 127367000 Gravida 4 127368005 Gravida 5 127369002 Gravida 6 127370001 Gravida 7 127371002 Gravida 8 127372009 Gravida 9 127373004 Gravida 10 127374005 Gravida more than 10 17618008 Previous pregnancies 9 443460007 Multigravida of advanced maternal age 6867004 Previous pregnancies more than 10 80856001 Previous pregnancies 8 82634006 Previous pregnancies 10 Procedure performed of delivery live births CPT Descripition 59400 OB CARE ANTEPARTUM VAG DLVR&POSTPARTUM 59409 VAG DLVR ONLY 59410 VAG DLVR ONLY POSTPARTUM CARE 53 . Active diagnosis of delivery live births ICD-9 Descripition 640…649 Complications Mainly Related to Pregnancy Normal Delivery and other indications for care in Pregnancy. delivered.Prenatal Care: Anti-D Immune Globulin (NQF 0014) (Additional Measure MENU) Description: Percentage of D (Rh) negative. regardless of age.

118 MG/ML Injectable Solution 247769 Rho(D) Immune Globulin 0.3 MG/ML Injectable Solution 406388 Rho(D) Immune Globulin 0.096 MG/ML Injectable Solution 351100 Rho(D) Immune Globulin 0.227 MG/ML Injectable Solution 731378 1 ML Rho(D) Immune Globulin 0.12 MG/ML Injectable Solution 616759 Rho(D) Immune Globulin 0.05 MG/ML Prefilled Syringe 731381 1 ML Rho(D) Immune Globulin 0. incidental 54 .0 Supervision of normal first pregnancy V22.59425 ANTEPARTUM CARE ONLY 4-6 VSTS 59426 ANTEPARTUM CARE ONLY 7+ VSTS 59510 OB ANTEPARTUM CARE C DLVR&POSTPARTUM 59514 CESAREAN DELIVERY ONLY 59515 C DLVR ONLY W/POSTPARTUM CARE 59610 OB ANTEPARTUM VAG DLVR&POSTPARTUM AFTER C DLVR 59612 VAG DLVR AFTER C DLVR 59614 VAG DLVR AFTER C DLVR POSTPARTUM CARE 59618 ANTEPARTUM C DLVR&POSTPARTUM FA V AP C DLVER 59620 C DLVR ONLY FA V AP C DLVER 59622 C DLVR ONLY FA V AP C DLVER W/POSTPARTUM CARE Lab test result for Rh status mother with value = negative LOINC Description A_1155 Rh Status Mother 10331-7 Rh [Type] in Blood 1314-4 Rh immune globulin screen [interpretation] 14906-2 Rh [Type] in Cord blood 14907-0 Rh [Type] in Blood from Blood product unit 14908-8 Rh [Type] in Blood from newborn 17531-5 Rh [Type] in Amniotic fluid 34961-3 Rh [Type] in Blood by Confirm method Lab test result for Rh status baby with value = negative LOINC Description 10331-7 Rh [Type] in Blood 1314-4 Rh immune globulin screen [interpretation] 14906-2 Rh [Type] in Cord blood 14907-0 Rh [Type] in Blood from Blood product unit 14908-8 Rh [Type] in Blood from newborn 17531-5 Rh [Type] in Amniotic fluid 34961-3 Rh [Type] in Blood by Confirm method Medication Anti-D immune globulin administered RXNorm Description 205066 Rho(D) Immune Globulin 0.1 Supervision of other normal pregnancy V22.2 Pregnant state.3 MG/ML Prefilled Syringe Encounter for a prenatal visit after the estimated date of conception (EDC) V22.15 MG/ML Injectable Solution 562566 Rho(D) Immune Globulin 0.

2 Supervision Of High-risk Pregnancy With History Of Abortion V23.84 Young multigravida V23.649 Complications Mainly Related to Pregnancy Normal Delivery and other Indications for care in Pregnancy.9 Supervision of unspecified high-risk pregnancy V28..9 Description 401 Essential hypertension 401.MENU) Definition: The percentage of patients 18-85 years of age who had a diagnosis of hypertension and who’s BP was adequately controlled during the measurement year...9 Description 630..1 Supervision Of High-risk Pregnancy With History Of Trophoblastic Disease V23. Labor.7 Supervision Of High-risk Pregnancy With Insufficient Prenatal Care V23.81 Elderly primigravida V23. Incidental V23.2 Encounter for other antenatal screening based on amniocentesis of mother 55 .89 Other high-risk pregnancy V23.9 Unspecified essential hypertension Diagnosis Pregnancy ICD.0 Supervision Of Normal First Pregnancy V22.633 Ectopic and Molar Pregnancy 634...669 Complications Occurring Mainly in the Course of Labor and Delivery 670.659 Delivery 660.2 Pregnant State.82 Elderly multigravida V23..0 Malignant essential hypertension 401.1 Supervision Of Other Normal Pregnancy V22.639 Other Pregnancy with Abortive Outcome 640. Diagnosis Hypertension ICD..677 Complications of the Puerperium V22.85 Pregnancy resulting from assisted reproductive technology V23.1 Encounter for antenatal screening for raised alpha-fetoprotein levels in amniotic fluid of mother V28..86 Pregnancy with history of in utero procedure during previous pregnancy V23..0 Encounter for antenatal screening for chromosomal anomalies by amniocentesis of mother V28.0 Supervision Of High-risk Pregnancy With History Of Infertility V23.41 Supervision Of High-risk Pregnancy With history of pre-term labor V23.3 Supervision Of High-risk Pregnancy With Grand Multiparity V23.5 Supervision Of High-risk Pregnancy With Other Poor Reproductive History V23.Controlling High Blood Pressure (NQF 0018) (Additional Measure .1 Benign essential hypertension 401.49 Supervision Of High-risk Pregnancy With other poor obstetric history V23.83 Young primigravida V23.. and 650..

0 V56. Stage V Procedure – ESRD – Enter in Past Medical History if Reported CPT Description 38.69 Other kidney transplantation 56 .5 Description Kidney replaced by transplant Postsurgical renal dialysis status Renal dialysis status Noncompliance with renal dialysis Encounter for dialysis and dialysis catheter care Encounter for extracorporeal dialysis Fitting and adjustment of extracorporeal dialysis catheter Fitting and adjustment of peritoneal dialysis catheter Encounter for adequacy testing for dialysis Encounter for adequacy testing for hemodialysis Encounter for adequacy testing for peritoneal dialysis Encounter for other dialysis End stage renal disease Chronic kidney disease.2 V56.5 V28.42 Revision of arteriovenous shunt for renal dialysis 39.12 V56 V56.8 585.81 V28.ESRD ICD-9 V42.95 Venous catheterization for renal dialysis 39.53 Repair of arteriovenous fistula 39.94 Replacement of vessel-to-vessel cannula 39.43 Removal of arteriovenous shunt for renal dialysis 39.6 585.11 V45.0 V45.3 V28.9 Encounter for routine antenatal screening for malformation using ultrasonics of mother Encounter for antenatal screening for fetal growth retardation using ultrasonics of mother Encounter for antenatal screening for isoimmunization of mother Encounter for antenatal screening for Streptococcus B of mother Encounter for fetal anatomic survey Encounter for screening for risk of pre-term labor Other specified antenatal screening Encounter for unspecified antenatal screening of mother Diagnosis .95 Hemodialysis 54.6 V28.82 V28.1 V45.31 V56.3 V56.27 Arteriovenostomy for renal dialysis 39.1 V56.32 V56.89 V28.4 V28.6 Transplant of kidney 55.61 Renal autotransplantation 55.V28.98 Peritoneal dialysis 55.93 Insertion of vessel-to-vessel cannula 39.

Communication to Patient: Tobacco Use Cessation Counseling SNOMEDCT Descripition 171055003 Pregnancy smoking education 225323000 Smoking cessation education 225324006 Smoking effects education 315232003 Referral to stop-smoking clinic 384742004 Smoking cessation assistance 395700008 Referral to smoking cessation advisor Physical Exam Finding: Tobacco User SNOMEDCT Descripition 160603005 Light cigarette smoker (1-9 cigs/day) 160604004 Moderate cigarette smoker (10-19 cigs/day) 160605003 Heavy cigarette smoker (20-39 cigs/day) 160606002 Very heavy cigarette smoker (40+ cigs/day) 160619003 Rolls own cigarettes 228494002 Snuff user 228504007 User of moist powdered tobacco 228514003 Chews plug tobacco 228515002 Chews twist tobacco 228516001 Chews loose leaf tobacco 228517005 Chews fine cut tobacco 228518000 Chews products containing tobacco 230059006 Occasional cigarette smoker 230060001 Light cigarette smoker 230062009 Moderate cigarette smoker 230063004 Heavy cigarette smoker 230064005 Very heavy cigarette smoker 230065006 Chain smoker 266920004 Trivial cigarette smoker (less than one cigarette/day) (finding) 81703003 Chews tobacco 57 .MENU) Description: This measure facilitates efforts to implement recommended clinical practices and guidelines and subsequently reduce mortality rates and health problems related to smoking and tobacco use (Real-time Rule). Medical Assistance: (a) Advising (b) Discussing Medication (c) Discussing Strategies (NQF 0027) (Additional Measure .Smoking and Tobacco Use Cessation.

Encounter: Tobacco Use Cessation Counseling CPT Descripition 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES 99407 TOBACCO USE CESSATION INTENSIVE >10 MINUTES 58 .

symptomatic Mammogram .Breast Cancer Screening (NQF 0031) (Additional Measure .localization Mammogram coned Mammogram magnification Breast sinogram CT of breast Screening mammography Stereotactic mammography Partial mastectomy with axillary lymphadenectomy Mammography and aspiration Mammography and biopsy Bilateral mammography Mammogram in compression view Mammography Bilateral mastectomy – Enter in past surgical history CPT Description 19180 MAST SMPL COMPL 19200 MAST RAD W/PECTORAL MUSC AX LYMPH NOD 19220 MAST RAD W/PECTORAL MUSC AX&INT MAM LYMPH NOD 19240 MAST MODF RAD W/AX LYMPH NOD +-PECTORALIS MINOR 19303 MASTECTOMY SIMPLE COMPLETE 19304 MASTECTOMY SUBCUTANEOUS 19305 MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES 19306 MAST RAD W/PECTORAL MUSC AX INT MAM LYMPH NODES 19307 MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN 59 . Mammograms – Enter in Past Medical History CPT Description 76090 MAMMOGRAPY UNI 76091 MAMMOGRAPY BI 76092 SCR MAMMOGRAPY BI 2 VIEW FLM STD EA BRST 77055 MAMMOGRAPHY UNILATERAL 77056 MAMMOGRAPHY BILATERAL 77057 SCREENING MAMMOGRAPHY BILATERAL SNO-MED 12389009 241055006 241056007 241057003 241058008 241189009 241539009 24623002 258172002 35482003 418074003 418378007 43204002 439324009 71651007 Description Xeromammography Mammogram .MENU) Description: The percentage of women 40-69 years of age who had a mammogram to screen for breast cancer.

Unilateral mastectomy.enter in past surgical history CPT Description 19180 MAST SMPL COMPL 19200 MAST RAD W/PECTORAL MUSC AX LYMPH NOD 19220 MAST RAD W/PECTORAL MUSC AX&INT MAM LYMPH NOD 19240 MAST MODF RAD W/AX LYMPH NOD +-PECTORALIS MINOR 19303 MASTECTOMY SIMPLE COMPLETE 19304 MASTECTOMY SUBCUTANEOUS 19305 MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES 19306 MAST RAD W/PECTORAL MUSC AX INT MAM LYMPH NODES 19307 MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN 60 .

MENU) Description: The percentage of women 21-64 years of age who received one or more Pap tests to screen for cervical cancer.Cervical Cancer Screening (NQF 0032) (Additional Measure . Hysterectomy procedure CPT Description 51925 CLSR VESICOUTERINE FSTL W/HYST 58150 TAH +-RMVL TUBE +-RMVL OVARY 58152 TAH +-RMVL TUBE OVARY COLPO-URTCSTOPEXY 58200 TAH W/PRTL VAGNC PEL LYMPH NODE SAMPLING 58210 RAD ABDL HYST W/BI PEL LMPHADEC 58240 PEL EXNTJ GYNECOLOGIC MAL 58260 VAG HYST 250 GM/< 58262 VAG HYST 250 GM/< W/RMVL TUBE&/OVARY 58263 VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL 58267 VAG HYST 250 GM/< W/COLPO-URTCSTOPEXY 58270 VAG HYST 250 GM/< W/RPR NTRCL 58275 VAG HYST W/TOT/PRTL VAGNC 58280 VAG HYST W/TOT/PRTL VAGNC W/RPR NTRCL 58285 VAG HYST RAD SCHAUTA 58290 VAG HYST F/UTER > 250 GM 58291 VAG HYST > 250 GM RMVL TUBE&/OVARY 58292 VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR NTRCL 58293 VAG HYST > 250 GM COLPO-URTCSTOPEXY +-NDSC CTRL 58294 VAG HYST > 250 GM RPR NTRCL 58550 LAPS W/VAG HYST 250 GM/< 58552 LAPS W/VAG HYST 250 GM/< RMVL TUBE&/OVARY 58553 LAPS W/VAG HYST > 250 GRAMS 58554 LAPS VAG HYST > 250 GM RMVL TUBE&/OVARY 58570 58571 58572 58573 58951 58953 58954 58956 59135 LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 G/< LAPS TOTAL HYSTERECTOMY 250 G/<W TUBE/OVARY LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS>250 G LAPAROSCOPY TOT HYSTERECTOMY >250 G W TUBE/OVARY RESCJ PRIM PRTL MAL W/BSO&OMNTC TAH&LMPHADEC BSO W/OMNTC TAH&RAD DSJ DEBULKING BSO W/OMNTC TAH DEBULKING W/LMPHADEC BSO TOT OMNTC TAH MAL TX ECTOPIC PREGNANCY NTRSTL REQ TOT HYST 61 .

5 Presence of contraceptive device V61.Enter Past medical History ICD9 Description V24 Postpartum care and examination V25 Encounter for contraceptive management V26 Procreative management V27 Outcome of delivery V28 Encounter for antenatal screening of mother V45.2 High-risk sexual behavior V72.Lab test result for a pap test LOINC 10524-7 18500-9 19762-4 19764-0 19765-7 19766-5 19774-9 33717-0 47527-7 47528-5 Description Microscopic observation [Identifier] in Cervix by Cyto stain Microscopic observation [Identifier] in Cervix by Cyto stain.5 Multiparity V61.4 Pregnancy examination or test 62 .7 Other unwanted pregnancy V69.3 Special investigations and examinations .thin prep General categories [interpretation] of Cervical or vaginal smear or scraping by Cyto stain Statement of adequacy [interpretation] of Cervical or vaginal smear or scraping by Cyto stain Microscopic observation [Identifier] in Cervical or vaginal smear or scraping by Cyto stain Microscopic observation [Identifier] in Cervical or vaginal smear or scraping by Cyto stain Cytology study comment Cervical or vaginal smear or scraping Cyto stain Cytology Cervical or vaginal smear or scraping study Cytology report of Cervical or vaginal smear or scraping Cyto stain.Gynecological examination V72.6 Illegitimacy or illegitimate pregnancy V61.thin prep Cytology report of Cervical or vaginal smear or scraping Cyto stain One encounter (OB/Gyn or outpatient) .

0 Genital syphilis (primary) 091.6 Secondary syphilis of viscera and bone 091. type I [HTLV-I] infection in conditions 079.50 Syphilitic uveitis.52 Syphilitic iridocyclitis (secondary) 091.69 Secondary syphilis of other viscera 091. relapse 091.MENU) Description: Chlamydia is one of the most frequently occurring sexually transmitted diseases in the U.5 Uveitis due to secondary syphilis 091.2 Other primary syphilis 091. type 2 [HIV-2] infection in conditions 079.51 classified elsewhere and of unspecified site Human T-cell lymphotrophic virus.11 Herpetic vulvovaginitis 054.51 Syphilitic chorioretinitis (secondary) 091. Women ages 14-30 account for 80% of new cases.8 Other forms of secondary syphilis 091.4 Adenopathy due to secondary syphilis 091.7 Secondary syphilis.19 Other genital herpes 078. Sexually active woman – Diagnosis active ICD-9-CM Descripition 054.12 Herpetic ulceration of vulva 054.1 Primary anal syphilis 091. This measure facilitates efforts towards early screening and treatment to improve health outcomes for infected women and prevent the spread of disease (Real-Time Rule).88 Other specified diseases due to Chlamydiae Human papillomavirus infection in conditions classified elsewhere and of 079.62 Secondary syphilitic hepatitis 091.61 Secondary syphilitic periostitis 091.3 Secondary syphilis of skin or mucous membranes 091. symptomatic 091.Chlamydia Screening for Women (NQF 0033) (Additional Measure .82 Syphilitic alopecia 63 .S.11 Condyloma acuminatum 078. unspecified 091. type II [HTLV-II] infection in conditions 079.52 classified elsewhere and of unspecified site Human immunodeficiency virus.98 unspecified site 091 Early syphilis.81 Acute syphilitic meningitis (secondary) 091.10 Genital herpes.53 classified elsewhere and of unspecified site Other specified chlamydial infection in conditions classified elsewhere and of 079.4 unspecified site Human T-cell lymphotrophic virus.88 unspecified site Unspecified chlamydial infection in conditions classified elsewhere and of 079. unspecified 054.

9 092 092. latent Early syphilis.0 Other forms of secondary syphilis Unspecified secondary syphilis Early syphilis. latent.091.89 091. serological relapse after treatment Procedures indicative of sexually active woman – Procedure performed LOINC Descripition 11975 INSERTION IMPLANTABLE CONTRACEPTIVE CAPSULES 11976 REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES 11977 RMVL W/RINSJ IMPLANTABLE CONTRACEPTIVE CAPSULES 57022 I&D VAG HMTMA OBAL/POSTPARTUM 57170 DPHRM/CRV CAP FITG W/INSTRUCTIONS 58300 INSJ INTRAUTERINE DEV 58301 RMVL INTRAUTERINE DEV 58600 LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI 58605 LIG/TRNSXJ FLP TUBE ABDL/VAG POSTPARTUM SPX 58611 LIG/TRNSXJ FLP TUBE DONE TM C DLVR/SURG 58615 OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR 58970 FOLLICLE PNXR OOCYTE RETRIEVAL ANY METH 58974 EMBRYO TR INTRAUTERINE 58976 GAMETE ZYGOTE/EMBRYO INTRAFLP TR ANY METH 59000 AMNIOCNTS DX 59001 AMNIOCNTS THER AMNIOTIC FLU RDCTJ US GID 59012 CORDOCNTS INTRAUTERINE 59015 CHORNC VILLUS SAMPLING 59020 FTL CONTRCJ STRS TST 59025 FTL NON-STRS TST 59030 FTL SCALP BLD SAMPLING 59050 FTL MNTR LABOR PHYS WRTTN REPRT S&I 59051 FTL MNTR LABOR PHYS WRTTN REPRT INTERPJ ONLY 59070 TABDL AMNIONFS US GID 59072 FTL UMBILICAL CORD OCCLUSION W/US GID 59074 FTL FLU DRG US GID 59076 FTL SHUNT PLMT US GID 59100 HYSTOT ABDL 59120 TX ECTOPIC PREGNANCY REQ SO 59121 TX ECTOPIC PREGNANCY W/O SO 59130 TX ECTOPIC PREGNANCY ABDL PREGNANCY 59135 TX ECTOPIC PREGNANCY NTRSTL REQ TOT HYST 59136 TX ECTOPIC PREGNANCY NTRSTL PRTL RESCJ UTER 59140 TX ECTOPIC PREGNANCY CRV W/EVAC 64 .

no problems 169481005 IUD checked .pregnant 169489007 IUD partially expelled 169490003 IUD threads lost 169491004 IUD check X-ray study – Diagnostic study result CPT Descripition 70010 MYELOGRAPY POST FOSSA RS&I 70015 CISTRNG POSITIVE CNTRST RS&I 70030 RADEX EYE DETCJ FB 70100 RADEX MNDBL PRTL < 4 VIEWS 70110 RADEX MNDBL COMPL MINIMUM 4 VIEWS 70120 RADEX MASTOIDS < 3 VIEWS PR SIDE 70130 RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE 70134 RADEX INT AUD MEATI COMPL 70140 RADEX FACIAL B1S < 3 VIEWS 70150 RADEX FACIAL B1S COMPL MINIMUM 3 VIEWS 70160 RADEX NSL B1S COMPL MINIMUM 3 VIEWS 70170 DACRYOCSTOGRAPY NASOLACRIMAL DUX RS&I 65 .59150 LAPS TX ECTOPIC PREGNANCY W/O SO 59151 LAPS TX ECTOPIC PREGNANCY W/SO Contraceptive Use Education: Communication to the Patient SNOMEDCT Descripition 16311004 Condom use education 398780007 Contraception education 40176008 Diaphragm use education 44651004 Contraceptive use education IUD Use: Device Applied SNOMEDCT Descripition 169477005 Intrauterine contraceptive device fitted 169479008 Intrauterine contraceptive device re-fitted 169480006 IUD checked .problems 169482003 IUD .defaulted from check 169483008 IUD fitting awaited 169484002 IUD removal awaited 169485001 IUD change due 169486000 IUD check due 169487009 IUD expelled 169488004 IUD failure .

70190 70200 70210 70220 70240 70250 70260 70300 70310 70320 70328 70330 70332 70336 70350 70355 70360 70370 70371 70373 70380 70390 70450 70460 RADEX OPTIC FORAMINA RADEX ORBITS COMPL MINIMUM 4 VIEWS RADEX SINUSES PARANSL < 3 VIEWS RADEX SINUSES PARANSL COMPL MINIMUM 3 VIEWS RADEX SELLA TURCICA RADEX SKL < 4 VIEWS RADEX SKL COMPL MINIMUM 4 VIEWS RADEX TEETH 1 VIEW RADEX TEETH PRTL XM < FULL MOUTH RADEX TEETH COMPL FULL MOUTH RADEX TMPRMAND JT OPN&CLSD MOUTH UNI RADEX TMPRMAND JT OPN&CLSD MOUTH BI TMPRMAND JT ARTHG RS&I MRI TMPRMAND JT CEPHALOGRAM ORTHODONTIC ORTHOPANTOGRAM RADEX NCK SOFT TISS RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ CPLX DYNAMIC PHARYNGEAL&SP EVAL C/V REC LARYNGOGRAPY CNTRST RS&I RADEX SALIVARY GLND F/ST1 SIALOGRAPY RS&I CT HEAD/BRN C-MATRL CT HEAD/BRN C+ MATRL Chlamydia Screening: Laboratory Test Result LOINC Description 14463-4 Chlamydia trachomatis [Presence] in Cervix by Organism specific culture 14464-2 14467-5 14470-9 14471-7 14474-1 14509-4 Chlamydia trachomatis [Presence] in Vaginal fluid by Organism specific culture Chlamydia trachomatis [Presence] in Urine sediment by Organism specific culture Chlamydia trachomatis Ag [Presence] in Cervix by Immunoassay Chlamydia trachomatis Ag [Presence] in Vaginal fluid by Immunoassay Chlamydia trachomatis Ag [Presence] in Urine sediment by Immunoassay Chlamydia trachomatis Ag [Presence] in Cervix by Immunofluorescence 66 .

14510-2 14513-6 16600-9 16601-7 21189-6 21190-4 21191-2 21192-0 21613-5 23838-6 31771-9 31772-7 31775-0 31777-6 4993-2 50387-0 53925-4 53926-2 Chlamydia trachomatis Ag [Presence] in Vaginal fluid by Immunofluorescence Chlamydia trachomatis Ag [Presence] in Urine sediment by Immunofluorescence Chlamydia trachomatis rRNA [Presence] in Genital specimen by DNA probe Chlamydia trachomatis rRNA [Presence] in Urine by DNA probe Chlamydia trachomatis DNA [Presence] in Cervical mucus by Probe & target amplification method Chlamydia trachomatis DNA [Presence] in Cervix by Probe & target amplification method Chlamydia trachomatis DNA [Presence] in Urethra by Probe & target amplification method Chlamydia trachomatis rRNA [Presence] in Urethra by DNA probe Chlamydia trachomatis DNA [Presence] in Unspecified specimen by Probe & target amplification method Chlamydia trachomatis rRNA [Presence] in Genital fluid by DNA probe Chlamydia trachomatis Ag [Presence] in Cervix Chlamydia trachomatis Ag [Presence] in Vaginal fluid Chlamydia trachomatis Ag [Presence] in Urine sediment Chlamydia trachomatis Ag [Presence] in Unspecified specimen Chlamydia trachomatis rRNA [Presence] in Unspecified specimen by DNA probe Chlamydia trachomatis rRNA [Presence] in Cervix by Probe & target amplification method Chlamydia trachomatis rRNA [Presence] in Urethra by Probe & target amplification method Chlamydia trachomatis rRNA [Presence] in Vaginal fluid by Probe & target amplification method Laboratory Test indicative of sexually active woman – Laboratory test performed LOINC Descripition 10705-2 Human papilloma virus Ag [Presence] in Tissue by Immune stain 11083-3 Human papilloma virus identified in Cervix 67 .

11084-1 11481-9 11597-2 12222-6 12223-4 14499-8 14500-3 14502-9 14503-7 14504-5 14506-0 15019-3 16280-0 17398-9 17399-7 17400-3 17401-1 17402-9 17403-7 17404-5 17405-2 17406-0 17407-8 17408-6 17409-4 17410-2 Reagin Ab [Titer] in Serum Human papilloma virus identified in Unspecified specimen Treponema pallidum Ab [Units/volume] in Serum Human papilloma virus Ag [Presence] in Genital specimen Human papilloma virus 16+18 Ag [Presence] in Genital specimen Human papilloma virus Ag [Presence] in Cervix Human papilloma virus Ag [Presence] in Vaginal fluid Human papilloma virus Ag [Presence] in Urethra Human papilloma virus 16+18 Ag [Presence] in Cervix Human papilloma virus 16+18 Ag [Presence] in Vaginal fluid Human papilloma virus 16+18 Ag [Presence] in Urethra Alpha-1-Fetoprotein [Moles/volume] in Amniotic fluid Human papilloma virus DNA [Presence] in Unspecified specimen by Probe with amplification Human papilloma virus 11 Ag [Presence] in Unspecified specimen Human papilloma virus 16 Ag [Presence] in Unspecified specimen Human papilloma virus 16+18 Ag [Presence] in Unspecified specimen Human papilloma virus 18 Ag [Presence] in Unspecified specimen Human papilloma virus 31 Ag [Presence] in Unspecified specimen Human papilloma virus 31+33+35 Ag [Presence] in Unspecified specimen Human papilloma virus 33 Ag [Presence] in Unspecified specimen Human papilloma virus 42 Ag [Presence] in Unspecified specimen Human papilloma virus 43 Ag [Presence] in Unspecified specimen Human papilloma virus 44 Ag [Presence] in Unspecified specimen Human papilloma virus 45 Ag [Presence] in Unspecified specimen Human papilloma virus 5 Ag [Presence] in Unspecified specimen Human papilloma virus 51 Ag [Presence] in Unspecified specimen Pregnancy Test – Laboratory test performed LOINC Descripition 19080-1 Choriogonadotropin [Units/volume] in Serum or Plasma 19180-9 Choriogonadotropin.beta subunit free [Units/volume] in Serum or Plasma Choriogonadotropin.beta subunit [Presence] in Urine 2113-9 Choriogonadotropin.beta subunit [Units/volume] in Serum or Plasma by 20415-6 Immunoassay (EIA) 3rd IS 20994-0 Choriogonadotropin [interpretation] in Serum or Plasma 2106-3 Choriogonadotropin [Presence] in Urine 2107-1 Choriogonadotropin [Moles/volume] in Urine 2110-5 Choriogonadotropin.beta subunit [Moles/volume] in Urine 68 .beta subunit [Moles/volume] in Serum or Plasma 2112-1 Choriogonadotropin.beta subunit [Presence] in Serum or Plasma 2111-3 Choriogonadotropin.beta subunit [Mass/time] in 24 hour Urine 2114-7 Choriogonadotropin.

01 MG Oral Tablet 249357 Desogestrel 0.05 MG Oral Tablet 198043 Mestranol 0.035 MG / norgestimate 0.25 MG Oral Tablet 240707 Desogestrel 0.4 MG Oral Tablet 238019 Ethinyl Estradiol 0.02 MG Oral Tablet 250505 Ethinyl Estradiol 1 MG Oral Tablet 250506 Ethinyl Estradiol 0.075 MG Oral Tablet 248310 Ethinyl Estradiol 0.15 MG Oral Tablet 238020 Estradiol 10 MG / Ethinyl Estradiol 5 MG / Levonorgestrel 6 MG Oral Tablet 240128 Ethinyl Estradiol 0.25 MG Oral Tablet 250893 Ethinyl Estradiol 0.03 MG Oral Tablet 310226 Ethinyl Estradiol 0.05 MG / Levonorgestrel 0.03 MG / Levonorgestrel 0.15 MG / Ethinyl Estradiol 0.5 MG Oral Tablet 238015 Ethinyl Estradiol 0. or active RxNorm Descripition 106318 Isotretinoin 5 MG Oral Capsule 107436 Isotretinoin 0.0005 MG/MG Topical Gel 197679 Ethinyl Estradiol 0.02 MG / Fluoxymesterone 1 MG Oral Tablet 310227 Ethinyl Estradiol 0.05 MG / Norethindrone 1 MG Oral Tablet 204407 Ethinyl Estradiol 0.03 MG / Levonorgestrel 0.0005 MG/MG Topical Gel 197843 Isotretinoin 10 MG Oral Capsule 197844 Isotretinoin 20 MG Oral Capsule 197845 Isotretinoin 40 MG Oral Capsule 403930 Isotretinoin 30 MG Oral Capsule Contraceptives: Medication Dispensed RxNorm Descripition 153371 Erythromycin 0.03 MG / Gestodene 0.005 MG / Norethindrone 1 MG Oral Tablet 284207 drospirenone 3 MG / Ethinyl Estradiol 0.02 MG / Levonorgestrel 0.25 MG Oral Tablet 246640 Ethinyl Estradiol 0.beta subunit free [Mass/volume] in Serum or Plasma Choriogonadotropin [Mass/volume] in Serum or Plasma Retinoid – Medication dispensed.beta subunit [Units/volume] in Serum or Plasma Choriogonadotropin [Units/volume] in Urine Choriogonadotropin.02 MG / Norethindrone 1 MG Oral Tablet 69 .035 MG / Norethindrone 0.02 MG Oral Tablet 197680 Ethinyl Estradiol 0.1 MG Oral Tablet 246521 Ethinyl Estradiol 0.03 MG Oral Tablet 242297 Ethinyl Estradiol 0.beta subunit free [Moles/volume] in Serum or Plasma Choriogonadotropin [Presence] in Serum or Plasma Choriogonadotropin [Moles/volume] in Serum or Plasma Choriogonadotropin. ordered.15 MG / Ethinyl Estradiol 0.25 MG Oral Tablet 259166 Ethinyl Estradiol 0.03 MG / Levonorgestrel 0.02 MG/MG / Isotretinoin 0.2115-4 2118-8 2119-6 21198-7 25372-4 25373-2 34670-0 Choriogonadotropin.

82 Encounter for screening for risk of pre-term labor V72.81 Encounter for assisted reproductive fertility procedure cycle V28 Encounter for antenatal screening of mother Encounter for routine antenatal screening for malformation using ultrasonics V28.035 MG / Norethindrone 0.02 measures V25.4 Pregnancy examination or test V72.42 Pregnancy examination or test.3 MG Oral Tablet Mestranol 0.05 MG / Norethindrone 2.2 Routine postpartum follow-up V25 Encounter for contraceptive management V25.81 Encounter for fetal anatomic survey V28.3 of mother V28.05 MG / Norethindrone 1 MG Oral Tablet Encounter: Pregnancy ICD-9-CM Descripition V24 Postpartum care and examination V24.41 Pregnancy examination or test.1 MG / Norethindrone 2 MG Oral Tablet Ethinyl Estradiol 0.0 Postpartum care and examination immediately after delivery V24.01 Encounter for general counseling on prescription of oral contraceptives Encounter for general counseling on initiation of other contraceptive V25.03 MG / Norgestrel 0. positive result 70 .40 Pregnancy examination or test.15 MG / Norethynodrel 9. pregnancy unconfirmed V72. negative result V72.5 MG Oral Tablet Ethinyl Estradiol 0.310228 310230 310234 310463 311359 311556 311557 311558 312033 312124 Ethinyl Estradiol 0.05 MG Oral Tablet Ethinyl Estradiol 0.85 MG Oral Tablet Mestranol 0.035 MG / Norethindrone 1 MG Oral Tablet Ethinyl Estradiol 0.035 MG / ethynodiol 1 MG Oral Tablet Ethinyl Estradiol 0.03 MG / Levonorgestrel 0.075 MG / Norethynodrel 5 MG Oral Tablet Mestranol 0.09 management V26.03 Encounter for emergency contraceptive counseling and prescription Encounter for other general counseling and advice on contraceptive V25.5 MG Oral Tablet Ethinyl Estradiol 0.

unspecified 154 Malignant neoplasm of rectum.1 Malignant neoplasm of rectum 197.5 Secondary malignant neoplasm of large intestine and rectum V10.3 Malignant neoplasm of sigmoid colon 153.Colorectal Cancer Screening (NQF 0034) (Additional Measure .MENU) Description: The percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer. and anus 154.7 Malignant neoplasm of splenic flexure 153.6 Malignant neoplasm of ascending colon 153.4 Malignant neoplasm of cecum 153.2 Malignant neoplasm of descending colon 153.1 Malignant neoplasm of transverse colon 153.8 Malignant neoplasm of other specified sites of large intestine 153.9 Malignant neoplasm of colon.05 Personal history of malignant neoplasm of large intestine Total colectomy CPT 44150 44151 44152 44153 44155 44156 44157 44158 44210 44211 44212 Description COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST COLCT TOT ABDL W/O PRCTECT W/MUCOSEC ANAST COLCT TOT ABDL W/O PRCTECT W/MUCOSEC ANAST RSVR COLCT TOT ABDL W/PRCTECT W/ILEOST COLCT TOT ABDL W/PRCTECT W/CONTINENT ILEOST COLCT TTL ABD W/PRCTECT ILEOANAL ANAST COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR LAPS COLCT TOT W/O PRCTECT W/ILEOST/ILEOPXTS LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANAST&RSVR LAPS COLCT ABDL W/PRCTECT W/ILEOST Flexible sigmoidoscopy CPT 45330 45331 45332 45333 45334 45335 71 Description SCOPE OF SIGMOID COLON ONLY FOR DIAGNOSIS SCOPE OF SIGMOID COLON ONLY WITH BIOPSY SGMDSC FLX RMVL FB SGMDSC FLX RMVL LES CAUT SGMDSC FLX CTRL BLD SGMDSC FLX DIRED SBMCSL NJX ANY SBST . rectosigmoid junction.5 Malignant neoplasm of appendix vermiformis 153. Diagnosis of colorectal cancer ICD-9 Description 153 Malignant neoplasm of colon 153.

CPT code 74280) during the measurement year or the 4 years prior to the measurement year Colonoscopy CPT 44388 44389 44390 44391 44392 44393 44394 44397 45355 45378 45379 45380 45381 45382 45383 45384 45385 45386 45387 45391 45392 Description SCOPE OF COLON THRU OSTOMY FOR DIAGNOSIS SCOPE OF COLON WITH BIOPSY THRU OSTOMY COLSC THRU STOMA W/RMVL FB COLSC THRU STOMA CTRL BLD COLSC THRU STOMA RMVL LES CAUT COLSC THRU STOMA ABLTJ LES COLSC THRU STOMA W/RMVL TUM POLYP/OTH LES SNARE COLSC THRU STOMA W/TNDSC STENT PLMT COLSC RGD/FLX TABDL VIA COLOTOMY 1/MLT SCOPE OF COLON FOR DIAGNOSIS COLSC FLX PROX SPLENIC FLXR RMVL FB SCOPE OF COLON WITH BIOPSY COLSC FLX PROX SPLENIC FLXR SBMCSL NJX COLSC FLX PROX SPLENIC FLXR CTRL BLD COLSC FLX PROX SPLENIC FLXR ABLTJ LES COLSC FLX PROX SPLENIC FLXR RMVL LES CAUT COLSC FLX PROX SPLENIC FLXR RMVL LES SNARE TQ COLSC FLX PROX SPLENIC FLXR DILAT BALO 1+ STRIXS COLSC FLX PROX SPLENIC FLXR TNDSC STENT PLMT COLSC FLX PROX SPLENIC FLXR NDSC US XM COLSC FLX PROX SPLENIC FLXR US GID NDL ASPIR/BX Fecal occult blood test during the measurement year 12503-9 Hemoglobin.gastrointestinal [Presence] in Stool --3rd specimen 2335-8 Hemoglobin.gastrointestinal [Presence] in Stool --6th specimen 72 .gastrointestinal [Presence] in Stool --4th specimen 12504-7 Hemoglobin.gastrointestinal [Presence] in Stool --1st specimen 14564-9 Hemoglobin.gastrointestinal [Presence] in Stool 27396-1 Hemoglobin.45337 45338 45339 45340 45341 45342 45345 SGMDSC FLX DCMPRN VOLVULUS ANY METH SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ SGMDSC FLX ABLTJ LES SGMDSC FLX DILAT BALO 1/MORE STRIXS SGMDSC FLX NDSC US XM SGMDSC FLX TNDSC US GID NDL ASPIR/BX SGMDSC FLX TNDSC STENT PLMT Double contrast barium enema (DCBE.gastrointestinal [Presence] in Stool --2nd specimen 14565-6 Hemoglobin.gastrointestinal [Mass/mass] in Stool 27401-9 Hemoglobin.gastrointestinal [Presence] in Stool --5th specimen 14563-1 Hemoglobin.

gastrointestinal [Presence] in Stool by Immunologic method 73 .gastrointestinal [Presence] in Stool --8th specimen Hemoglobin.gastrointestinal [Presence] in Stool --7th specimen Hemoglobin.27925-7 27926-5 29771-3 Hemoglobin.

Use of Appropriate Medications for Asthma (NQF 0036) (Additional Measure . with (acute) exacerbation 493.81 Acute respiratory failure Use of Appropriate Medications for Asthma – Active Diagnosis of Asthma ICD-9-CM Description 493.11 Intrinsic asthma with status asthmaticus 74 .MENU) Description: Assesses the appropriate and timely use of medication for long-term control of asthma symptoms. Use of Appropriate Medications for Asthma – Encounter Acute Inpatient CPT Description 99221 1ST HOSP CARE PR D 30 MIN 99222 1ST HOSP CARE PR D 50 MIN 99223 1ST HOSP CARE PR D 70 MIN 99231 SBSQ HOSP CARE PR D 15 MIN 99232 SBSQ HOSP CARE PR D 25 MIN 99233 SBSQ HOSP CARE PR D 35 MIN 99238 HOSP DSCHRG D MGMT 30 MIN/< 99239 HOSP DSCHRG D MGMT > 30 MIN 99251 1ST INPT CONSLTJ 20 MIN 99252 1ST INPT CONSLTJ 40 MIN 99253 1ST INPT CONSLTJ 55 MIN 99254 1ST INPT CONSLTJ 80 MIN 99255 1ST INPT CONSLTJ 110 MIN 99291 CC E/M CRITICALLY ILL/INJURED 1ST 30-74 MIN Use of Appropriate Medications for Asthma – Encounter ED CPT Description 99281 EMER DEPT SELF LIMITED/MINOR 99282 EMER DEPT LOW TO MODERATE SEVERITY 99283 EMER DEPT MODERATE SEVERITY 99284 EMER DEPT HI SEVERITY&URGENT EVAL 99285 EMER DEPT HIGH SEVERITY&THREAT FUNCJ Use of Appropriate Medications for Asthma – Active Diagnosis of Acute Respiratory Failure ICD-9-CM Description 518. The measure facilitates efforts toward effective disease management and prevention of traumatic outcomes (Real-Time Rule).10 Intrinsic asthma 493.01 Extrinsic asthma with status asthmaticus 493.00 Asthma 493.02 Extrinsic asthma.

02 Cystic fibrosis with pulmonary manifestations 277. Ordered.20 493. with (acute) exacerbation Exercise induced bronchospasm Cough variant asthma Asthma.81 493. with (acute) exacerbation 496 Chronic airway obstruction.0 Cystic fibrosis 277.2 Chronic obstructive asthma 493. with status asthmaticus Asthma.92 Intrinsic asthma.1 Interstitial emphysema 518.03 Cystic fibrosis with gastrointestinal manifestations 277.09 Cystic fibrosis with other manifestations Use of Appropriate Medications for Asthma – Active Diagnosis of Emphysema ICD-9-CM Description 492 Emphysema 492.12 493.493.22 493. not elsewhere classified 506.8 Other emphysema 518.4 Chronic respiratory conditions due to fumes and vapors Use of Appropriate Medications for Asthma – Active Diagnosis of Cystic Fibrosis ICD-9-CM Description 277.90 493.21 Obstructive chronic bronchitis with (acute) exacerbation 491.01 Cystic fibrosis with meconium ileus 277. unspecified with (acute) exacerbation Use of Appropriate Medications for Asthma – Active Diagnosis of COPD ICD-9-CM Description 491.91 493.22 Chronic obstructive asthma. unspecified Asthma. or Dispensed RxNorm Description 197639 Dyphylline 200 MG / Guaifenesin 200 MG Oral Tablet 198266 Guaifenesin 180 MG / Theophylline 300 MG Oral Capsule 75 . unspecified type.22 Obstructive chronic bronchitis with acute bronchitis 492 Emphysema 493. with status asthmaticus 493.21 493.82 493.2 Compensatory emphysema Use of Appropriate Medications for Asthma – Antiasthmatic Combinations of Medication Active.00 Cystic fibrosis without mention of meconium ileus 277. with status asthmaticus Chronic obstructive asthma.2 Obstructive chronic bronchitis 491.21 Chronic obstructive asthma. with (acute) exacerbation Chronic obstructive asthma Chronic obstructive asthma.

or Dispensed RxNorm Description 104568 Beclomethasone 0.25 MG/ACTUAT Inhalant Solution 76 . Ordered.4 MG/ACTUAT Inhalant Powder 150810 Beclomethasone 0.33 MG/ML Oral Solution Potassium Iodide 8.5 MG / Guaifenesin 100 MG / Theophylline 60 MG Oral Tablet Dyphylline 200 MG / Guaifenesin 100 MG Oral Capsule Dyphylline 20 MG/ML / Guaifenesin 20 MG/ML Oral Solution Ephedrine 24 MG / Guaifenesin 100 MG / Theophylline 100 MG Oral Tablet Ephedrine 24 MG / Phenobarbital 24 MG / Potassium Iodide 320 MG / Theophylline 130 MG Oral Tablet Guaifenesin 6.67 MG/ML / Theophylline 20 MG/ML Oral Solution Dyphylline 200 MG / Guaifenesin 100 MG Oral Tablet Guaifenesin 13.198267 243324 243325 243327 246453 251963 260063 283239 310043 310045 310096 310097 310616 310617 310658 314004 315111 346733 349386 349629 359468 388681 428925 756306 756311 Guaifenesin 90 MG / Theophylline 150 MG Oral Capsule Guaifenesin 6.67 MG/ML / Theophylline 8.67 MG/ML / Theophylline 6.3 MG/ML / Theophylline 10 MG/ML Oral Solution Guaifenesin 200 MG / Theophylline 150 MG Oral Tablet Ephedrine 12. or Dispensed RxNorm Description 403866 omalizumab 125 MG/ML Injectable Solution Use of Appropriate Medications for Asthma – Inhaled corticosteroids of Medication Active.2 MG/ACTUAT Inhalant Powder 152594 24 HR Budesonide 3 MG Extended Release Capsule 152680 Beclomethasone 0.168 MG/ACTUAT Inhalant Solution 141917 Budesonide 0.33 MG/ML Oral Solution Guaifenesin 6.67 MG/ML Oral Solution Guaifenesin 100 MG / Theophylline 125 MG Oral Tablet Guaifenesin 6 MG/ML / Theophylline 10 MG/ML Oral Solution Guaifenesin 180 MG / Theophylline 300 MG Extended Release Capsule Guaifenesin 200 MG / Theophylline 250 MG Oral Tablet Guaifenesin 183 MG / Theophylline 305 MG Oral Capsule Dyphylline 200 MG / Guaifenesin 400 MG Extended Release Tablet Dyphylline 200 MG / Guaifenesin 300 MG Oral Tablet Dyphylline 200 MG / Guaifenesin 400 MG Oral Tablet Dyphylline 100 MG / Guaifenesin 100 MG Oral Tablet Guaifenesin 100 MG / Theophylline 137 MG Oral Tablet Guaifenesin 10 MG/ML / Pseudoephedrine 2 MG/ML / Theophylline 10 MG/ML Oral Solution Guaifenesin 30 MG/ML / Pseudoephedrine 6 MG/ML / Theophylline 30 MG/ML Oral Solution Use of Appropriate Medications for Asthma – Antibody Inhibitor of Medication Active.67 MG/ML / Theophylline 5. Ordered.2 MG/ACTUAT Inhalant Solution 150807 Beclomethasone 0.

04 MG/ACTUAT Inhalant Solution Budesonide 0.0045 MG/ACTUAT Inhalant Powder Budesonide 0.0045 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Budesonide 0.08 MG/ACTUAT / formoterol 0.32 MG/ACTUAT / formoterol 0.009 MG/ACTUAT Inhalant Powder Budesonide 0.0045 MG/ACTUAT Metered Dose Inhaler .4 MG/ACTUAT Inhalant Powder mometasone furoate 0.25 MG/ACTUAT Inhalant Powder Dyphylline 6.1 MG/ACTUAT Nasal Spray Budesonide 0.08 MG/ACTUAT Inhalant Solution Budesonide 0.08 MG/ACTUAT / formoterol 0.2 MG/ACTUAT Inhalant Powder Budesonide 0.67 MG/ML Oral Solution Triamcinolone 0.16 MG/ACTUAT / formoterol 0.055 MG/ACTUAT Nasal Spray Budesonide 0.055 MG/ACTUAT Nasal Inhalant Beclomethasone 0.032 MG/ACTUAT Nasal Spray Budesonide 0.064 MG/ACTUAT Nasal Spray Budesonide 0.197704 241063 245785 247042 247047 247048 247551 247691 249853 250648 252559 308817 311754 313458 313461 313882 349094 351109 387015 389134 401958 409732 582486 597829 603778 617268 617270 644548 692475 692477 707365 745798 745803 617270 745807 77 flunisolide 0.09 MG/ACTUAT Inhalant Powder Budesonide 0.05 MG/ACTUAT Nasal Spray Triamcinolone 0.1 MG/ACTUAT Inhalant Powder Budesonide 0.0045 MG/ACTUAT Inhalant Powder flunisolide 0.5 MG/ML Inhalant Solution Budesonide 0.0045 MG/ACTUAT Metered Dose Inhaler mometasone furoate 0.05 MG/ACTUAT Inhalant Solution Budesonide 0.1 MG/ACTUAT Inhalant Solution Triamcinolone 0.029 MG/ACTUAT Nasal Spray mometasone furoate 0.67 MG/ML / Guaifenesin 6.16 MG/ACTUAT / formoterol 0.2 MG/ACTUAT Inhalant Powder 60 ACTUAT Budesonide 0.18 MG/ACTUAT Inhalant Powder Budesonide 0.125 MG/ML Inhalant Solution Budesonide 0.05 MG/ACTUAT Nasal Spray Budesonide 0.0045 MG/ACTUAT Inhalant Solution 60 ACTUAT Budesonide 0.0045 MG/ACTUAT Inhalant Powder Budesonide 0.08 MG/ACTUAT / formoterol 0.25 MG/ML Inhalant Solution Budesonide 3 MG Oral Capsule Budesonide 0.006 MG/ACTUAT Inhalant Powder Budesonide 0.16 MG/ACTUAT / formoterol 0.08 MG/ACTUAT / formoterol 0.032 MG/ACTUAT Nasal Inhalant mometasone furoate 0.2 MG/ACTUAT Inhalant Powder flunisolide 0.16 MG/ACTUAT / formoterol 0.

055 MG/ACTUAT Nasal Inhaler 200 ACTUAT flunisolide 0.25 MG/ACTUAT Metered Dose Inhaler 50 ACTUAT flunisolide 0.2 MG/ACTUAT Dry Powder Inhaler 14 ACTUAT mometasone furoate 0.1 MG/ACTUAT / salmeterol 0.055 MG/ACTUAT Nasal Inhaler 30 ACTUAT Triamcinolone 0.2 MG/ACTUAT Dry Powder Inhaler 30 ACTUAT mometasone furoate 0.08 MG/ACTUAT / formoterol 0.032 MG/ACTUAT Nasal Inhaler 240 ACTUAT Triamcinolone 0.05 MG/ACTUAT Dry Powder Inhaler 28 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT Dry Powder Inhaler mometasone furoate 0.1 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT Fluticasone propionate 0.0275 MG/ACTUAT Nasal Inhaler 120 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Nasal Inhaler Budesonide 3 MG Extended Release Capsule 120 ACTUAT fluticasone furoate 0.25 MG/ACTUAT Dry Powder Inhaler 28 ACTUAT Fluticasone propionate 0.075 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Triamcinolone 0.25 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Triamcinolone Acetonide 0.05 MG/ACTUAT Nasal Inhaler 100 ACTUAT Triamcinolone 0.1 MG/ACTUAT Dry Powder Inhaler 14 ACTUAT Fluticasone propionate 0.22 MG/ACTUAT Metered Dose Inhaler 60 ACTUAT Fluticasone propionate 0.11 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT / salmeterol 0.2 MG/ACTUAT Dry Powder Inhaler 120 ACTUAT Budesonide 0.22 MG/ACTUAT Metered Dose Inhaler 60 ACTUAT Fluticasone propionate 0.2 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT mometasone furoate 0.05 MG/ACTUAT Dry Powder Inhaler 28 ACTUAT Fluticasone propionate 0.745812 746199 746460 746803 746810 746812 746814 746821 746832 748625 752369 752372 752376 790278 790283 792945 828927 828930 833245 844426 895968 895994 895999 896004 896008 896010 896012 896018 896021 896025 896028 896030 896161 896174 896184 78 120 ACTUAT Budesonide 0.05 .11 MG/ACTUAT Metered Dose Inhaler 60 ACTUAT Fluticasone propionate 0.0045 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT mometasone furoate 0.1 MG/ACTUAT / salmeterol 0.029 MG/ACTUAT Nasal Inhaler 7 ACTUAT mometasone furoate 0.044 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Fluticasone propionate 0.032 MG/ACTUAT Nasal Inhaler 200 ACTUAT Budesonide 0.05 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT Fluticasone propionate 0.1 MG/ML Inhalant Powder 100 ACTUAT flunisolide 0.044 MG/ACTUAT Metered Dose Inhaler 60 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT Fluticasone propionate 0.055 MG/ACTUAT Nasal Inhaler 120 ACTUAT mometasone furoate 0.1 MG/ACTUAT Dry Powder Inhaler 30 ACTUAT mometasone furoate 0.

5 MG/ACTUAT / salmeterol 0.08 MG/ACTUAT / formoterol 0.0045 745798 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Budesonide 0.05 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT Fluticasone propionate 0.25 MG/ML Inhalant Solution 120 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler 14 ACTUAT Fluticasone propionate 0.006 MG/ACTUAT Inhalant 389134 Powder Budesonide 0.115 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Fluticasone propionate 0.0045 745803 MG/ACTUAT Metered Dose Inhaler 60 ACTUAT Budesonide 0. or Dispensed RxNorm Description Budesonide 0.05 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT Fluticasone propionate 0.16 MG/ACTUAT / formoterol 0.115 MG/ACTUAT / salmeterol 0.009 MG/ACTUAT Inhalant 401958 Powder Budesonide 0.5 MG/ACTUAT / salmeterol 0.045 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler 28 ACTUAT Fluticasone propionate 0.08 MG/ACTUAT / formoterol 0.23 MG/ACTUAT / salmeterol 0.0045 MG/ACTUAT Inhalant 409732 Powder Budesonide 0.08 MG/ACTUAT / formoterol 0.05 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT Fluticasone propionate 0.021 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Fluticasone propionate 0.021 MG/ACTUAT Metered Dose Inhaler 60 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler 28 ACTUAT Fluticasone propionate 0.896186 896192 896209 896218 896225 896228 896231 896236 896239 896244 896267 96272 896294 896300 896321 896324 MG/ACTUAT Dry Powder Inhaler 14 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Nasal Inhaler 60 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT / salmeterol 0.045 MG/ACTUAT / salmeterol 0.32 MG/ACTUAT / formoterol 0.0045 MG/ACTUAT Inhalant 707365 Solution 60 ACTUAT Budesonide 0.25 MG/ACTUAT / salmeterol 0.0045 745807 MG/ACTUAT Metered Dose Inhaler 79 . Ordered.16 MG/ACTUAT / formoterol 0.021 MG/ACTUAT Metered Dose Inhaler 60 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Nasal Inhaler Use of Appropriate Medications for Asthma – Inhaled steroid combinations of Medication Active.16 MG/ACTUAT / formoterol 0.25 MG/ACTUAT / salmeterol 0.0045 MG/ACTUAT Inhalant 597829 Powder Budesonide 0.021 MG/ACTUAT Metered Dose Inhaler Fluticasone propionate 1 MG/ML Inhalant Solution Fluticasone propionate 1 MG/ML Inhalant Solution Fluticasone propionate 0.08 MG/ACTUAT / formoterol 0.5 MG/ACTUAT / salmeterol 0.

021 MG/ACTUAT Metered Dose Inhaler 60 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler 60 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler 14 ACTUAT Fluticasone propionate 0. or Dispensed RxNorm Description 199655 zafirlukast 20 MG Oral Tablet 199904 zileuton 600 MG Oral Tablet 200224 montelukast 10 MG Oral Tablet 242438 montelukast 5 MG Chewable Tablet 311759 montelukast 4 MG Chewable Tablet 313758 zafirlukast 10 MG Oral Tablet 351246 montelukast 4 MG Granules 391880 montelukast 4 MG Oral Tablet 392072 montelukast 5 MG Oral Tablet 723848 zileuton 600 MG Extended Release Tablet 730834 12 HR zileuton 600 MG Extended Release Tablet Use of Appropriate Medications for Asthma – Long acting inhaled beta 2 agonist of Medication Active.23 MG/ACTUAT / salmeterol 0.1 MG/ACTUAT / salmeterol 0.115 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler 28 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT / salmeterol 0.745812 896161 896174 896184 896186 896192 896218 896225 896228 896231 896239 896244 896267 896272 120 ACTUAT Budesonide 0.021 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler 14 ACTUAT Fluticasone propionate 0.5 MG/ACTUAT / salmeterol 0.045 MG/ACTUAT / salmeterol 0.23 MG/ACTUAT / salmeterol 0.25 MG/ACTUAT / salmeterol 0. Ordered.5 MG/ACTUAT / salmeterol 0. or Dispensed RxNorm Description 80 .05 MG/ACTUAT Dry Powder Inhaler 28 ACTUAT Fluticasone propionate 0.115 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT Fluticasone propionate 0.0045 MG/ACTUAT Metered Dose Inhaler 14 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler 28 ACTUAT Fluticasone propionate 0.08 MG/ACTUAT / formoterol 0.021 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT / salmeterol 0. Ordered.5 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler Use of Appropriate Medications for Asthma – Leukotriene inhibitors of Medication Active.

021 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT Fluticasone propionate 0.021 MG/ACTUAT Metered Dose Inhaler 60 ACTUAT Fluticasone propionate 0.5 MG/ACTUAT / salmeterol 0.251366 312897 318142 349154 389134 401958 409732 597829 707365 728211 745798 745803 745807 745812 866044 866048 896161 896174 896184 896186 896192 896209 896218 896225 896228 896231 896236 896239 81 formoterol 0.05 MG/ACTUAT Dry Powder Inhaler 14 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT Fluticasone propionate 0.0045 MG/ACTUAT Metered Dose Inhaler 28 ACTUAT salmeterol 0.25 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT salmeterol 0.08 MG/ACTUAT / formoterol 0.16 MG/ACTUAT / formoterol 0.05 MG/ACTUAT Dry Powder Inhaler 28 ACTUAT Fluticasone propionate 0.006 MG/ACTUAT Inhalant Powder Budesonide 0.012 MG/ACTUAT Inhalant Powder Budesonide 0.0045 MG/ACTUAT Inhalant Powder Budesonide 0.009 MG/ACTUAT Inhalant Powder Budesonide 0.05 MG/ACTUAT Dry Powder Inhaler 14 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler 28 ACTUAT Fluticasone propionate 0.021 .05 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler 60 ACTUAT Fluticasone propionate 0.08 MG/ACTUAT / formoterol 0.08 MG/ACTUAT / formoterol 0.08 MG/ACTUAT / formoterol 0.045 MG/ACTUAT / salmeterol 0.1 MG/ACTUAT / salmeterol 0.01 MG/ML Inhalant Solution 60 ACTUAT Budesonide 0.0045 MG/ACTUAT Inhalant Solution formoterol 0.5 MG/ACTUAT / salmeterol 0.08 MG/ACTUAT / formoterol 0.16 MG/ACTUAT / formoterol 0.05 MG/ACTUAT Dry Powder Inhaler 28 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT / salmeterol 0.0045 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Budesonide 0.25 MG/ACTUAT / salmeterol 0.006 MG/ACTUAT Inhalant Powder salmeterol 0.021 MG/ACTUAT Inhalant Solution salmeterol 0.0045 MG/ACTUAT Inhalant Powder Budesonide 0.5 MG/ACTUAT / salmeterol 0.16 MG/ACTUAT / formoterol 0.32 MG/ACTUAT / formoterol 0.1 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Inhalant Powder formoterol 0.0045 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Budesonide 0.0045 MG/ACTUAT Metered Dose Inhaler 60 ACTUAT Budesonide 0.115 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler 14 ACTUAT Fluticasone propionate 0.045 MG/ACTUAT / salmeterol 0.

23 MG/ACTUAT / salmeterol 0. or Dispensed RxNorm Description 746340 112 ACTUAT Cromolyn Sodium 0.2 MG/ACTUAT Nasal Inhaler 746342 200 ACTUAT Cromolyn Sodium 0.8 MG/ACTUAT Metered Dose Inhaler 830585 Cromolyn Sodium 20 MG/ML / xylometazoline 0.8 MG/ACTUAT Inhalant Powder 831261 Cromolyn Sodium 20 MG/ML Oral Solution 831263 Cromolyn Sodium 100 MG Oral Capsule 831303 Cromolyn Sodium 20 MG/ML Nasal Solution 831487 Cromolyn Sodium 20 MG/ML Inhalant Solution 849548 Cromolyn Sodium 5.2 MG/ACTUAT Nasal Inhaler 746342 200 ACTUAT Cromolyn Sodium 0.8 MG/ACTUAT Metered Dose Inhaler 746341 200 ACTUAT Cromolyn Sodium 5.8 MG/ACTUAT Metered Dose Inhaler 746341 200 ACTUAT Cromolyn Sodium 5.896244 896267 896272 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Fluticasone propionate 0.115 MG/ACTUAT / salmeterol 0.8 MG/ACTUAT Metered Dose Inhaler 830585 Cromolyn Sodium 20 MG/ML / xylometazoline 0.25 MG/ML Nasal Spray 831109 Cromolyn Sodium 40 MG/ML Ophthalmic Solution Use of Appropriate Medications for Asthma – Methylxanthines of Medication Active.2 MG/ACTUAT Nasal Spray 885241 Cromolyn Sodium 5 MG/ACTUAT Inhalant Powder 746340 112 ACTUAT Cromolyn Sodium 0.021 MG/ACTUAT Metered Dose Inhaler Use of Appropriate Medications for Asthma – Mast Cell stabilizer of Medication Active. or Dispensed RxNorm Description 104553 Theophylline 12 MG/ML Oral Solution 108870 Theophylline 2 MG/ML Oral Solution 197354 Aminophylline 250 MG Rectal Suppository 197637 Dyphylline 200 MG Oral Tablet 197638 Dyphylline 400 MG Oral Tablet 197639 Dyphylline 200 MG / Guaifenesin 200 MG Oral Tablet 198255 Theophylline 100 MG Oral Capsule 198256 Theophylline 100 MG Oral Tablet 198257 Theophylline 125 MG Extended Release Capsule 198258 Theophylline 125 MG Oral Tablet 82 .25 MG/ML Nasal Spray 831109 Cromolyn Sodium 40 MG/ML Ophthalmic Solution 831246 Cromolyn Sodium 10 MG/ML Inhalant Solution 831257 Cromolyn Sodium 0. Ordered.23 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler 120 ACTUAT Fluticasone propionate 0.021 MG/ACTUAT Metered Dose Inhaler 60 ACTUAT Fluticasone propionate 0. Ordered.

5 MG / Theophylline 120 MG Oral Tablet Theophylline 100 MG Extended Release Tablet Dyphylline 6.5 MG / Phenobarbital 7.3 MG/ML / Theophylline 10 MG/ML Oral Solution 12 HR Theophylline 100 MG Extended Release Capsule 12 HR Theophylline 125 MG Extended Release Capsule 12 HR Theophylline 130 MG Extended Release Capsule 12 HR Theophylline 200 MG Extended Release Capsule 12 HR Theophylline 260 MG Extended Release Capsule 12 HR Theophylline 300 MG Extended Release Capsule 12 HR Theophylline 50 MG Extended Release Capsule 12 HR Theophylline 60 MG Extended Release Capsule 12 HR Theophylline 65 MG Extended Release Capsule 12 HR Theophylline 75 MG Extended Release Capsule 24 HR Theophylline 100 MG Extended Release Capsule 24 HR Theophylline 200 MG Extended Release Capsule 24 HR Theophylline 300 MG Extended Release Capsule 24 HR Theophylline 400 MG Extended Release Capsule 12 HR Theophylline 200 MG Extended Release Tablet 12 HR Theophylline 250 MG Extended Release Tablet 83 .67 MG/ML Oral Solution Aminophylline 250 MG/ML Injectable Solution Ephedrine 15 MG / Theophylline 120 MG Oral Tablet Ephedrine 11 MG / Theophylline 120 MG Oral Tablet Guaifenesin 13.198259 198260 198261 198262 198264 198266 198267 199809 204403 204683 237178 241063 242959 243324 243325 243327 243329 245318 246453 248333 249984 250604 250799 251963 259060 259061 259062 259063 259064 259065 259066 259067 259068 259069 259070 259071 259072 259073 259074 259075 Theophylline 200 MG Oral Capsule Theophylline 200 MG Oral Tablet Theophylline 250 MG Oral Tablet Theophylline 300 MG Oral Capsule Theophylline 400 MG Extended Release Capsule Guaifenesin 180 MG / Theophylline 300 MG Oral Capsule Guaifenesin 90 MG / Theophylline 150 MG Oral Capsule Theophylline 175 MG Extended Release Tablet Dyphylline 250 MG/ML Injectable Solution Ephedrine 22.67 MG/ML / Theophylline 5.67 MG/ML Oral Solution Mersalyl 100 MG/ML / Theophylline 50 MG/ML Injectable Solution Guaifenesin 6.67 MG/ML / Theophylline 20 MG/ML Oral Solution Ephedrine 24 MG / Theophylline 130 MG Oral Tablet Aminophylline 350 MG Extended Release Tablet Dyphylline 200 MG / Guaifenesin 100 MG Oral Tablet Dyphylline 6.67 MG/ML / Guaifenesin 6.33 MG/ML Oral Solution Guaifenesin 6.33 MG/ML Oral Solution Potassium Iodide 8.67 MG/ML / Theophylline 8.

4 MG/ML Injectable Solution Theophylline 0.7 MG/ML Oral Solution Theophylline 200 MG Extended Release Capsule Theophylline 250 MG Oral Capsule .05 MG/ACTUAT Nasal Spray 12 HR Theophylline 250 MG Extended Release Capsule 24 HR Theophylline 400 MG Extended Release Tablet Guaifenesin 200 MG / Theophylline 150 MG Oral Tablet Ephedrine 12.259076 259077 259078 259079 259259 259292 259325 260063 283239 308103 308105 308106 308107 308108 308110 308112 308113 308114 308117 308118 308119 308120 308121 310039 310041 310043 310045 310096 310097 310099 310616 310658 313262 313263 313264 313271 313272 313278 84 12 HR Theophylline 300 MG Extended Release Tablet 12 HR Theophylline 450 MG Extended Release Tablet 12 HR Theophylline 500 MG Extended Release Tablet 24 HR Theophylline 600 MG Extended Release Tablet Triamcinolone 0.5 MG Oral Tablet Aminophylline 1 MG/ML Injectable Solution Aminophylline 200 MG Oral Tablet Aminophylline 25 MG/ML Injectable Solution Aminophylline 500 MG Rectal Suppository Dyphylline 100 MG / Ephedrine 16 MG / Guaifenesin 200 MG / Phenobarbital 16 MG Oral Tablet Dyphylline 125 MG/ML Injectable Solution Dyphylline 200 MG / Guaifenesin 100 MG Oral Capsule Dyphylline 20 MG/ML / Guaifenesin 20 MG/ML Oral Solution Ephedrine 24 MG / Guaifenesin 100 MG / Theophylline 100 MG Oral Tablet Ephedrine 24 MG / Phenobarbital 24 MG / Potassium Iodide 320 MG / Theophylline 130 MG Oral Tablet Ephedrine 24 MG / Phenobarbital 8 MG / Theophylline 130 MG Oral Tablet Guaifenesin 6.67 MG/ML / Theophylline 6.6 MG/ML Injectable Solution Theophylline 10.5 MG / Guaifenesin 100 MG / Theophylline 60 MG Oral Tablet Aminophylline 100 MG Enteric Coated Tablet Aminophylline 21 MG/ML Oral Solution Aminophylline 120 MG / Ephedrine 24 MG / Phenobarbital 24 MG Oral Capsule Aminophylline 130 MG / Guaifenesin 100 MG / Phenobarbital 8 MG Oral Tablet Aminophylline 130 MG / Ephedrine 16 MG / Phenobarbital 8 MG / Potassium Iodide 195 MG Oral Tablet Aminophylline 130 MG / Potassium Iodide 195 MG Oral Tablet Aminophylline 195 MG Oral Tablet Aminophylline 200 MG Enteric Coated Tablet Aminophylline 225 MG Extended Release Tablet Aminophylline 97.67 MG/ML Oral Solution Guaifenesin 6 MG/ML / Theophylline 10 MG/ML Oral Solution Theophylline 0.8 MG/ML Injectable Solution Theophylline 1.

33 MG/ML Oral Solution Theophylline 225 MG Oral Tablet Theophylline 300 MG Extended Release Capsule Theophylline 60 MG Extended Release Capsule Aminophylline 100 MG Oral Tablet Aminophylline 100 MG / Phenobarbital 15 MG Enteric Coated Tablet Aminophylline 2 MG/ML Injectable Solution Ephedrine 25 MG / Theophylline 104 MG Oral Capsule Guaifenesin 180 MG / Theophylline 300 MG Extended Release Capsule Theophylline 250 MG Extended Release Tablet Theophylline 450 MG Extended Release Tablet Guaifenesin 200 MG / Theophylline 250 MG Oral Tablet Theophylline 300 MG Extended Release Tablet Theophylline 130 MG Extended Release Capsule Theophylline 250 MG Extended Release Capsule Theophylline 200 MG Extended Release Tablet Guaifenesin 183 MG / Theophylline 305 MG Oral Capsule Theophylline 600 MG Extended Release Tablet Dyphylline 200 MG / Guaifenesin 400 MG Extended Release Tablet Dyphylline 200 MG / Guaifenesin 300 MG Oral Tablet 12 HR Theophylline 100 MG Extended Release Tablet Dyphylline 200 MG / Guaifenesin 400 MG Oral Tablet Dyphylline 100 MG / Guaifenesin 100 MG Oral Tablet Theophylline 50 MG Oral Capsule Theophylline 20 MG/ML Oral Suspension Aminophylline 60 MG/ML Enema Theophylline 10 MG/ML Oral Solution Aminophylline 130 MG / Guaifenesin 100 MG Oral Tablet Guaifenesin 100 MG / Theophylline 137 MG Oral Tablet Theophylline 330 MG Oral Tablet Noscapine 30 MG / Theophylline 200 MG Extended Release Tablet Theophylline 100 MG Chewable Tablet Aminophylline 300 MG Extended Release Tablet .313280 313284 313285 313291 313297 313298 313302 313304 313306 313309 313310 313312 313794 313835 313836 313966 314004 314240 314241 315111 317769 317831 317869 346574 346733 348472 349386 349629 358343 359468 388681 411090 421824 422737 425539 428923 428925 428980 431807 433559 434109 85 Theophylline 260 MG Extended Release Capsule Theophylline 2 MG/ML Injectable Solution Theophylline 3.2 MG/ML Injectable Solution Theophylline 400 MG Extended Release Tablet Theophylline 4 MG/ML Injectable Solution Theophylline 500 MG Extended Release Tablet Theophylline 65 MG Extended Release Capsule Theophylline 75 MG Extended Release Capsule Theophylline 5.

1 MG/ACTUAT / Ipratropium 0.5 MG/ML Oral Solution Aminophylline 100 MG/ML Enema Use of Appropriate Medications for Asthma – Short acting beta 2 agonist of Medication Active.6 MG/ML Oral Solution Dyphylline 10.1 MG/ACTUAT / Cromolyn 1 MG/ACTUAT Inhalant Solution 108889 Albuterol 2.5 MG/ACTUAT Inhalant Solution 153741 Albuterol 4 MG Extended Release Capsule 153742 Albuterol 8 MG Extended Release Capsule 197316 Albuterol 2 MG Oral Tablet 197318 Albuterol 4 MG Oral Tablet 198106 pirbuterol 0.434226 484500 484668 562298 562480 562482 562484 686919 701712 706550 727377 755737 755738 755739 756090 756248 756291 756292 756294 756306 756311 756346 756347 833038 12 HR Aminophylline 225 MG Extended Release Tablet Aminophylline 100 MG / Phenobarbital 15 MG Oral Tablet Aminophylline 130 MG / Ephedrine 25 MG Oral Capsule Guaifenesin 6 MG/ML / Theophylline 15 MG/ML Oral Solution Aminophylline 111 MG / Guaifenesin 100 MG Oral Tablet Aminophylline 130 MG / Amobarbital 25 MG / Ephedrine 25 MG Oral Tablet Aminophylline 130 MG / Ephedrine 16 MG / Guaifenesin 100 MG / Phenobarbital 8 MG Oral Tablet Guaifenesin 30 MG/ML / Theophylline 20 MG/ML Oral Solution Theophylline 100 MG Extended Release Capsule Theophylline 50 MG Extended Release Capsule 10 ML Aminophylline 25 MG/ML Prefilled Syringe Dyphylline 20 MG/ML / Guaifenesin 10 MG/ML Oral Solution Dyphylline 20 MG/ML / Guaifenesin 40 MG/ML Oral Solution Dyphylline 40 MG/ML / Guaifenesin 20 MG/ML Oral Solution Guaifenesin 40 MG/ML / Theophylline 30 MG/ML Oral Solution Aminophylline 16.02 MG/ACTUAT Inhalant 103987 Solution 104514 Albuterol 0.5 MG/ML Injectable Solution 86 .7 MG/ML Oral Solution Dyphylline 32 MG/ML Oral Solution Guaifenesin 10 MG/ML / Pseudoephedrine 2 MG/ML / Theophylline 10 MG/ML Oral Solution Guaifenesin 30 MG/ML / Pseudoephedrine 6 MG/ML / Theophylline 30 MG/ML Oral Solution Theophylline 22 MG/ML Oral Solution Theophylline 7. or Dispensed RxNorm Description Albuterol 0.7 MG/ML Oral Solution Dyphylline 10 MG/ML / Ephedrine 1.4 MG/ACTUAT Inhalant Powder 104582 Albuterol 0.5 MG/ACTUAT / Ipratropium 0.6 MG/ML / Guaifenesin 20 MG/ML / Phenobarbital 1.2 MG/ACTUAT Inhalant Powder 199924 Albuterol 0. Ordered.

1 MG/ML Inhalant Solution 12 HR Albuterol 4 MG Extended Release Tablet 12 HR Albuterol 8 MG Extended Release Tablet Albuterol 0.1 MG/ML Injectable Solution Albuterol 8 MG Oral Tablet Albuterol 0.17 MG/ML Inhalant Solution 200 ACTUAT Albuterol 0.09 MG/ACTUAT Metered Dose Inhaler 80 ACTUAT Albuterol 0.045 MG/ACTUAT Inhalant Solution Albuterol 0.226577 242754 245314 247044 247840 248066 248781 249777 307779 307781 307782 311286 312458 313813 349590 351136 351137 358992 359144 359145 386998 392321 582498 597908 630208 745679 745682 745791 755497 801092 835903 836286 Albuterol 0.21 MG/ML Inhalant Solution Levalbuterol 0.05 MG/ML Injectable Solution Albuterol 2 MG/ML Inhalant Solution Albuterol 1 MG/ML Injectable Solution Albuterol 0.83 MG/ML Inhalant Solution 200 ACTUAT Albuterol 0.018 MG/ACTUAT Metered Dose Inhaler 87 .09 MG/ACTUAT Inhalant Powder Levalbuterol 0.103 MG/ML Inhalant Solution Albuterol 0.21 MG/ML Inhalant Solution pirbuterol 0.09 MG/ACTUAT / Ipratropium Bromide 0.045 MG/ACTUAT Metered Dose Inhaler Albuterol 0.09 MG/ACTUAT Metered Dose Inhaler Albuterol 0.2 MG/ML Inhalant Solution Albuterol 0.09 MG/ACTUAT Inhalant Solution Levalbuterol 0.83 MG/ML / Ipratropium Bromide 0.09 MG/ACTUAT Metered Dose Inhaler 200 ACTUAT Levalbuterol 0.417 MG/ML Inhalant Solution Albuterol 0.417 MG/ML Inhalant Solution Albuterol 1 MG/ML (concentrate 0.1 MG/ACTUAT Inhalant Solution Albuterol 1 MG/ML / Ipratropium 0.5 % ) Inhalant Solution Albuterol 0.2 MG/ACTUAT Inhalant Powder Albuterol 4 MG Extended Release Tablet Albuterol 0.2 MG/ACTUAT Inhalant Solution Albuterol 8 MG Extended Release Tablet Levalbuterol 0.095 MG/ACTUAT Inhalant Powder Levalbuterol 0.4 MG/ML Oral Solution 60 ACTUAT Albuterol 0.

05 MG/ML pneumococcal capsular polysaccharide type 5 vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 12F vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 11A vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 9V vaccine 0.05 MG/ML 88 .05 MG/ML pneumococcal capsular polysaccharide type 15B vaccine 0.Pneumonia Vaccination Status for Older Adults (NQF 0043) (Additional Measure .05 MG/ML pneumococcal capsular polysaccharide type 4 vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 22F vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 18C vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 17F vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 8 vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 6B vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 7F vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 19A vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 14 vaccine 0.MENU) Definition: The percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine. RxNorm 854931 854933 854935 854937 854939 854941 854943 854945 854947 854949 854951 854953 854955 854957 854959 854961 854963 854965 854967 854969 854971 854973 854975 Description pneumococcal capsular polysaccharide type 1 vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 23F vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 9N vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 2 vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 10A vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 33F vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 20 vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 19F vaccine 0.05 MG/ML pneumococcal capsular polysaccharide type 3 vaccine 0.

05 MG/ML / pneumococcal capsular polysaccharide type 17F vaccine 0.05 MG/ML Injectable Solution 89 .05 MG/ML / pneumococcal capsular polysaccharide type 9V vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 11A vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 8 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 18C vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 23F vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 4 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 15B vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 5 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 3 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 19F vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 9N vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 33F vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 10A vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 19A vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 20 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 12F vaccine 0.854977 pneumococcal capsular polysaccharide type 1 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 14 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 7F vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 22F vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 2 vaccine 0.05 MG/ML / pneumococcal capsular polysaccharide type 6B vaccine 0.

81 493. or severe persistent asthma who were prescribed either the preferred long-term control medication (inhaled corticosteroid) or an acceptable alternative treatment. Inhaled or Alternative Asthma Medication 153892 montelukast 10 MG Oral Tablet [Singulair] 828929 100 ACTUAT flunisolide 0.21 493. with status asthmaticus Chronic obstructive asthma. with (acute) exacerbation Exercise induced bronchospasm Cough variant asthma Asthma.Asthma Pharmacologic Therapy (NQF 0047) (Additional Measure .MENU) Description: "Percentage of patients aged 5 through 40 years with a diagnosis of mild. unspecified with (acute) exacerbation Documentation of Medication (in Medication Ordering or Reported Medications) RxNorm Corticosteroid.00 493.12 493. unspecified Asthma." Diagnosis of Persistent Asthma SNOMED Description 426656000 Severe persistent asthma 426979002 Mild persistent asthma 427295004 Moderate persistent asthma ICD-9 493.8 MG/ACTUAT Metered Dose Inhaler 831259 [Intal] 313275 12 HR Theophylline 200 MG Extended Release Tablet [T-Phyl] 895996 896001 896006 746804 90 120 ACTUAT Fluticasone propionate 0.22 MG/ACTUAT Metered Dose Inhaler [Flovent] 120 ACTUAT mometasone furoate 0.25 MG/ACTUAT Metered Dose Inhaler [AeroBid] 112 ACTUAT Cromolyn Sodium 0.11 MG/ACTUAT Metered Dose Inhaler [Flovent] 120 ACTUAT Fluticasone propionate 0. with status asthmaticus Asthma.20 493.2 MG/ACTUAT Dry Powder Inhaler [Asmanex] .11 493.044 MG/ACTUAT Metered Dose Inhaler [Flovent] 120 ACTUAT Fluticasone propionate 0.91 493. unspecified type.82 493.22 493.90 493. with (acute) exacerbation Chronic obstructive asthma Chronic obstructive asthma. with (acute) exacerbation Intrinsic asthma Intrinsic asthma with status asthmaticus Intrinsic asthma.02 493.10 493.92 Description Asthma Extrinsic asthma with status asthmaticus Extrinsic asthma. moderate.01 493.

05 MG/ACTUAT Dry Powder Inhaler [Flovent] 28 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler [Serevent] 30 ACTUAT mometasone furoate 0.11 MG/ACTUAT Metered Dose Inhaler [Flovent] 60 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler [Flovent] 60 ACTUAT Fluticasone propionate 0.8 MG/ACTUAT Metered Dose Inhaler [Intal] 200 ACTUAT Levalbuterol 0.044 MG/ACTUAT Metered Dose Inhaler [Flovent] 60 ACTUAT Fluticasone propionate 0.2 MG/ACTUAT Dry Powder Inhaler [Asmanex] 200 ACTUAT Albuterol 0.2 MG/ACTUAT Dry Powder Inhaler [Asmanex] 60 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler [Advair 100/50] 60 ACTUAT Fluticasone propionate 0.09 MG/ACTUAT Metered Dose Inhaler 200 ACTUAT Albuterol 0.1 MG/ACTUAT Dry Powder Inhaler [Flovent] 60 ACTUAT Fluticasone propionate 0.09 MG/ACTUAT / Ipratropium Bromide 0.05 MG/ACTUAT Dry Powder Inhaler [Advair 500/50] 28 ACTUAT salmeterol 0.5 MG/ACTUAT / salmeterol 0.075 MG/ACTUAT Metered Dose Inhaler [Azmacort] 28 ACTUAT Fluticasone propionate 0.22 MG/ACTUAT Metered Dose Inhaler [Flovent] 60 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT / salmeterol 0.045 MG/ACTUAT Metered Dose Inhaler [Xopenex] 24 HR Theophylline 100 MG Extended Release Capsule [Theo-24] 24 HR Theophylline 200 MG Extended Release Capsule [Theo-24] 24 HR Theophylline 300 MG Extended Release Capsule [Theo-24] 24 HR Theophylline 400 MG Extended Release Capsule [Theo-24] 24 HR Theophylline 400 MG Extended Release Tablet 24 HR Theophylline 400 MG Extended Release Tablet [Uniphyl] 24 HR Theophylline 600 MG Extended Release Tablet [Uniphyl] 240 ACTUAT Triamcinolone 0.09 MG/ACTUAT Metered Dose Inhaler [Proventil] 200 ACTUAT Albuterol 0.25 MG/ACTUAT / salmeterol 0.09 MG/ACTUAT Metered Dose Inhaler [Ventolin] 200 ACTUAT Cromolyn Sodium 0.05 MG/ACTUAT Dry Powder Inhaler [Advair 250/50] .05 MG/ACTUAT Dry Powder Inhaler [Advair 100/50] 28 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler [Advair 250/50] 28 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT / salmeterol 0.018 MG/ACTUAT Metered Dose Inhaler [Combivent] 200 ACTUAT Albuterol 0.746811 836366 745679 746763 859088 831260 746466 208217 313274 208226 318245 259325 351464 351465 748627 896029 896175 896193 896226 866047 746813 896009 896019 896185 896023 896011 896013 896212 91 14 ACTUAT mometasone furoate 0.

2 MG/ML Inhalant Solution [Arm-A-Med Isoetharine HCl] Isoetharine 1.21 MG/ML Inhalant Solution [Accuneb] Albuterol 0.05 MG/ACTUAT Dry Powder Inhaler [Advair 500/50] 60 ACTUAT mometasone furoate 0.25 MG/ML Inhalant Solution [Pulmicort] cholinophyllin 400 MG Extended Release Tablet cholinophyllin 400 MG Extended Release Tablet [Choledyl-SA] cholinophyllin 600 MG Extended Release Tablet cholinophyllin 600 MG Extended Release Tablet [Choledyl-SA] Cromolyn Sodium 10 MG/ML Inhalant Solution Cromolyn Sodium 10 MG/ML Inhalant Solution [Intal] formoterol 0.25 MG/ML Inhalant Solution Isoetharine 1.83 MG/ML Inhalant Solution [Proventil] Albuterol 1 MG/ML Inhalant Solution Albuterol 1 MG/ML Inhalant Solution [Proventil] Albuterol 1 MG/ML Inhalant Solution [Ventolin] bitolterol 8 MG/ML Inhalant Solution bitolterol 8 MG/ML Inhalant Solution [Tornalate] Budesonide 0.6 MG/ML Inhalant Solution [Arm-A-Med Isoetharine HCl] Isoetharine 0.896027 896229 746815 866049 859082 307779 859091 352052 351136 352051 630208 630209 245314 795356 795354 485046 542073 616830 616817 314145 207251 312146 207254 831246 831267 284417 206255 206234 311152 311153 311154 206238 314041 206239 311156 311157 311159 206246 206243 92 60 ACTUAT Fluticasone propionate 0.417 MG/ML Inhalant Solution Albuterol 0.5 MG/ACTUAT / salmeterol 0.012 MG/ACTUAT Inhalant Powder [Foradil] Isoetharine 0.09 MG/ACTUAT Metered Dose Inhaler [Ventolin] Albuterol 0.25 MG/ACTUAT Dry Powder Inhaler [Flovent] 60 ACTUAT Fluticasone propionate 0.2 MG/ACTUAT Inhalant Powder [Ventolin] Albuterol 0.62 MG/ML Inhalant Solution Isoetharine 0.125 MG/ML Inhalant Solution [Pulmicort] Budesonide 0.2 MG/ACTUAT Inhalant Powder Albuterol 0.83 MG/ML Inhalant Solution Albuterol 0.2 MG/ACTUAT Dry Powder Inhaler [Asmanex] 60 ACTUAT salmeterol 0.6 MG/ML Inhalant Solution [Arm-A-Med Isoetharine HCl] Isoetharine 1.417 MG/ML Inhalant Solution [Accuneb] Albuterol 0.7 MG/ML Inhalant Solution Isoetharine 10 MG/ML Inhalant Solution Isoetharine 10 MG/ML Inhalant Solution [bronkosol] Isoetharine 2 MG/ML Inhalant Solution [Arm-A-Med Isoetharine HCl] .05 MG/ACTUAT Dry Powder Inhaler [Serevent] 80 ACTUAT Albuterol 0.34 MG/ACTUAT Inhalant Solution [Bronkometer] Isoetharine 0.67 MG/ML Inhalant Solution Isoetharine 1.8 MG/ML Inhalant Solution Isoetharine 1 MG/ML Inhalant Solution Isoetharine 1.

21 MG/ML Inhalant Solution [Xopenex] Levalbuterol 0.5 MG/ML Inhalant Solution [Arm-A-Med Isoetharine HCl] Isoetharine 5 MG/ML Inhalant Solution Isoproterenol 0.5 MG/ML Inhalant Solution Isoetharine 2.311158 206245 314043 706456 311187 206720 206748 409303 311184 206746 352132 261136 833470 261367 404406 153893 857631 701712 708224 237178 208266 208263 317770 208265 198257 314251 208218 853008 701709 208219 313268 313269 313272 313273 701711 346574 313277 208270 208273 313276 208272 93 Isoetharine 2.08 MG/ACTUAT Inhalant Solution Isoproterenol 0.13 MG/ACTUAT Inhalant Solution [Isuprel Mistometer] Isoproterenol 10 MG/ML Inhalant Solution [Isuprel HCl] Isoproterenol 2.13 MG/ACTUAT Inhalant Solution Isoproterenol 0.103 MG/ML Inhalant Solution [Xopenex] Levalbuterol 0.5 MG/ML Inhalant Solution Isoproterenol 5 MG/ML Inhalant Solution Isoproterenol 5 MG/ML Inhalant Solution [Isuprel HCl] Levalbuterol 0.417 MG/ML Inhalant Solution [Xopenex] montelukast 4 MG Chewable Tablet [Singulair] montelukast 4 MG Granules [Singulair] montelukast 5 MG Chewable Tablet [Singulair] Terbutaline Sulfate 0.2 MG/ML Inhalant Solution [Brethaire] Theophylline 100 MG Extended Release Capsule Theophylline 100 MG Extended Release Capsule [Slo-bid] Theophylline 100 MG Extended Release Tablet Theophylline 100 MG Extended Release Tablet [Theochron] Theophylline 100 MG Extended Release Tablet [Theodur] Theophylline 100 MG Extended Release Tablet [Theo-Sav] Theophylline 100 MG Extended Release Tablet [Theo-X] Theophylline 125 MG Extended Release Capsule Theophylline 125 MG Extended Release Capsule [Aerolate JR] Theophylline 125 MG Extended Release Capsule [Slo-bid Gyrocaps] Theophylline 125 MG Extended Release Capsule [Slo-Phyllin] Theophylline 125 MG Extended Release Capsule [Theo-Dur Sprinkle] Theophylline 125 MG Extended Release Capsule [Theovent] Theophylline 130 MG Extended Release Capsule [Theobid] Theophylline 130 MG Extended Release Capsule [Theoclear] Theophylline 200 MG Extended Release Capsule Theophylline 200 MG Extended Release Capsule [Slo-bid Gyrocaps] Theophylline 200 MG Extended Release Capsule [Theo-Dur Sprinkle] Theophylline 200 MG Extended Release Tablet Theophylline 200 MG Extended Release Tablet [Theochron] Theophylline 200 MG Extended Release Tablet [Theodur] Theophylline 200 MG Extended Release Tablet [Theolair] Theophylline 200 MG Extended Release Tablet [Theo-Sav] Theophylline 200 MG Extended Release Tablet [Theo-X] .

37 MG/ACTUAT Inhalant Solution zafirlukast 10 MG Oral Tablet [Accolate] zafirlukast 20 MG Oral Tablet [Accolate] zileuton 600 MG Oral Tablet [Zyflo] 94 .313279 317771 853010 208223 208274 208257 313281 313282 313310 208225 317769 208275 208278 201541 313289 208277 198262 208262 313292 314241 208284 313296 708226 706552 313299 313300 201545 208285 313305 208214 213897 261313 211776 211777 Theophylline 250 MG Extended Release Capsule [Aerolate] Theophylline 250 MG Extended Release Capsule [Elixophyllin] Theophylline 250 MG Extended Release Capsule [Slo-Phyllin] Theophylline 250 MG Extended Release Capsule [Theovent] Theophylline 250 MG Extended Release Tablet [Respbid] Theophylline 250 MG Extended Release Tablet [Theolair] Theophylline 260 MG Extended Release Capsule [Theobid] Theophylline 260 MG Extended Release Capsule [Theoclear] Theophylline 300 MG Extended Release Capsule Theophylline 300 MG Extended Release Capsule [Slo-bid Gyrocaps] Theophylline 300 MG Extended Release Tablet Theophylline 300 MG Extended Release Tablet [Quibron T-SR] Theophylline 300 MG Extended Release Tablet [Theochron] Theophylline 300 MG Extended Release Tablet [Theodur] Theophylline 300 MG Extended Release Tablet [Theo-Sav] Theophylline 300 MG Extended Release Tablet [Theo-X] Theophylline 300 MG Oral Capsule Theophylline 300 MG Oral Tablet [Quibron-T] Theophylline 400 MG Extended Release Tablet [Uni-Dur] Theophylline 450 MG Extended Release Tablet Theophylline 450 MG Extended Release Tablet [Theochron] Theophylline 450 MG Extended Release Tablet [Theodur] Theophylline 50 MG Extended Release Capsule [Slo-bid] Theophylline 50 MG Extended Release Capsule [Theodur] Theophylline 500 MG Extended Release Tablet [Respbid] Theophylline 500 MG Extended Release Tablet [Theolair] Theophylline 60 MG Extended Release Capsule [Slo-Phyllin] Theophylline 600 MG Extended Release Tablet [Uni-Dur] Theophylline 75 MG Extended Release Capsule [Slo-bid Gyrocaps] Theophylline 75 MG Extended Release Capsule [Theo-Dur Sprinkle] Tornalate 0.

02 Opioid type dependence.1 Sedative.0 Opioid type dependence 304. unspecified 305. in remission 305.03 Opioid type dependence. unspecified use 304. hypnotic or anxiolytic dependence.11 Sedative. continuous use 305.Low Back Pain – Use of Imaging Studies (NQF 0052) (Additional Measure MENU) Description: Low back pain is a prevalent diagnosis and normally does not warrant imaging studies within the first month (Retrospective and Negative Rule). in remission 305. hypnotic or anxiolytic abuse. in remission 304.60 Cocaine abuse.9 (approximately 1000 codes) Diagnosis Active – IV drug abuse ICD-9CM Description 304.00 Opioid type dependence. in remission 304.13 Sedative.50 Opioid abuse. episodic 304. continuous 304.23 Cocaine dependence. hypnotic or anxiolytic abuse 305.43 Amphetamine and other psychostimulant dependence.42 Amphetamine and other psychostimulant dependence. hypnotic or anxiolytic abuse. continuous use 304. episodic use 304.43 Sedative.41 Sedative. episodic 305.22 Cocaine dependence.52 Opioid abuse. episodic use 304. in remission 304.01 Opioid type dependence.20 Cocaine dependence.4 Sedative. unspecified 304. Active or inactive diagnosis of cancer ICD-9 Description Codes 140.4 Amphetamine and other psychostimulant dependence 304.10 Sedative. unspecified use 95 . episodic use 304.40 Amphetamine and other psychostimulant dependence.2 Cocaine dependence 304.53 Opioid abuse. continuous 305.51 Opioid abuse. hypnotic or anxiolytic dependence. episodic use 305. hypnotic or anxiolytic dependence. unspecified use 304.9 Codes V10 through V10. hypnotic or anxiolytic abuse. unspecified use 304. hypnotic or anxiolytic abuse. unspecified use 305.12 Sedative. hypnotic or anxiolytic dependence 304. in remission 305. continuous use 304. hypnotic or anxiolytic dependence.41 Amphetamine and other psychostimulant dependence.42 Sedative.40 Sedative.0 through 238.

continuous use Cocaine abuse.8 Other specified sites of sacroiliac region sprain 846.3 Nonallopathic lesions of lumbar region.71 305.305.1 Sacroiliac (ligament) sprain 846.02 Spinal stenosis of lumbar region without neurogenic claudication 724. neuritis.6 Cauda equina syndrome 729. unspecified 96 .2 Neuralgia.9 Unspecified site of sacroiliac region sprain Diagnosis Active – neurologic impairment ICD-9CM Description 344.3 Sciatica 724. in remission Amphetamine or related acting sympathomimetic abuse Amphetamine or related acting sympathomimetic abuse.10 Displacement of lumbar intervertebral disc without myelopathy 722.72 305.5 Other acquired deformity of back or spine 739. in remission Diagnosis Active – low back pain ICD-9CM Description 721. and radiculitis.3 Lumbosacral spondylosis without myelopathy 722. episodic use Amphetamine or related acting sympathomimetic abuse.2 Lumbago 724. episodic use Cocaine abuse.62 305.73 Cocaine abuse.7 305.32 Schmorl's nodes of lumbar region 722.63 305.7 Disorders of coccyx 738.0 Lumbosacral (joint) (ligament) sprain 846.3 Sacrotuberous (ligament) sprain 846. unspecified 724.4 Nonallopathic lesions of sacral region.70 305. unspecified use Amphetamine or related acting sympathomimetic abuse.5 Backache. not elsewhere classified 739. continuous use Amphetamine or related acting sympathomimetic abuse. not elsewhere classified 846.2 Sacrospinatus (ligament) sprain 846.93 Other and unspecified disc disorder of lumbar region 724 Other and unspecified disorders of back 724.52 Degeneration of lumbar or lumbosacral intervertebral disc 722.61 305.

Diagnosis Active – trauma ICD-9CM Description Codes 800 through 959.chiropractics CPT Description 98925 OSTEOPATHIC MANIPULATIVE TX 1-2 BDY REGIONS 98926 OSTEOPATHIC MANIPULATIVE TX 3-4 BDY REGIONS 98927 OSTEOPATHIC MANIPULATIVE TX 5-6 BDY REGIONS 98928 OSTEOPATHIC MANIPULATIVE TX 7-8 BDY REGIONS 98929 OSTEOPATHIC MANIPULATIVE TX 9-10 BDY REGIONS 98940 CMT SPI 1-2 REGIONS 98941 CMT SPI 3-4 REGIONS 98942 CMT SPI 5 REGIONS 97 .9 (approximately 1400 codes) Diagnostic Study Performed – imaging study – spinal CPT Description 72010 RADEX SPI ENTIRE SURV STD ANTEROPOST&LAT 72020 RADEX SPI 1 VIEW SPEC LVL 72052 RADEX SPI CRV COMPL W/OBLQ&FLEXION&/XTN STDS 72100 RADEX SPI LUMBOSAC 2/3 VIEWS 72110 RADEX SPI LUMBOSAC MINIMUM 4 VIEWS 72114 RADEX SPI LUMBOSAC COMPL W/BENDING VIEWS 72120 RADEX SPI LUMBOSAC BENDING MINIMUM 4 VIEWS 72131 CT LMBR SPI C-MATRL 72132 CT LMBR SPI C+ MATRL 72133 CT LMBR SPI C-/C+ 72141 MRI SPI CANAL&CNTS CRV C-MATRL 72142 MRI SPI CANAL&CNTS CRV C+ MATRL 72146 MRI SPI CANAL&CNTS THRC C-MATRL 72147 MRI SPI CANAL&CNTS THRC C+ MATRL 72148 MRI SPI CANAL&CNTS LMBR C-MATRL 72149 MRI SPI CANAL&CNTS LMBR C+ MATRL 72156 MRI SPI CANAL&CNTS C-/C+ CRV 72158 MRI SPI CANAL&CNTS C-/C+ LMBR 72200 RADEX SI JTS < 3 VIEWS 72202 RADEX SI JTS 3/MORE VIEWS 72220 RADEX SACRUM&COCCYX MINIMUM 2 VIEWS Encounter .

Encounter .ED CPT Description 99281 EMER DEPT SELF LIMITED/MINOR 99282 EMER DEPT LOW TO MODERATE SEVERITY 99283 EMER DEPT MODERATE SEVERITY 99284 EMER DEPT HI SEVERITY&URGENT EVAL 99285 EMER DEPT HIGH SEVERITY&THREAT FUNCJ 98 .

Fifth digit 0 is for use with type two patients. Type Two or unspecified type.33 Diabetes Mellitus With Other Coma. Type One [juvenile type] Not Stated As Uncontrolled 250. Uncontrolled.03 Diabetes Mellitus Without Mention Of Complication. even if the patient requires insulin. Type One [juvenile type]. Fifth digit 2 is for use with type two patients. Fifth digit 0 is for use with type two patients. Uncontrolled 250.01 Diabetes Mellitus Without Mention Of Complication.30 Diabetes Mellitus With Other Coma. Uncontrolled. even if the patient requires insulin 250. uncontrolled. Type One [juvenile]. Not Stated As Uncontrolled. Uncontrolled 250.12 Diabetes Mellitus With Ketoacidosis.20 Diabetes Mellitus With Hyperosmolar Coma. Type one [juvenile type]. Type Two or unspecified type. Fifth digit 2 is for use with type two patients.31 Diabetes Mellitus With Other Coma. even if the patient requires insulin 250.22 Diabetes Mellitus With Hyperosmolar Coma. Diagnosis: Diabetes ICD-9 Description 250 Diabetes Mellitus 250. Not Stated As Uncontrolled. even if the patient requires insulin 250.23 Diabetes Mellitus With Hyperosmolar Coma. Type one [juvenile type]. Type One [juvenile type]. even if the patient requires insulin 250. Not Stated As Uncontrolled 250. Uncontrolled 250. Type One [juvenile]. uncontrolled 250. 250. not stated as uncontrolled.00 Diabetes Mellitus Without Mention Of Complication. even if the patient requires insulin 250. Not Stated As Uncontrolled 250.02 Diabetes Mellitus Without Mention Of Complication.10 Diabetes Mellitus With Ketoacidosis. Uncontrolled. Type Two or unspecified type.21 Diabetes Mellitus With Hyperosmolar Coma. Type One [juvenile type]. even if the patient requires insulin 250. Fifth digit 0 is for use with type two patients. 250.32 Diabetes Mellitus With Other Coma. Fifth digit 2 is for use with type two patients. type two or unspecified type. Fifth digit 0 is for use with type two patients. Not Stated As Uncontrolled. Type Two or unspecified type. not stated as uncontrolled.0 Diabetes Mellitus Without Mention Of Complication 250.13 Diabetes Mellitus With Ketoacidosis.4 Diabetes With Renal Manifestations 99 .11 Diabetes Mellitus With Ketoacidosis.Diabetes: Eye Exam (NQF 0055) (Additional Measure – MENU) Description: The percentage of patients 18–75 years of age with diabetes (type 1 or type 2) who had a retinal or dilated eye exam or a negative retinal exam (no evidence of retinopathy) by an eye care professional . even if the patient requires insulin 250. Type two or unspecified type. Type Two or unspecified type. Type Two or unspecified type. Fifth digit 2 is for use with type two patients.

Type Two or unspecified type. Type Two or unspecified type. Not Stated As Uncontrolled Diabetes Mellitus With Other Specified Manifestations.52 250. even if the patient requires insulin Diabetes Mellitus With Ophthalmic Manifestations. Uncontrolled. Fifth-digit 0 is for use with type two patients. Not Stated As Uncontrolled. even if the patient requires insulin Diabetes Mellitus With Neurological Manifestations.42 250. Type One [juvenile type].41 250.72 250.43 250.40 250. Fifth-digit 2 is for use with type two patients. Uncontrolled Diabetes Mellitus With Neurological Manifestations.7 250. Type Two or unspecified type. Not Stated As Uncontrolled Diabetes Mellitus With Peripheral Circulatory Disorders.61 250. Uncontrolled.63 250. Type One [juvenile type] Uncontrolled Diabetes With Peripheral Circulatory Disorders Diabetes Mellitus With Peripheral Circulatory Disorders. Type Two or unspecified type. Not Stated As Uncontrolled.62 250. Fifth-digit 2 is for use with type two patients.250. Type One [juvenile type]. Not Stated As Uncontrolled Diabetes Mellitus With Ophthalmic Manifestations.81 250. Uncontrolled.71 250. Type Two or unspecified type. Not Stated As Uncontrolled.8 250. Fifth digit 2 is for use with type two patients. Fifth-digit 2 is for use with type two 100 .73 250. Type Two or unspecified type. Type Two or unspecified type.50 250.60 250.51 250.53 250. Type One [juvenile type]. Type One [juvenile type]. Fifth-digit 0 is for use with type two patients.82 Diabetes Mellitus With Renal Manifestations. even if the patient requires insulin Diabetes Mellitus With Peripheral Circulatory Disorders. even if the patient requires insulin Diabetes Mellitus With Renal Manifestations. Type One [juvenile type]. Type Two or unspecified type. even if the patient requires insulin Diabetes Mellitus With Peripheral Circulatory Disorders. Uncontrolled. Type One [juvenile type]. even if the patient requires insulin Diabetes Mellitus With Ophthalmic Manifestations. Type One [juvenile type]. Type One [juvenile type] Not Stated As Uncontrolled Diabetes Mellitus With Neurological Manifestations. Type Two or unspecified type. even if the patient requires insulin Diabetes Mellitus With Neurological Manifestations. Uncontrolled. Type Two or unspecified type. Fifth-digit 2 is for use with type two patients.70 250. Not Stated As Uncontrolled Diabetes Mellitus With Renal Manifestations. Uncontrolled Diabetes Mellitus With Ophthalmic Manifestations. Not Stated As Uncontrolled. Uncontrolled Diabetes With Other Specified Manifestations Diabetes Mellitus With Other Specified Manifestations. Fifth digit 0 is for use with type two patients. even if the patient requires insulin Diabetes Mellitus With Other Specified Manifestations.80 250. Fifth-digit 0 is for use with type two patients. Not Stated As Uncontrolled. Fifth-digit 0 is for use with type two patients. even if the patient requires insulin Diabetes Mellitus With Renal Manifestations.

90 250. Antepartum 648. Not Stated As Uncontrolled.04 362.4 Polycystic Ovaries Diagnosis Active of gestational diabetes 648. Type One [juvenile type]. Type Two or unspecified type. Type Two or unspecified type.81 Abnormal Glucose Tolerance Of Mother. Unspecified As To Episode Of Care 648.00 Secondary diabetes mellitus without mention of complication. Or The Puerperium. Or The Puerperium 648.82 Abnormal Glucose Tolerance Of Mother. Complicating Pregnancy.92 250.01 Secondary diabetes mellitus without mention of complication.0 648. Not Stated As Uncontrolled Diabetes Mellitus With Unspecified Complication.0 Secondary diabetes mellitus without mention of complication 249. Childbirth.2 362. With Delivery 648. Complicating Pregnancy. Or The Puerperium Diabetes Mellitus Of Mother.03 362.05 362. Type One [juvenile type]. Complicating Pregnancy. Or The Puerperium.93 357.80 Abnormal Glucose Tolerance Of Mother. not stated as uncontrolled or unspecified 249. Childbirth. even if the patient requires insulin Diabetes Mellitus With Unspecified Complication.0 362. Fifth-digit 0 is for use with type two patients. With Delivery Active diagnosis of polycystic ovaries 256. Uncontrolled Polyneuropathy In Diabetes Diabetic Retinopathy Background Diabetic Retinopathy Proliferative Diabetic Retinopathy Nonproliferative diabetic retinopathy NOS Mild nonproliferative diabetic retinopathy Moderate nonproliferative diabetic retinopathy Severe nonproliferative diabetic retinopathy Diabetic macular edema Diabetic Cataract Diabetes Mellitus Complicating Pregnancy.83 250. Uncontrolled. Childbirth. Fifth-digit 2 is for use with type two patients.01 362. even if the patient requires insulin Diabetes Mellitus With Unspecified Complication. With Delivery. Unspecified As To Episode Of Care Diabetes Mellitus Of Mother.00 648. Uncontrolled Diabetes With Unspecified Complication Diabetes Mellitus With Unspecified Complication.91 250.41 648.250. Type One [juvenile type].9 250.07 366.02 362. even if the patient requires insulin Diabetes Mellitus With Other Specified Manifestations. Childbirth.83 Abnormal Glucose Tolerance Of Mother.01 patients. Postpartum Diagnosis Active of Steroid induced diabetes 249 Secondary Diabetes Mellitus 249. uncontrolled 101 . With Mention Of Postpartum Complication 648.8 Abnormal Glucose Tolerance Of Mother.06 362.84 Abnormal Glucose Tolerance Of Mother.

04 Mild nonproliferative diabetic retinopathy 362. uncontrolled Secondary diabetes mellitus with unspecified complication Secondary diabetes mellitus with unspecified complication.03 Nonproliferative diabetic retinopathy NOS 362.31 249. not stated as uncontrolled.3 249.4 249. uncontrolled Secondary diabetes mellitus with renal manifestations Secondary diabetes mellitus with renal manifestations. or unspecified Secondary diabetes mellitus with peripheral circulatory disorders. or unspecified Secondary diabetes mellitus with neurological manifestations.8 962.0 Secondary diabetes mellitus without mention of complication Secondary diabetes mellitus with ketoacidosis. or unspecified Secondary diabetes mellitus with other coma.6.81 249. not stated as uncontrolled.51 249. not stated as uncontrolled.02 Proliferative diabetic retinopathy 362. uncontrolled Secondary diabetes mellitus with other specified manifestations Secondary diabetes mellitus with other specified manifestations. not stated as uncontrolled.50 249. uncontrolled Secondary diabetes mellitus with other coma Secondary diabetes mellitus with other coma. or unspecified Secondary diabetes mellitus with unspecified complication.11 249.06 Severe nonproliferative diabetic retinopathy 102 .05 Moderate nonproliferative diabetic retinopathy 362.21 249.60 249. or unspecified Secondary diabetes mellitus with renal manifestations.41 249. not stated as uncontrolled. not stated as uncontrolled. not stated as uncontrolled. uncontrolled Secondary diabetes mellitus with peripheral circulatory disorders Secondary diabetes mellitus with peripheral circulatory disorders.71 249.5 249. not stated as uncontrolled. not stated as uncontrolled.40 249. 249. uncontrolled Secondary diabetes mellitus with neurological manifestations Secondary diabetes mellitus with neurological manifestations.01 Background diabetic retinopathy 362. uncontrolled Secondary diabetes mellitus with hyperosmolarity Secondary diabetes mellitus with hyperosmolarity. or unspecified Secondary diabetes mellitus with ophthalmic manifestations. or unspecified Secondary diabetes mellitus with ketoacidosis.90 249.7 249. uncontrolled Secondary diabetes mellitus with ophthalmic manifestations Secondary diabetes mellitus with ophthalmic manifestations. or unspecified Secondary diabetes mellitus with other specified manifestations.91 251.249.30 249.20 249.61 249.10 249.70 249. or unspecified Secondary diabetes mellitus with hyperosmolarity. uncontrolled Other Specified Disorders Of Pancreatic Internal Secretion Poisoning By Adrenal Cortical Steroids Diabetic Retinopathy ICD-9 Description 362.80 249.2 249.1 249.8 249.9 249.

Eye Exam CPT 67028 67030 67036 67038 67039 67040 67041 67042 67043 67101 67105 67107 67108 67110 67112 67113 67121 67141 67145 67208 67210 67218 67220 67221 67227 67228 92002 92004 92012 92014 92018 92019 92225 92226 92230 92235 92240 92250 92260 Description INTRAVITREAL NJX PHARMACOLOGIC AGT SPX DSCJ VTS STRANDS PARS PLNA VTRC MCHNL PARS PLNA VTRC MCHNL PARS PLNA EPIRTA MEMB STRIPPING VTRC MCHNL PARS PLNA FOCAL ENDOLASER PC VTRC MCHNL PARS PLNA ENDOLASER PANRTA PC VITRECTOMY PARS PLANA REMOVE PRERETINAL MEMBRANE VITRECTOMY PARS PLANA REMOVE INT MEMB RETINA VITRECTOMY PARS PLANA REMOVE SUBRETINAL MEMBRANE RPR RTA DTCHMNT 1+ SESS CRTX/DTHRM +-DRG RPR RTA DTCHMNT 1+ SESS PC +-DRG SUBRTA RPR RTA DTCHMNT SCLL BUCKLING +-IMPLT RPR RTA DTCHMNT W/VTRC ANY METH RPR RTA DTCHMNT NJX AIR/OTH GAS RPR RTA DTCHMNT SCLL BUCKLING/VTRC PT RPR COMPLEX RETINA DETACH VITRECTOMY & MEMB PEEL RMVL IMPLTED MATRL POST SGM IO PROPH RTA DTCHMNT W/O DRG 1+ SESS CRTX DTHRM PROPH RTA DTCHMNT W/O DRG 1+ SESS DSTRJ LOCLZD LES RETINA 1+ SESS CRTX DTHRM DSTRJ LOCLZD LES RETINA 1+ SESS PC DSTRJ LES RETINA 1+ SESS RADJ IMPLTJ DSTRJ LES CHOROID PC 1+ SESS DSTRJ LES CHOROID PDT DESTRUCTION RETINOPATHY 1+ SESS DIATHERMY EXTENSIVE RETINOPATHY 1+ SESS PHOTOCOAGULATION OPH MEDICAL XM&EVAL INTRM NEW PT OPH MEDICAL XM&EVAL COMPRE NEW PT 1+ VST OPH MEDICAL XM&EVAL INTRM EST PT OPH MEDICAL XM&EVAL COMPRE EST PT 1+ VST OPH XM&EVAL ANES +-MNPJ GLOBE COMPL OPH XM&EVAL ANES +-MNPJ GLOBE LMTD OPSCPY EXTND RTA DRAWING I&R 1ST OPSCPY EXTND RTA DRAWING I&R SBSQ FLUORESCEIN ANGIOSCOPY I&R FLUORESCEIN ANGRPH I&R INDOCYA9-GREEN ANGRPH I&R FUNDUS PHTGRPHY I&R OPHTHALMODYNAMOMETRY 103 .

25 MG/ML Injectable Solution 847910 pioglitazone 15 MG Oral Tablet 847915 60 ACTUAT exenatide 0.6 MG/ML Injectable Solution 861042 2. Dispensed.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet .005 MG/ACTUAT Prefilled Syringe Antidiabetic Combination 602544 glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet 602549 glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet 602550 glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet 647237 glimepiride 2 MG / pioglitazone 30 MG Oral Tablet 647239 glimepiride 4 MG / pioglitazone 30 MG Oral Tablet 706895 glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet 706896 glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet 861731 Glipizide 2.RXNORM .25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2. Active Alph-glucosides 199149 Acarbose 50 MG Oral Tablet 199150 Acarbose 100 MG Oral Tablet 200132 Acarbose 25 MG Oral Tablet 205329 miglitol 25 MG Oral Tablet 205330 miglitol 50 MG Oral Tablet 205331 miglitol 100 MG Oral Tablet 401938 Miglustat 100 MG Oral Capsule Amylin analogs 200256 repaglinide 1 MG Oral Tablet 200257 repaglinide 0.7 ML pramlintide acetate 1 MG/ML Prefilled Syringe 861044 1.5 MG / Metformin hydrochloride 500 MG Oral Tablet 861740 861743 861748 861753 861760 861763 861769 861783 861787 104 Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.5 ML pramlintide acetate 1 MG/ML Prefilled Syringe 861787 Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet 861790 Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Antidiabetic Agents 744863 exenatide 0.Medications Ordered.5 MG Oral Tablet 200258 repaglinide 2 MG Oral Tablet 311919 nateglinide 120 MG Oral Tablet 314142 nateglinide 60 MG Oral Tablet 389139 nateglinide 180 MG Oral Tablet 861035 pramlintide acetate 1 MG/ML Injectable Solution 861039 pramlintide acetate 0.5 MG / Metformin hydrochloride 250 MG Oral Tablet 861736 Glipizide 2.

5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.861790 861795 861806 861816 861819 861822 665033 665038 665042 860975 860978 860981 860984 860996 860999 861004 861007 861010 861021 861025 861731 861736 861740 861743 861748 861753 861760 861763 861769 861783 861787 861790 861795 861806 861816 Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Biguanides sitagliptin 100 MG Oral Tablet sitagliptin 25 MG Oral Tablet sitagliptin 50 MG Oral Tablet 24 HR Metformin hydrochloride 500 MG Extended Release Tablet Metformin hydrochloride 500 MG Extended Release Tablet 24 HR Metformin hydrochloride 750 MG Extended Release Tablet Metformin hydrochloride 750 MG Extended Release Tablet 24 HR Metformin hydrochloride 1000 MG Extended Release Tablet Metformin hydrochloride 1000 MG Extended Release Tablet Metformin hydrochloride 1000 MG Oral Tablet Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 850 MG Oral Tablet Metformin hydrochloride 625 MG Oral Tablet Metformin hydrochloride 100 MG/ML Oral Solution Glipizide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet 105 .25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.

Beef-Pork 100 UNT/ML Injectable Solution Insulin. Regular. Prompt Zinc. Pork 500 UNT/ML Injectable Solution Insulin. Zinc. beef 100 UNT/ML Injectable Suspension Insulin. Beef-Pork 40 UNT/ML Inhalant Solution Insulin. Protamine Lispro. Prompt Zinc. rDNA origin 1 MG/ACTUAT Inhalant Powder 106 . Human 75 UNT/ML Injectable Suspension Insulin Lispro 50 UNT/ML / Insulin. Aspart Protamine. Regular. Regular. Regular. Pork 40 UNT/ML Injectable Solution Insulin. Glulisine. Protamine Zinc. Aspart. Regular. Human 30 UNT/ML Injectable Suspension Insulin. Aspart. Protamine Lispro. Prompt Zinc. rDNA origin 1 MG/ACTUAT Dry Powder Inhaler 90 ACTUAT insulin human. Human 70 UNT/ML / Insulin. Human 100 UNT/ML Injectable Suspension Insulin Lispro 100 UNT/ML Injectable Solution insulin. Pork 40 UNT/ML Injectable Solution 90 ACTUAT insulin human. Beef-Pork 100 UNT/ML Injectable Suspension Insulin. Regular. Beef-Pork 40 UNT/ML Injectable Suspension Insulin. Regular. Human 50 UNT/ML Injectable Suspension Insulin. Zinc.861819 861822 205314 237527 242120 242916 242917 259111 260265 283394 311040 311041 311053 311054 311055 311056 311057 311058 311059 311060 311061 314038 317800 351297 358349 484322 485210 544614 763002 763007 763013 Metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Insulin Insulin. Beef-Pork 100 UNT/ML Injectable Suspension Insulin. Human 100 UNT/ML Injectable Solution Insulin. Protamine Zinc. Pork 70 UNT/ML Injectable Suspension insulin detemir 100 UNT/ML Injectable Solution Insulin. Pork 100 UNT/ML Injectable Suspension Insulin Lispro 25 UNT/ML / Insulin. Human 100 UNT/ML Injectable Solution Insulin Glargine 100 UNT/ML Injectable Solution Insulin. Pork 100 UNT/ML Injectable Suspension Insulin. rDNA origin 3 MG/ACTUAT Dry Powder Inhaler insulin human. protamine zinc. Zinc. Pork 100 UNT/ML Injectable Solution Insulin. Pork 30 UNT/ML / NPH Insulin. Beef 100 UNT/ML Injectable Suspension Insulin. Pork 100 UNT/ML Injectable Suspension Insulin. Beef-Pork 40 UNT/ML Injectable Suspension Insulin. Prompt Zinc. Protamine Zinc. Beef 100 UNT/ML Injectable Solution Insulin.

Aspart.25 MG Oral Tablet Tolazamide 100 MG Oral Tablet Tolazamide 250 MG Oral Tablet Tolazamide 500 MG Oral Tablet Tolbutamide 500 MG Oral Tablet glimepiride 1 MG Oral Tablet glimepiride 2 MG Oral Tablet glimepiride 4 MG Oral Tablet Gliclazide 80 MG Oral Tablet 107 .763014 833159 847191 847207 847211 847230 847239 847252 847259 847263 847416 200256 200257 200258 311919 314142 389139 105374 153842 197306 197307 197495 197496 197737 198291 198292 198293 198294 199245 199246 199247 199825 insulin human. Aspart Protamine. Human 50 UNT/ML Injectable Suspension 3 ML Insulin. Aspart Protamine. Human 70 UNT/ML / Insulin. Protamine Lispro. rDNA origin 3 MG/ACTUAT Inhalant Powder Insulin.5 MG Oral Tablet repaglinide 2 MG Oral Tablet\ nateglinide 120 MG Oral Tablet nateglinide 60 MG Oral Tablet nateglinide 180 MG Oral Tablet Sulfonylureas gliquidone 30 MG Oral Tablet glimepiride 3 MG Oral Tablet Acetohexamide 250 MG Oral Tablet Acetohexamide 500 MG Oral Tablet Chlorpropamide 100 MG Oral Tablet Chlorpropamide 250 MG Oral Tablet Glyburide 1. Aspart. Glulisine. Human 100 UNT/ML Prefilled Syringe 3 ML Insulin. Human 50 UNT/ML / Insulin. Human 100 UNT/ML Prefilled Syringe 1. Human 30 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 100 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 50 UNT/ML / Insulin. Protamine Lispro. Aspart.5 ML Insulin Lispro 100 UNT/ML Prefilled Syringe Meglitinides repaglinide 1 MG Oral Tablet repaglinide 0. Human 50 UNT/ML Prefilled Syringe 3 ML Insulin Glargine 100 UNT/ML Prefilled Syringe 3 ML insulin detemir 100 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 25 UNT/ML / Insulin. Human 75 UNT/ML Prefilled Syringe 3 ML Insulin.

5 MG Extended Release Tablet Glipizide 5 MG Oral Tablet Glyburide 2.199984 199985 200065 252960 310488 310489 310490 310534 310536 310537 310539 312440 312441 312859 312860 312861 313418 313419 314000 314006 315107 315239 317573 379804 389137 602544 602549 602550 647237 647239 706895 706896 757710 757712 844809 844824 troglitazone 200 MG Oral Tablet troglitazone 400 MG Oral Tablet troglitazone 300 MG Oral Tablet Glyburide 4.5 MG Extended Release Tablet Glipizide 5 MG Extended Release Tablet 108 .5 MG Oral Tablet Glyburide 3 MG Oral Tablet Glyburide 5 MG Oral Tablet Glyburide 6 MG Oral Tablet pioglitazone 30 MG Oral Tablet pioglitazone 45 MG Oral Tablet rosiglitazone 2 MG Oral Tablet rosiglitazone 4 MG Oral Tablet rosiglitazone 8 MG Oral Tablet Tolazamide 250 MG Oral Capsule Tolbutamide 250 MG Oral Tablet Glyburide 1.5 MG Oral Tablet Gliclazide 30 MG Extended Release Tablet glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / pioglitazone 30 MG Oral Tablet glimepiride 4 MG / pioglitazone 30 MG Oral Tablet glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet vildagliptin 100 MG Oral Tablet vildagliptin 50 MG Oral Tablet Glipizide 2.5 MG Oral Tablet Glipizide 10 MG Oral Tablet 24 HR Glipizide 2.5 MG Oral Tablet 24 HR Glipizide 5 MG Extended Release Tablet 24 HR Glipizide 10 MG Extended Release Tablet Tolbutamide 50 MG/ML Injectable Solution pioglitazone 15 MG Oral Tablet Glipizide 2.

25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Thiazolidinediones pioglitazone 30 MG Oral Tablet pioglitazone 45 MG Oral Tablet rosiglitazone 2 MG Oral Tablet rosiglitazone 4 MG Oral Tablet rosiglitazone 8 MG Oral Tablet pioglitazone 15 MG Oral Tablet Encounter Codes Accepted for appointment outside of Physician using MU: Encounte CPT Encounter Encounter Encounter CPT CPT CPT r Acute ED Non-Acute Outpatient Inpatient Inpatient Opthamolo gical services 99221 1ST HOSP CARE PR D 30 MIN 99222 1ST HOSP CARE PR D 50 MIN 99281 EMER DEPT SELF LIMITED/MI NOR EMER DEPT LOW TO MODERAT E SEVERITY EMER DEPT MODERAT E SEVERITY EMER DEPT HI 99304 1ST NF CARE PR D E/M LW SEVERITY 92002 OPH MEDICAL XM&EVAL INTRM NEW PT OPH MEDICAL XM&EVAL COMPRE NEW PT 1+ VST OPH MEDICAL XM&EVAL INTRM EST PT OPH MEDICAL 99282 99305 1ST NF CARE PR D E/M MOD SEVERITY 92004 99223 1ST HOSP CARE PR D 70 MIN 99231 SBSQ HOSP 99283 99306 1ST NF CARE PR D E/M HI SEVERITY 92012 99284 99307 SBSQ NF CARE PR D 92014 109 .5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.844827 861731 861736 861740 861743 861748 861753 861760 861763 861783 861806 861816 861822 312440 312441 312859 312860 312861 317573 Glipizide 10 MG Extended Release Tablet Glipizide 2.

CARE PR D 15 MIN SEVERITY &URGENT EVAL 99285 EMER DEPT HIGH SEVERITY &THREAT FUNCJ 99308 E/M STABLE XM&EVAL COMPRE EST PT 1+ VST 99232 SBSQ HOSP CARE PR D 25 MIN 99233 SBSQ HOSP CARE PR D 35 MIN 99238 HOSP DSCHRG D MGMT 30 MIN/ 99239 HOSP DSCHRG D MGMT > 30 MIN 99251 1ST INPT 99252 CONSLTJ 20 MIN 1ST INPT CONSLTJ 40 MIN 99253 1ST INPT CONSLTJ 55 MIN 99254 1ST INPT CONSLTJ 80 MIN 99255 1ST INPT CONSLTJ 110 MIN SBSQ NF CARE PR D E/M MINOR COMPLCTJ SBSQ NF CARE PR D E/M NEW PROBLEM SBSQ NF CARE PR D E/M UNSTABLE/N EW PROBLEM NF DSCHRG D MGMT 30 MIN/< NF DSCHRG D MGMT > 30 MIN 99309 99310 99315 99316 99318 99324 E/M PT INVG ANNUAL NF ASSMT DOM/R-HOME LW SEVERITY DOM/R-HOME E/M NEW PT MOD SEVERITY DOM/R-HOME E/M NEW PT MOD HI SEVERITY DOM/R-HOME E/M NEW PT HI SEVERITY DOM/R-HOME E/M NEW PT SIGNIFICANT NEW PROBLEM 99325 99326 99327 99328 110 .

99334 99335 99337 DOM/R-HOME E/M EST PT SELFLMTD/MINOR DOM/R-HOME E/M EST PT LW MOD SEVERITY DOM/R-HOME E/M EST PT SIGNIFICANT NEW PROBLEM 111 .

Fifth digit 0 is for use with type two patients. uncontrolled. even if the patient requires insulin 250. Type One [juvenile type]. Not Stated As Uncontrolled. even if the patient requires insulin 250. Type Two or unspecified type. Type One [juvenile]. Fifth digit 2 is for use with type two patients. Type two or unspecified type.32 Diabetes Mellitus With Other Coma. Uncontrolled 250. Type One [juvenile]. Not Stated As Uncontrolled 250. Fifth digit 2 is for use with type two patients. Type Two or unspecified type. Uncontrolled.20 Diabetes Mellitus With Hyperosmolar Coma. even if the patient requires insulin 250.02 Diabetes Mellitus Without Mention Of Complication. Uncontrolled 250. even if the patient requires insulin 250. Type One [juvenile type].Diabetes: Foot Exam (NQF 0056) (Additional Measure .03 Diabetes Mellitus Without Mention Of Complication.30 Diabetes Mellitus With Other Coma. even if the patient requires insulin.11 Diabetes Mellitus With Ketoacidosis. type two or unspecified type. Type Two or unspecified type. or pulse exam). Not Stated As Uncontrolled. Type Two or unspecified type. even if the patient requires insulin 250. Uncontrolled. Type Two or unspecified type. Not Stated As Uncontrolled. Fifth digit 2 is for use with type two patients. 250. Type One [juvenile type] Not Stated As Uncontrolled 250. Fifth digit 0 is for use with type two patients.4 Diabetes With Renal Manifestations 250.22 Diabetes Mellitus With Hyperosmolar Coma. uncontrolled 250.12 Diabetes Mellitus With Ketoacidosis. not stated as uncontrolled. not stated as uncontrolled. Diagnosis – Diabetes ICD-9 Description 250 Diabetes Mellitus 250.00 Diabetes Mellitus Without Mention Of Complication. Type one [juvenile type].31 Diabetes Mellitus With Other Coma.MENU) Description: The percentage of patients aged 18‐75 years with diabetes (type 1 or type 2) who had a foot exam (visual inspection. even if the patient requires insulin 250.10 Diabetes Mellitus With Ketoacidosis. Type One [juvenile type]. Fifth digit 0 is for use with type two patients.21 Diabetes Mellitus With Hyperosmolar Coma.13 Diabetes Mellitus With Ketoacidosis. Uncontrolled 250. 250.23 Diabetes Mellitus With Hyperosmolar Coma. Uncontrolled.01 Diabetes Mellitus Without Mention Of Complication. Fifth digit 2 is for use with type two patients. Type Two or unspecified type.0 Diabetes Mellitus Without Mention Of Complication 250. Fifth digit 0 is for use with type two patients. Type one [juvenile type]. Type Two or unspecified 112 . sensory exam with monofilament.40 Diabetes Mellitus With Renal Manifestations. Not Stated As Uncontrolled 250.33 Diabetes Mellitus With Other Coma. even if the patient requires insulin 250.

41 250. even if the patient requires insulin Diabetes Mellitus With Peripheral Circulatory Disorders. Fifth-digit 2 is for use with type two patients. Fifth-digit 2 is for use with type two patients. Not Stated As Uncontrolled.73 250. Type One [juvenile type]. Fifth-digit 0 is for use with type two patients. Uncontrolled. Type One [juvenile type]. Not Stated As Uncontrolled Diabetes Mellitus With Peripheral Circulatory Disorders. Type One [juvenile type]. Not Stated As Uncontrolled. Uncontrolled Diabetes Mellitus With Neurological Manifestations. Uncontrolled.7 250. Type One [juvenile type] Not Stated As Uncontrolled Diabetes Mellitus With Neurological Manifestations. Type Two or unspecified type. Type Two or unspecified type. Type One [juvenile type]. Type Two or unspecified type. even if the patient requires insulin Diabetes Mellitus With Ophthalmic Manifestations. Not Stated As Uncontrolled.53 250.250.61 250. Type Two or unspecified type. Type Two or unspecified type.60 250.52 250. Uncontrolled Diabetes Mellitus With Ophthalmic Manifestations. Not Stated As Uncontrolled. Not Stated As Uncontrolled Diabetes Mellitus With Other Specified Manifestations. Fifth-digit 0 is for use with type two patients. Type One [juvenile type]. even if the patient requires insulin Diabetes Mellitus With Neurological Manifestations. Fifth-digit 0 is for use with type two patients.80 type.43 250.72 250. even if the patient requires insulin Diabetes Mellitus With Other Specified Manifestations. Fifth digit 2 is for use with type two patients. Fifth-digit 2 is for use with type two patients. Type Two or unspecified type.51 250. Fifth-digit 0 is for use with type two patients.71 250.63 250. Uncontrolled. Fifth digit 0 is for use with type two patients.8 250. Not Stated As Uncontrolled. Not Stated As Uncontrolled Diabetes Mellitus With Renal Manifestations.81 250. Type Two or unspecified type. Type One [juvenile type].50 250. Fifth-digit 2 is for use with type two patients. even if the patient requires insulin Diabetes Mellitus With Peripheral Circulatory Disorders. even if the patient requires insulin Diabetes Mellitus With Neurological Manifestations. Not Stated As Uncontrolled Diabetes Mellitus With Ophthalmic Manifestations. Type One [juvenile type] Uncontrolled Diabetes With Peripheral Circulatory Disorders Diabetes Mellitus With Peripheral Circulatory Disorders. even if the patient requires insulin Diabetes Mellitus With Renal Manifestations. Uncontrolled Diabetes With Other Specified Manifestations Diabetes Mellitus With Other Specified Manifestations. Uncontrolled.62 250. Type Two or unspecified type.70 250.42 250. Type Two or unspecified type. even if the patient requires insulin Diabetes Mellitus With Ophthalmic Manifestations.82 113 . Uncontrolled. even if the patient requires insulin 250. Type One [juvenile type]. even if the patient requires insulin Diabetes Mellitus With Renal Manifestations.

Or The Puerperium. Unspecified As To Episode Of Care 648.03 362. Type Two or unspecified type.41 648. Or The Puerperium 648.0 362.92 250.91 250. Or The Puerperium Diabetes Mellitus Of Mother. Complicating Pregnancy. Type One [juvenile type]. Childbirth.8 Abnormal Glucose Tolerance Of Mother.4 Polycystic Ovaries Diagnosis Active of gestational diabetes 648. Childbirth. Not Stated As Uncontrolled Diabetes Mellitus With Unspecified Complication.00 648. Unspecified As To Episode Of Care Diabetes Mellitus Of Mother.93 357.04 362. even if the patient requires insulin Diabetes Mellitus With Unspecified Complication.9 250.2 362. Uncontrolled.02 362. Type One [juvenile type].82 Abnormal Glucose Tolerance Of Mother. Or The Puerperium. Uncontrolled Polyneuropathy In Diabetes Diabetic Retinopathy Background Diabetic Retinopathy Proliferative Diabetic Retinopathy Nonproliferative diabetic retinopathy NOS Mild nonproliferative diabetic retinopathy Moderate nonproliferative diabetic retinopathy Diabetic macular edema Diabetic Cataract Diabetes Mellitus Complicating Pregnancy.250. Fifth-digit 2 is for use with type two patients. Uncontrolled Diabetes With Unspecified Complication Diabetes Mellitus With Unspecified Complication. Type Two or unspecified type.80 Abnormal Glucose Tolerance Of Mother. Complicating Pregnancy. With Delivery 648.01 362. With Delivery 250.0 648.90 Diabetes Mellitus With Other Specified Manifestations.05 362. Type One [juvenile type].07 366.01 They have an active diagnosis of polycystic ovaries 256. Fifth-digit 0 is for use with type two patients. Childbirth. Childbirth.81 Abnormal Glucose Tolerance Of Mother. even if the patient requires insulin Diabetes Mellitus With Unspecified Complication. Not Stated As Uncontrolled.83 250. Complicating Pregnancy. With Delivery. With Mention Of 114 .

uncontrolled 249.01 Secondary diabetes mellitus without mention of complication. not stated as uncontrolled. or unspecified 249.8 Secondary diabetes mellitus with other specified manifestations 249. or unspecified 249.61 Secondary diabetes mellitus with neurological manifestations.41 Secondary diabetes mellitus with renal manifestations.51 Secondary diabetes mellitus with ophthalmic manifestations.8 Other Specified Disorders Of Pancreatic Internal Secretion 115 .91 Secondary diabetes mellitus with unspecified complication.9 Secondary diabetes mellitus with unspecified complication 249.30 Secondary diabetes mellitus with other coma.83 648.84 Postpartum Complication Abnormal Glucose Tolerance Of Mother. uncontrolled 249. Postpartum Diagnosis Active of Steroid induced diabetes 249 Secondary Diabetes Mellitus 249. uncontrolled 249. not stated as uncontrolled or unspecified 249.11 Secondary diabetes mellitus with ketoacidosis.50 Secondary diabetes mellitus with ophthalmic manifestations. or unspecified 249. or unspecified 249. or unspecified 249.71 Secondary diabetes mellitus with peripheral circulatory disorders.90 Secondary diabetes mellitus with unspecified complication. uncontrolled 249. or unspecified 249.6. or unspecified 249. uncontrolled 249.20 Secondary diabetes mellitus with hyperosmolarity. not stated as uncontrolled.648. not stated as uncontrolled.70 Secondary diabetes mellitus with peripheral circulatory disorders.31 Secondary diabetes mellitus with other coma. uncontrolled 249.5 Secondary diabetes mellitus with ophthalmic manifestations 249. not stated as uncontrolled. uncontrolled 249.81 Secondary diabetes mellitus with other specified manifestations.40 Secondary diabetes mellitus with renal manifestations. uncontrolled 249. not stated as uncontrolled. or unspecified 249. not stated as uncontrolled.21 Secondary diabetes mellitus with hyperosmolarity. Antepartum Abnormal Glucose Tolerance Of Mother.0 Secondary diabetes mellitus without mention of complication 249. not stated as uncontrolled. Secondary diabetes mellitus with neurological manifestations 249. uncontrolled 249.2 Secondary diabetes mellitus with hyperosmolarity 249.60 Secondary diabetes mellitus with neurological manifestations.10 Secondary diabetes mellitus with ketoacidosis.00 Secondary diabetes mellitus without mention of complication.1 Secondary diabetes mellitus without mention of complication 249.4 Secondary diabetes mellitus with renal manifestations 249.7 Secondary diabetes mellitus with peripheral circulatory disorders 249.80 Secondary diabetes mellitus with other specified manifestations. uncontrolled 251.3 Secondary diabetes mellitus with other coma 249. or unspecified 249. not stated as uncontrolled. not stated as uncontrolled.

005 MG/ACTUAT Prefilled Syringe Antidiabetic Combination 602544 glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet 602549 glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet 602550 glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet 647237 glimepiride 2 MG / pioglitazone 30 MG Oral Tablet 647239 glimepiride 4 MG / pioglitazone 30 MG Oral Tablet 706895 glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet 706896 glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet 861731 Glipizide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet 116 .7 ML pramlintide acetate 1 MG/ML Prefilled Syringe 861044 1. Dispensed.6 MG/ML Injectable Solution 861042 2. Active RxNorm Description Alph-glucosides 199149 Acarbose 50 MG Oral Tablet 199150 Acarbose 100 MG Oral Tablet 200132 Acarbose 25 MG Oral Tablet 205329 miglitol 25 MG Oral Tablet 205330 miglitol 50 MG Oral Tablet 205331 miglitol 100 MG Oral Tablet 401938 Miglustat 100 MG Oral Capsule Amylin analogs 200256 repaglinide 1 MG Oral Tablet 200257 repaglinide 0.962.0 Poisoning By Adrenal Cortical Steroids Foot Exam SNOMED 401191002 80314008 89521000 91161007 Description Diabetic foot e amination Sensory testing Sensory and motor e ting Pedal pulse taking Medications Ordered.25 MG/ML Injectable Solution 847910 pioglitazone 15 MG Oral Tablet 847915 60 ACTUAT exenatide 0.5 ML pramlintide acetate 1 MG/ML Prefilled Syringe 861787 Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet 861790 Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Antidiabetic Agents 744863 exenatide 0.5 MG Oral Tablet 200258 repaglinide 2 MG Oral Tablet 311919 nateglinide 120 MG Oral Tablet 314142 nateglinide 60 MG Oral Tablet 389139 nateglinide 180 MG Oral Tablet 861035 pramlintide acetate 1 MG/ML Injectable Solution 861039 pramlintide acetate 0.5 MG / Metformin hydrochloride 250 MG Oral Tablet 861736 Glipizide 2.

5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Biguanides sitagliptin 100 MG Oral Tablet sitagliptin 25 MG Oral Tablet sitagliptin 50 MG Oral Tablet 24 HR Metformin hydrochloride 500 MG Extended Release Tablet Metformin hydrochloride 500 MG Extended Release Tablet 24 HR Metformin hydrochloride 750 MG Extended Release Tablet Metformin hydrochloride 750 MG Extended Release Tablet 24 HR Metformin hydrochloride 1000 MG Extended Release Tablet Metformin hydrochloride 1000 MG Extended Release Tablet Metformin hydrochloride 1000 MG Oral Tablet Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 850 MG Oral Tablet Metformin hydrochloride 625 MG Oral Tablet Metformin hydrochloride 100 MG/ML Oral Solution Glipizide 2.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet 117 .5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.861740 861743 861748 861753 861760 861763 861769 861783 861787 861790 861795 861806 861816 861819 861822 665033 665038 665042 860975 860978 860981 860984 860996 860999 861004 861007 861010 861021 861025 861731 861736 861740 861743 861748 861753 Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.

Pork 100 UNT/ML Injectable Suspension Insulin. Aspart. Human 70 UNT/ML / Insulin. Pork 100 UNT/ML Injectable Suspension Insulin. Human 50 UNT/ML Injectable Suspension Insulin. Beef-Pork 40 UNT/ML Injectable Suspension Insulin. Zinc. Protamine Zinc. protamine zinc. Pork 100 UNT/ML Injectable Suspension Insulin Lispro 25 UNT/ML / Insulin. Human 75 UNT/ML Injectable Suspension Insulin Lispro 50 UNT/ML / Insulin. Beef 100 UNT/ML Injectable Suspension Insulin. Human 100 UNT/ML Injectable Suspension Insulin Lispro 100 UNT/ML Injectable Solution insulin. Regular. Prompt Zinc. Regular. Regular. Regular.861760 861763 861769 861783 861787 861790 861795 861806 861816 861819 861822 205314 237527 242120 242916 242917 259111 260265 283394 311040 311041 311053 311054 311055 311056 311057 311058 311059 311060 311061 314038 317800 351297 Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Insulin Insulin. Beef-Pork 100 UNT/ML Injectable Suspension Insulin. Beef-Pork 40 UNT/ML Inhalant Solution Insulin. Protamine Zinc. Human 100 UNT/ML Injectable Solution Insulin Glargine 100 UNT/ML Injectable Solution Insulin. beef 100 UNT/ML Injectable Suspension Insulin. Pork 500 UNT/ML Injectable Solution Insulin. Prompt Zinc. Aspart Protamine. Protamine Lispro. Pork 40 UNT/ML Injectable Solution Insulin. Aspart. Zinc. Beef 100 UNT/ML Injectable Solution Insulin. Prompt Zinc. Human 30 UNT/ML Injectable Suspension 118 . Prompt Zinc. Protamine Lispro. Protamine Zinc. Beef-Pork 100 UNT/ML Injectable Solution Insulin. Regular. Pork 100 UNT/ML Injectable Solution Insulin. Beef-Pork 100 UNT/ML Injectable Suspension Insulin. Regular. Beef-Pork 40 UNT/ML Injectable Suspension Insulin.

Human 30 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 100 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 50 UNT/ML / Insulin. rDNA origin 3 MG/ACTUAT Dry Powder Inhaler insulin human. Human 50 UNT/ML Prefilled Syringe 3 ML Insulin Glargine 100 UNT/ML Prefilled Syringe 3 ML insulin detemir 100 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 25 UNT/ML / Insulin. Aspart Protamine.5 ML Insulin Lispro 100 UNT/ML Prefilled Syringe Meglitinides repaglinide 1 MG Oral Tablet repaglinide 0. Protamine Lispro. Regular.5 MG Oral Tablet repaglinide 2 MG Oral Tablet nateglinide 120 MG Oral Tablet nateglinide 60 MG Oral Tablet nateglinide 180 MG Oral Tablet Sulfonylureas gliquidone 30 MG Oral Tablet glimepiride 3 MG Oral Tablet Acetohexamide 250 MG Oral Tablet Acetohexamide 500 MG Oral Tablet Chlorpropamide 100 MG Oral Tablet Chlorpropamide 250 MG Oral Tablet 200256 200257 200258 311919 314142 389139 105374 153842 197306 197307 197495 197496 119 . Human 50 UNT/ML / Insulin. Human 100 UNT/ML Prefilled Syringe 1.358349 484322 485210 544614 763002 763007 763013 763014 833159 847191 847207 847211 847230 847239 847252 847259 847263 847416 Insulin. rDNA origin 1 MG/ACTUAT Inhalant Powder insulin human. Aspart. Pork 70 UNT/ML Injectable Suspension insulin detemir 100 UNT/ML Injectable Solution Insulin. Human 50 UNT/ML Injectable Suspension 3 ML Insulin. Glulisine. Human 100 UNT/ML Prefilled Syringe 3 ML Insulin. Protamine Lispro. Glulisine. Human 75 UNT/ML Prefilled Syringe 3 ML Insulin. Pork 40 UNT/ML Injectable Solution 90 ACTUAT insulin human. Human 70 UNT/ML / Insulin. Zinc. rDNA origin 3 MG/ACTUAT Inhalant Powder Insulin. Human 100 UNT/ML Injectable Solution Insulin. Aspart. Aspart. Pork 30 UNT/ML / NPH Insulin. rDNA origin 1 MG/ACTUAT Dry Powder Inhaler 90 ACTUAT insulin human. Aspart Protamine.

197737 198291 198292 198293 198294 199245 199246 199247 199825 199984 199985 200065 252960 310488 310489 310490 310534 310536 310537 310539 312440 312441 312859 312860 312861 313418 313419 314000 314006 315107 315239 317573 379804 389137 602544 602549 602550 Glyburide 1.25 MG Oral Tablet Tolazamide 100 MG Oral Tablet Tolazamide 250 MG Oral Tablet Tolazamide 500 MG Oral Tablet Tolbutamide 500 MG Oral Tablet glimepiride 1 MG Oral Tablet glimepiride 2 MG Oral Tablet glimepiride 4 MG Oral Tablet Gliclazide 80 MG Oral Tablet troglitazone 200 MG Oral Tablet troglitazone 400 MG Oral Tablet troglitazone 300 MG Oral Tablet Glyburide 4.5 MG Extended Release Tablet Glipizide 5 MG Oral Tablet Glyburide 2.5 MG Oral Tablet Gliclazide 30 MG Extended Release Tablet glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet 120 .5 MG Oral Tablet Glipizide 10 MG Oral Tablet 24 HR Glipizide 2.5 MG Oral Tablet 24 HR Glipizide 5 MG Extended Release Tablet 24 HR Glipizide 10 MG Extended Release Tablet Tolbutamide 50 MG/ML Injectable Solution pioglitazone 15 MG Oral Tablet Glipizide 2.5 MG Oral Tablet Glyburide 3 MG Oral Tablet Glyburide 5 MG Oral Tablet Glyburide 6 MG Oral Tablet pioglitazone 30 MG Oral Tablet pioglitazone 45 MG Oral Tablet rosiglitazone 2 MG Oral Tablet rosiglitazone 4 MG Oral Tablet rosiglitazone 8 MG Oral Tablet Tolazamide 250 MG Oral Capsule Tolbutamide 250 MG Oral Tablet Glyburide 1.

5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.647237 647239 706895 706896 757710 757712 844809 844824 844827 861731 861736 861740 861743 861748 861753 861760 861763 861783 861806 861816 861822 glimepiride 2 MG / pioglitazone 30 MG Oral Tablet glimepiride 4 MG / pioglitazone 30 MG Oral Tablet glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet vildagliptin 100 MG Oral Tablet vildagliptin 50 MG Oral Tablet Glipizide 2.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Thiazolidinediones 312440 312441 312859 312860 312861 317573 pioglitazone 30 MG Oral Tablet pioglitazone 45 MG Oral Tablet rosiglitazone 2 MG Oral Tablet rosiglitazone 4 MG Oral Tablet rosiglitazone 8 MG Oral Tablet pioglitazone 15 MG Oral Tablet 121 .5 MG Extended Release Tablet Glipizide 5 MG Extended Release Tablet Glipizide 10 MG Extended Release Tablet Glipizide 2.

Encounter Codes Accepted for appointment outside of Physician using MU: Encount CPT Encounter Encounter Encounter CPT CPT CPT er Acute ED Non-Acute Outpatient Inpatient Inpatient Opthamolo gical services 99221 1ST 99281 EMER DEPT 99304 1ST NF CARE 92002 OPH HOSP SELF PR D E/M LW MEDICAL CARE LIMITED/MIN SEVERITY XM&EVAL PR D 30 OR INTRM MIN NEW PT 99222 1ST HOSP CARE PR D 50 MIN 99282 EMER DEPT LOW TO MODERATE SEVERITY 99305 1ST NF CARE PR D E/M MOD SEVERITY 92004 OPH MEDICAL XM&EVAL COMPRE NEW PT 1+ VST OPH MEDICAL XM&EVAL INTRM EST PT OPH MEDICAL XM&EVAL COMPRE EST PT 1+ VST 99223 1ST HOSP CARE PR D 70 MIN SBSQ HOSP CARE PR D 15 MIN 99283 EMER DEPT MODERATE SEVERITY 99306 1ST NF CARE PR D E/M HI SEVERITY 92012 99231 99284 EMER DEPT HI SEVERITY&U RGENT EVAL 99307 SBSQ NF CARE PR D E/M STABLE 92014 99232 SBSQ HOSP CARE PR D 25 MIN SBSQ HOSP CARE PR D 35 MIN HOSP DSCHRG D MGMT 30 MIN/< 99285 EMER DEPT HIGH SEVERITY&T HREAT FUNCJ 99308 SBSQ NF CARE PR D E/M MINOR COMPLCTJ 99233 99309 SBSQ NF CARE PR D E/M NEW PROBLEM 99238 99310 SBSQ NF CARE PR D E/M UNSTABLE/N EW PROBLEM 122 .

99239 HOSP DSCHRG D MGMT > 30 MIN 1ST INPT CONSLT J 20 MIN 1ST INPT CONSLT J 40 MIN 1ST INPT CONSLT J 55 MIN 1ST INPT CONSLT J 80 MIN 1ST INPT CONSLT J 110 MIN 99315 NF DSCHRG D MGMT 30 MIN/< 99251 99252 99316 NF DSCHRG D MGMT > 30 MIN 99253 99318 E/M PT INVG ANNUAL NF ASSMT 99254 99324 DOM/RHOME LW SEVERITY 99255 99325 DOM/RHOME E/M NEW PT MOD SEVERITY 99326 DOM/RHOME E/M NEW PT MOD HI SEVERITY DOM/RHOME E/M NEW PT HI SEVERITY DOM/RHOME E/M NEW PT SIGNIFICANT NEW PROBLEM DOM/RHOME E/M 99327 99328 99334 123 .

EST PT SELFLMTD/MINOR 99335 DOM/RHOME E/M EST PT LW MOD SEVERITY DOM/RHOME E/M EST PT SIGNIFICANT NEW PROBLEM 99337 124 .

13 Diabetes Mellitus With Ketoacidosis.12 Diabetes Mellitus With Ketoacidosis. Type Two or unspecified type.Diabetes: HbA1c Poor Control (NQF 0059) (Additional Measure . Fifth digit 2 is for use with type two patients.00 Diabetes Mellitus Without Mention Of Complication. Type Two or unspecified type. Type One [juvenile type]. Uncontrolled.22 Diabetes Mellitus With Hyperosmolar Coma. Type One [juvenile type] Not Stated As Uncontrolled 250. Fifth digit 0 is for use with type two patients. Type one [juvenile type]. Type One [juvenile]. Fifth digit 2 is for use with type two patients.0%.10 Diabetes Mellitus With Ketoacidosis. Fifth digit 0 is for use with type two patients.11 Diabetes Mellitus With Ketoacidosis. even if the patient requires insulin 250.31 Diabetes Mellitus With Other Coma.4 Diabetes With Renal Manifestations 250.23 Diabetes Mellitus With Hyperosmolar Coma.03 Diabetes Mellitus Without Mention Of Complication.30 Diabetes Mellitus With Other Coma. Type One [juvenile type]. even if the patient requires insulin 250. Type One [juvenile]. not stated as uncontrolled. Uncontrolled. Type Two or unspecified type.MENU) Description: The percentage of patients 18–75 years of age with diabetes (type 1 or type 2) who had HbA1c >9.40 Diabetes Mellitus With Renal Manifestations.32 Diabetes Mellitus With Other Coma.33 Diabetes Mellitus With Other Coma. Not Stated As Uncontrolled 250.01 Diabetes Mellitus Without Mention Of Complication. type two or unspecified type.20 Diabetes Mellitus With Hyperosmolar Coma. 250. Not Stated As Uncontrolled 250. uncontrolled. even if the patient requires insulin 250. Fifth digit 0 is for use with type two patients. even if the patient requires insulin 250. Not Stated As Uncontrolled. not stated as uncontrolled. Type Two or unspecified type. 250. uncontrolled 250. 125 . Not Stated As Uncontrolled. Type One [juvenile type]. even if the patient requires insulin 250. Diagnosis – Diabetes ICD-9 Description 250 Diabetes Mellitus 250. Fifth digit 2 is for use with type two patients. Type two or unspecified type. Uncontrolled.02 Diabetes Mellitus Without Mention Of Complication. Fifth digit 2 is for use with type two patients. Not Stated As Uncontrolled. Uncontrolled 250.21 Diabetes Mellitus With Hyperosmolar Coma. even if the patient requires insulin 250. Not Stated As Uncontrolled. Type one [juvenile type]. even if the patient requires insulin. Type Two or unspecified type.0 Diabetes Mellitus Without Mention Of Complication 250. Type Two or unspecified type. Type Two or unspecified type. Uncontrolled 250. even if the patient requires insulin 250. Uncontrolled 250. Fifth digit 0 is for use with type two patients. Fifth digit 0 is for use with type two patients.

Uncontrolled. Type One [juvenile 126 .53 250. Fifth-digit 2 is for use with type two patients.82 250.52 250.250.62 250.80 250. Type One [juvenile type]. Not Stated As Uncontrolled Diabetes Mellitus With Other Specified Manifestations.61 250.7 250. Not Stated As Uncontrolled Diabetes Mellitus With Ophthalmic Manifestations.51 250.50 250. Uncontrolled Diabetes Mellitus With Ophthalmic Manifestations. Not Stated As Uncontrolled. even if the patient requires insulin Diabetes Mellitus With Other Specified Manifestations.70 250. Fifth-digit 2 is for use with type two patients. Not Stated As Uncontrolled Diabetes Mellitus With Renal Manifestations.83 even if the patient requires insulin Diabetes Mellitus With Renal Manifestations. even if the patient requires insulin Diabetes Mellitus With Neurological Manifestations. Not Stated As Uncontrolled. Fifth-digit 2 is for use with type two patients. Type Two or unspecified type.8 250. Not Stated As Uncontrolled Diabetes Mellitus With Peripheral Circulatory Disorders.60 250. even if the patient requires insulin Diabetes Mellitus With Ophthalmic Manifestations. Fifth digit 2 is for use with type two patients. Type Two or unspecified type. Type Two or unspecified type.43 250. even if the patient requires insulin Diabetes Mellitus With Ophthalmic Manifestations. even if the patient requires insulin Diabetes Mellitus With Other Specified Manifestations. Uncontrolled. Type Two or unspecified type. even if the patient requires insulin Diabetes Mellitus With Renal Manifestations. Type One [juvenile type].41 250. Uncontrolled Diabetes Mellitus With Neurological Manifestations.42 250. Type One [juvenile type] Not Stated As Uncontrolled Diabetes Mellitus With Neurological Manifestations. Fifth-digit 2 is for use with type two patients.63 250. even if the patient requires insulin Diabetes Mellitus With Peripheral Circulatory Disorders. Type One [juvenile type]. Type One [juvenile type]. Not Stated As Uncontrolled. Type Two or unspecified type. Uncontrolled. Type Two or unspecified type. Type One [juvenile type].81 250.72 250. Fifth-digit 0 is for use with type two patients. Type Two or unspecified type. Fifth-digit 0 is for use with type two patients. even if the patient requires insulin Diabetes Mellitus With Neurological Manifestations.71 250. Fifth-digit 0 is for use with type two patients.73 250. even if the patient requires insulin Diabetes Mellitus With Peripheral Circulatory Disorders. Fifth-digit 0 is for use with type two patients. Type Two or unspecified type. Type Two or unspecified type. Type One [juvenile type]. Uncontrolled Diabetes With Other Specified Manifestations Diabetes Mellitus With Other Specified Manifestations. Type One [juvenile type]. Uncontrolled. Uncontrolled. Type One [juvenile type] Uncontrolled Diabetes With Peripheral Circulatory Disorders Diabetes Mellitus With Peripheral Circulatory Disorders. Not Stated As Uncontrolled.

250. With Delivery Active diagnosis of polycystic ovaries ICD-9 Description 256.4 Polycystic Ovaries Diagnosis Active of gestational diabetes ICD-9 Description 648. Or The Puerperium 648.9 250. Fifth-digit 0 is for use with type two patients.90 250.0 362. Antepartum 648. Complicating Pregnancy. Complicating Pregnancy. Or The Puerperium. Uncontrolled Polyneuropathy In Diabetes Diabetic Retinopathy Background Diabetic Retinopathy Proliferative Diabetic Retinopathy Nonproliferative diabetic retinopathy NOS Mild nonproliferative diabetic retinopathy Moderate nonproliferative diabetic retinopathy Diabetic macular edema Diabetic Cataract Diabetes Mellitus Complicating Pregnancy.07 366.2 362.00 Secondary diabetes mellitus without mention of complication.01 Secondary diabetes mellitus without mention of complication.82 Abnormal Glucose Tolerance Of Mother.04 362. not stated as uncontrolled or unspecified 249. Uncontrolled. Childbirth.05 362. With Mention Of Postpartum Complication 648. Fifth-digit 2 is for use with type two patients.8 Abnormal Glucose Tolerance Of Mother. even if the patient requires insulin Diabetes Mellitus With Unspecified Complication. Not Stated As Uncontrolled. Type Two or unspecified type. Postpartum Diagnosis Active of Steroid induced diabetes ICD-9 Description 249 Secondary Diabetes Mellitus 249.02 362. Childbirth. Or The Puerperium.91 250.03 362. uncontrolled 127 . Uncontrolled Diabetes With Unspecified Complication Diabetes Mellitus With Unspecified Complication. Not Stated As Uncontrolled Diabetes Mellitus With Unspecified Complication.0 Secondary diabetes mellitus without mention of complication 249.93 357. Childbirth.01 362. With Delivery.81 Abnormal Glucose Tolerance Of Mother. Type Two or unspecified type.80 Abnormal Glucose Tolerance Of Mother.83 Abnormal Glucose Tolerance Of Mother. Unspecified As To Episode Of Care Diabetes Mellitus Of Mother. even if the patient requires insulin Diabetes Mellitus With Unspecified Complication.92 250. Type One [juvenile type].00 648.84 Abnormal Glucose Tolerance Of Mother.0 648. Childbirth. Or The Puerperium Diabetes Mellitus Of Mother.01 type]. With Delivery 648. Unspecified As To Episode Of Care 648.41 648. Complicating Pregnancy. Type One [juvenile type].

uncontrolled Secondary diabetes mellitus with renal manifestations Secondary diabetes mellitus with renal manifestations.2 249.51 249.6.9 249.8 249. not stated as uncontrolled.7 249.21 249. not stated as uncontrolled. 249.1 249. Dispensed. not stated as uncontrolled. uncontrolled Secondary diabetes mellitus with other coma Secondary diabetes mellitus with other coma. uncontrolled Other Specified Disorders Of Pancreatic Internal Secretion Poisoning By Adrenal Cortical Steroids HbA1c test LOINC 17856-6 4548-4 4549-2 Description Hemoglobin A1c/Hemoglobin.40 249.3 249.70 249.249. or unspecified Secondary diabetes mellitus with renal manifestations.41 249.71 249.81 249.8 962. not stated as uncontrolled.4 249.20 249. or unspecified Secondary diabetes mellitus with hyperosmolarity.11 249.91 251. not stated as uncontrolled. Active RxNORM Description Alph-glucosides 128 .90 249. not stated as uncontrolled.61 249. or unspecified Secondary diabetes mellitus with neurological manifestations.10 249. or unspecified Secondary diabetes mellitus with ophthalmic manifestations.50 249. or unspecified Secondary diabetes mellitus with other specified manifestations.5 249. not stated as uncontrolled.total in Blood by Electrophoresis Medications Ordered.30 249. uncontrolled Secondary diabetes mellitus with neurological manifestations Secondary diabetes mellitus with neurological manifestations.0 Secondary diabetes mellitus without mention of complication Secondary diabetes mellitus with ketoacidosis. or unspecified Secondary diabetes mellitus with ketoacidosis. uncontrolled Secondary diabetes mellitus with ophthalmic manifestations Secondary diabetes mellitus with ophthalmic manifestations. uncontrolled Secondary diabetes mellitus with peripheral circulatory disorders Secondary diabetes mellitus with peripheral circulatory disorders.80 249. or unspecified Secondary diabetes mellitus with unspecified complication. not stated as uncontrolled. uncontrolled Secondary diabetes mellitus with other specified manifestations Secondary diabetes mellitus with other specified manifestations.31 249. not stated as uncontrolled.total in Blood Hemoglobin A1c/Hemoglobin. uncontrolled Secondary diabetes mellitus with hyperosmolarity Secondary diabetes mellitus with hyperosmolarity.total in Blood by HPLC Hemoglobin A1c/Hemoglobin. or unspecified Secondary diabetes mellitus with other coma. uncontrolled Secondary diabetes mellitus with unspecified complication Secondary diabetes mellitus with unspecified complication.60 249. or unspecified Secondary diabetes mellitus with peripheral circulatory disorders.

199149 199150 200132 205329 205330 205331 401938 200256 200257 200258 311919 314142 389139 861035 861039 861042 861044 861787 861790 744863 847910 847915 602544 602549 602550 647237 647239 706895 706896 861731 861736 861740 861743 861748 861753 861760 861763 861769 861783 861787 861790 Acarbose 50 MG Oral Tablet Acarbose 100 MG Oral Tablet Acarbose 25 MG Oral Tablet miglitol 25 MG Oral Tablet miglitol 50 MG Oral Tablet miglitol 100 MG Oral Tablet Miglustat 100 MG Oral Capsule Amylin analogs repaglinide 1 MG Oral Tablet repaglinide 0.7 ML pramlintide acetate 1 MG/ML Prefilled Syringe 1.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet 129 .5 ML pramlintide acetate 1 MG/ML Prefilled Syringe Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Antidiabetic Agents exenatide 0.6 MG/ML Injectable Solution 2.5 MG Oral Tablet repaglinide 2 MG Oral Tablet nateglinide 120 MG Oral Tablet nateglinide 60 MG Oral Tablet nateglinide 180 MG Oral Tablet pramlintide acetate 1 MG/ML Injectable Solution pramlintide acetate 0.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.25 MG/ML Injectable Solution pioglitazone 15 MG Oral Tablet 60 ACTUAT exenatide 0.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.005 MG/ACTUAT Prefilled Syringe Antidiabetic Combination glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / pioglitazone 30 MG Oral Tablet glimepiride 4 MG / pioglitazone 30 MG Oral Tablet glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet Glipizide 2.5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.

861795 861806 861816 861819 861822 665033 665038 665042 860975 860978 860981 860984 860996 860999 861004 861007 861010 861021 861025 861731 861736 861740 861743 861748 861753 861760 861763 861769 861783 861787 861790 861795 861806 861816 861819

Metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Biguanides sitagliptin 100 MG Oral Tablet sitagliptin 25 MG Oral Tablet sitagliptin 50 MG Oral Tablet 24 HR Metformin hydrochloride 500 MG Extended Release Tablet Metformin hydrochloride 500 MG Extended Release Tablet 24 HR Metformin hydrochloride 750 MG Extended Release Tablet Metformin hydrochloride 750 MG Extended Release Tablet 24 HR Metformin hydrochloride 1000 MG Extended Release Tablet Metformin hydrochloride 1000 MG Extended Release Tablet Metformin hydrochloride 1000 MG Oral Tablet Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 850 MG Oral Tablet Metformin hydrochloride 625 MG Oral Tablet Metformin hydrochloride 100 MG/ML Oral Solution Glipizide 2.5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet

130

861822

Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Insulin Insulin, Regular, Pork 500 UNT/ML Injectable Solution Insulin, Zinc, Human 100 UNT/ML Injectable Suspension Insulin Lispro 100 UNT/ML Injectable Solution insulin, protamine zinc, beef 100 UNT/ML Injectable Suspension Insulin, Protamine Zinc, Pork 100 UNT/ML Injectable Suspension Insulin Lispro 25 UNT/ML / Insulin, Protamine Lispro, Human 75 UNT/ML Injectable Suspension Insulin Lispro 50 UNT/ML / Insulin, Protamine Lispro, Human 50 UNT/ML Injectable Suspension Insulin, Prompt Zinc, Beef 100 UNT/ML Injectable Suspension Insulin, Aspart, Human 100 UNT/ML Injectable Solution Insulin Glargine 100 UNT/ML Injectable Solution Insulin, Protamine Zinc, Beef-Pork 100 UNT/ML Injectable Suspension Insulin, Regular, Beef-Pork 100 UNT/ML Injectable Solution Insulin, Regular, Beef-Pork 40 UNT/ML Inhalant Solution Insulin, Regular, Beef 100 UNT/ML Injectable Solution Insulin, Regular, Pork 100 UNT/ML Injectable Solution Insulin, Regular, Pork 40 UNT/ML Injectable Solution Insulin, Prompt Zinc, Beef-Pork 100 UNT/ML Injectable Suspension Insulin, Prompt Zinc, Beef-Pork 40 UNT/ML Injectable Suspension Insulin, Prompt Zinc, Pork 100 UNT/ML Injectable Suspension Insulin, Protamine Zinc, Beef-Pork 40 UNT/ML Injectable Suspension Insulin, Zinc, Pork 100 UNT/ML Injectable Suspension Insulin, Aspart Protamine, Human 70 UNT/ML / Insulin, Aspart, Human 30 UNT/ML Injectable Suspension Insulin, Regular, Pork 30 UNT/ML / NPH Insulin, Pork 70 UNT/ML Injectable Suspension insulin detemir 100 UNT/ML Injectable Solution Insulin, Glulisine, Human 100 UNT/ML Injectable Solution Insulin, Zinc, Pork 40 UNT/ML Injectable Solution 90 ACTUAT insulin human, rDNA origin 1 MG/ACTUAT Dry Powder Inhaler 90 ACTUAT insulin human, rDNA origin 3 MG/ACTUAT Dry Powder Inhaler insulin human, rDNA origin 1 MG/ACTUAT Inhalant Powder

205314 237527 242120 242916 242917 259111 260265 283394 311040 311041 311053 311054 311055 311056 311057 311058 311059 311060 311061 314038 317800 351297 358349 484322 485210 544614 763002 763007 763013

131

763014 833159 847191 847207 847211 847230 847239 847252 847259 847263 847416 200256 200257 200258 311919 314142 389139 105374 153842 197306 197307 197495 197496 197737 198291 198292 198293 198294 199245 199246 199247 199825

insulin human, rDNA origin 3 MG/ACTUAT Inhalant Powder Insulin, Aspart Protamine, Human 50 UNT/ML / Insulin, Aspart, Human 50 UNT/ML Injectable Suspension 3 ML Insulin, Aspart Protamine, Human 70 UNT/ML / Insulin, Aspart, Human 30 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 100 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 50 UNT/ML / Insulin, Protamine Lispro, Human 50 UNT/ML Prefilled Syringe 3 ML Insulin Glargine 100 UNT/ML Prefilled Syringe 3 ML insulin detemir 100 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 25 UNT/ML / Insulin, Protamine Lispro, Human 75 UNT/ML Prefilled Syringe 3 ML Insulin, Glulisine, Human 100 UNT/ML Prefilled Syringe 3 ML Insulin, Aspart, Human 100 UNT/ML Prefilled Syringe 1.5 ML Insulin Lispro 100 UNT/ML Prefilled Syringe Meglitinides repaglinide 1 MG Oral Tablet repaglinide 0.5 MG Oral Tablet repaglinide 2 MG Oral Tablet nateglinide 120 MG Oral Tablet nateglinide 60 MG Oral Tablet nateglinide 180 MG Oral Tablet Sulfonylureas gliquidone 30 MG Oral Tablet glimepiride 3 MG Oral Tablet Acetohexamide 250 MG Oral Tablet Acetohexamide 500 MG Oral Tablet Chlorpropamide 100 MG Oral Tablet Chlorpropamide 250 MG Oral Tablet Glyburide 1.25 MG Oral Tablet Tolazamide 100 MG Oral Tablet Tolazamide 250 MG Oral Tablet Tolazamide 500 MG Oral Tablet Tolbutamide 500 MG Oral Tablet glimepiride 1 MG Oral Tablet glimepiride 2 MG Oral Tablet glimepiride 4 MG Oral Tablet Gliclazide 80 MG Oral Tablet

132

199984 199985 200065 252960 310488 310489 310490 310534 310536 310537 310539 312440 312441 312859 312860 312861 313418 313419 314000 314006 315107 315239 317573 379804 389137 602544 602549 602550 647237 647239 706895 706896 757710 757712 844809 133

troglitazone 200 MG Oral Tablet troglitazone 400 MG Oral Tablet troglitazone 300 MG Oral Tablet Glyburide 4.5 MG Oral Tablet Glipizide 10 MG Oral Tablet 24 HR Glipizide 2.5 MG Extended Release Tablet Glipizide 5 MG Oral Tablet Glyburide 2.5 MG Oral Tablet Glyburide 3 MG Oral Tablet Glyburide 5 MG Oral Tablet Glyburide 6 MG Oral Tablet pioglitazone 30 MG Oral Tablet pioglitazone 45 MG Oral Tablet rosiglitazone 2 MG Oral Tablet rosiglitazone 4 MG Oral Tablet rosiglitazone 8 MG Oral Tablet Tolazamide 250 MG Oral Capsule Tolbutamide 250 MG Oral Tablet Glyburide 1.5 MG Oral Tablet 24 HR Glipizide 5 MG Extended Release Tablet 24 HR Glipizide 10 MG Extended Release Tablet Tolbutamide 50 MG/ML Injectable Solution pioglitazone 15 MG Oral Tablet Glipizide 2.5 MG Oral Tablet Gliclazide 30 MG Extended Release Tablet glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / pioglitazone 30 MG Oral Tablet glimepiride 4 MG / pioglitazone 30 MG Oral Tablet glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet vildagliptin 100 MG Oral Tablet vildagliptin 50 MG Oral Tablet Glipizide 2.5 MG Extended Release Tablet

844824 844827 861731 861736 861740 861743 861748 861753 861760 861763 861783 861806 861816 861822 312440 312441 312859 312860 312861 317573

Glipizide 5 MG Extended Release Tablet Glipizide 10 MG Extended Release Tablet Glipizide 2.5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Thiazolidinediones pioglitazone 30 MG Oral Tablet pioglitazone 45 MG Oral Tablet rosiglitazone 2 MG Oral Tablet rosiglitazone 4 MG Oral Tablet rosiglitazone 8 MG Oral Tablet pioglitazone 15 MG Oral Tablet

Encounter Codes Accepted for appointment outside of Physician using MU: Encount CPT Encounter Encounter Encounter CPT CPT CPT er Acute ED Non-Acute Outpatient Inpatient Inpatient Opthamolog ical services 99221 1ST HOSP CARE PR D 30 MIN 99222 1ST HOSP CARE PR D 50 MIN 99281 EMER DEPT SELF LIMITED/MIN OR 99304 1ST NF CARE PR D E/M LW SEVERITY 92002 OPH MEDICAL XM&EVAL INTRM NEW PT OPH MEDICAL XM&EVAL COMPRE NEW PT 1+ VST OPH MEDICAL XM&EVAL INTRM EST PT

99282

EMER DEPT LOW TO MODERATE SEVERITY

99305

1ST NF CARE PR D E/M MOD SEVERITY

92004

99223 1ST HOSP CARE PR D 70 MIN 134

99283

EMER DEPT MODERATE SEVERITY

99306

1ST NF CARE PR D E/M HI SEVERITY

92012

99231 SBSQ HOSP CARE PR D 15 MIN 99284 EMER DEPT HI SEVERITY&U RGENT EVAL 99307 SBSQ NF CARE PR D E/M STABLE 92014 OPH MEDICAL XM&EVAL COMPRE EST PT 1+ VST 99232 SBSQ HOSP CARE PR D 25 MIN 99233 SBSQ HOSP CARE PR D 35 MIN 99238 HOSP DSCHRG D MGMT 30 MIN/< 99285 EMER DEPT HIGH SEVERITY&T HREAT FUNCJ 99308 SBSQ NF CARE PR D E/M MINOR COMPLCTJ 99309 SBSQ NF CARE PR D E/M NEW PROBLEM 99310 SBSQ NF CARE PR D E/M UNSTABLE/N EW PROBLEM NF DSCHRG D MGMT 30 MIN/< 99239 HOSP DSCHRG D MGMT > 30 MIN 99251 1ST 99252 INPT CONSLT J 20 MIN 1ST INPT CONSLT J 40 MIN 99253 1ST INPT CONSLT J 55 MIN 99254 1ST INPT CONSLT J 80 MIN 135 99315 99316 NF DSCHRG D MGMT > 30 MIN 99318 E/M PT INVG ANNUAL NF ASSMT 99324 DOM/RHOME LW SEVERITY .

99255 1ST INPT CONSLT J 110 MIN 99325 DOM/RHOME E/M NEW PT MOD SEVERITY DOM/RHOME E/M NEW PT MOD HI SEVERITY DOM/RHOME E/M NEW PT HI SEVERITY DOM/RHOME E/M NEW PT SIGNIFICANT NEW PROBLEM DOM/RHOME E/M EST PT SELFLMTD/MINOR DOM/RHOME E/M EST PT LW MOD SEVERITY DOM/RHOME E/M EST PT SIGNIFICANT NEW PROBLEM 99326 99327 99328 99334 99335 99337 136 .

Uncontrolled.20 Diabetes Mellitus With Hyperosmolar Coma. Uncontrolled 250.30 Diabetes Mellitus With Other Coma. Type Two or unspecified type. Type Two or unspecified type.11 Diabetes Mellitus With Ketoacidosis. Type One [juvenile type]. Type Two or unspecified type. even if the patient requires insulin 250. Fifth digit 2 is for use with type two patients. Fifth digit 0 is for use with type two patients.40 Diabetes Mellitus With Renal Manifestations.31 Diabetes Mellitus With Other Coma.33 Diabetes Mellitus With Other Coma. 137 . Type Two or unspecified type. not stated as uncontrolled.22 Diabetes Mellitus With Hyperosmolar Coma.0 Diabetes Mellitus Without Mention Of Complication 250. even if the patient requires insulin 250. Not Stated As Uncontrolled. Fifth digit 2 is for use with type two patients. even if the patient requires insulin 250.23 Diabetes Mellitus With Hyperosmolar Coma. Type One [juvenile type]. Fifth digit 2 is for use with type two patients.10 Diabetes Mellitus With Ketoacidosis. Type One [juvenile type].Diabetes: Blood Pressure Management (NQF 0061) (Additional Measure MENU) Description: The percentage of patients 18–75 years of age with diabetes (type 1 or type 2) who had BP <140/90 mmHg.03 Diabetes Mellitus Without Mention Of Complication. even if the patient requires insulin 250. Uncontrolled 250.32 Diabetes Mellitus With Other Coma. Fifth digit 0 is for use with type two patients. Type one [juvenile type]. Type Two or unspecified type. not stated as uncontrolled. Type One [juvenile]. Fifth digit 2 is for use with type two patients. uncontrolled 250. Type Two or unspecified type. even if the patient requires insulin 250. Active diagnosis: Diabetes ICD Description 250 Diabetes Mellitus 250.21 Diabetes Mellitus With Hyperosmolar Coma. even if the patient requires insulin 250.4 Diabetes With Renal Manifestations 250. type two or unspecified type. Uncontrolled 250. 250.12 Diabetes Mellitus With Ketoacidosis. Not Stated As Uncontrolled. Type one [juvenile type].01 Diabetes Mellitus Without Mention Of Complication.00 Diabetes Mellitus Without Mention Of Complication. 250. Not Stated As Uncontrolled 250. Fifth digit 0 is for use with type two patients. Fifth digit 0 is for use with type two patients. Type two or unspecified type. Not Stated As Uncontrolled 250. uncontrolled. even if the patient requires insulin 250. Type Two or unspecified type. Uncontrolled. Not Stated As Uncontrolled.02 Diabetes Mellitus Without Mention Of Complication. Type One [juvenile]. even if the patient requires insulin.13 Diabetes Mellitus With Ketoacidosis. Type One [juvenile type] Not Stated As Uncontrolled 250. Uncontrolled.

Type One [juvenile type]. Type One [juvenile type]. Type Two or unspecified type. Fifth-digit 2 is for use with type two patients. Fifth-digit 0 is for use with type two patients.73 250.63 250.43 250. Type Two or unspecified type.53 250.71 250. even if the patient requires insulin Diabetes Mellitus With Ophthalmic Manifestations.72 250. Fifth-digit 2 is for use with type two patients.82 138 . even if the patient requires insulin Diabetes Mellitus With Neurological Manifestations. Not Stated As Uncontrolled Diabetes Mellitus With Peripheral Circulatory Disorders. Type One [juvenile type]. Type One [juvenile type]. even if the patient requires insulin 250.250. even if the patient requires insulin Diabetes Mellitus With Renal Manifestations. Type Two or unspecified type. Type Two or unspecified type.42 250.50 250. even if the patient requires insulin Diabetes Mellitus With Neurological Manifestations. even if the patient requires insulin Diabetes Mellitus With Peripheral Circulatory Disorders. Type Two or unspecified type. Not Stated As Uncontrolled. Type One [juvenile type]. Uncontrolled Diabetes With Other Specified Manifestations Diabetes Mellitus With Other Specified Manifestations.52 250. even if the patient requires insulin Diabetes Mellitus With Renal Manifestations.41 250. Not Stated As Uncontrolled.51 250. Not Stated As Uncontrolled.60 250. Type Two or unspecified type. even if the patient requires insulin Diabetes Mellitus With Ophthalmic Manifestations. Uncontrolled. Fifth-digit 0 is for use with type two patients. Uncontrolled. Uncontrolled. Uncontrolled.61 250.81 250. Fifth digit 0 is for use with type two patients. Type Two or unspecified type. even if the patient requires insulin Diabetes Mellitus With Peripheral Circulatory Disorders. Type One [juvenile type]. Type One [juvenile type] Uncontrolled Diabetes With Peripheral Circulatory Disorders Diabetes Mellitus With Peripheral Circulatory Disorders.80 Not Stated As Uncontrolled. Uncontrolled Diabetes Mellitus With Neurological Manifestations. Uncontrolled Diabetes Mellitus With Ophthalmic Manifestations.70 250. Not Stated As Uncontrolled. Type Two or unspecified type. Type One [juvenile type]. Type Two or unspecified type. Uncontrolled. Not Stated As Uncontrolled Diabetes Mellitus With Other Specified Manifestations. Not Stated As Uncontrolled Diabetes Mellitus With Ophthalmic Manifestations. Fifth-digit 0 is for use with type two patients. Not Stated As Uncontrolled Diabetes Mellitus With Renal Manifestations. Type One [juvenile type] Not Stated As Uncontrolled Diabetes Mellitus With Neurological Manifestations. Fifth-digit 2 is for use with type two patients.8 250.62 250.7 250. Fifth-digit 0 is for use with type two patients. even if the patient requires insulin Diabetes Mellitus With Other Specified Manifestations. Fifth-digit 2 is for use with type two patients. Fifth digit 2 is for use with type two patients.

With Delivery 250. With Mention Of Postpartum Complication 648.82 Abnormal Glucose Tolerance Of Mother. Uncontrolled Diabetes With Unspecified Complication Diabetes Mellitus With Unspecified Complication.80 Abnormal Glucose Tolerance Of Mother. Or The Puerperium 648. Uncontrolled Polyneuropathy In Diabetes Diabetic Retinopathy Background Diabetic Retinopathy Proliferative Diabetic Retinopathy Nonproliferative diabetic retinopathy NOS Mild nonproliferative diabetic retinopathy Moderate nonproliferative diabetic retinopathy Diabetic macular edema Diabetic Cataract Diabetes Mellitus Complicating Pregnancy. Not Stated As Uncontrolled.92 250.03 362.93 357. Type One [juvenile type]. Childbirth. Uncontrolled. even if the patient requires insulin Diabetes Mellitus With Unspecified Complication. Childbirth.0 648.01 362. Not Stated As Uncontrolled Diabetes Mellitus With Unspecified Complication. Or The Puerperium.83 250.01 Active diagnosis of polycystic ovaries ICD-9 Description 256.83 Abnormal Glucose Tolerance Of Mother. Postpartum Active diagnosis of Steroid induced diabetes ICD-9 Description 249 Secondary Diabetes Mellitus 249.81 Abnormal Glucose Tolerance Of Mother. Complicating Pregnancy. Or The Puerperium Diabetes Mellitus Of Mother. Type One [juvenile type].07 366. With Delivery. even if the patient requires insulin Diabetes Mellitus With Unspecified Complication. Antepartum 648.2 362. Unspecified As To Episode Of Care Diabetes Mellitus Of Mother.00 648.04 362. Complicating Pregnancy. Unspecified As To Episode Of Care 648. Or The Puerperium.41 648. Type Two or unspecified type.05 362. Fifth-digit 0 is for use with type two patients.90 Diabetes Mellitus With Other Specified Manifestations.4 Polycystic Ovaries Active diagnosis of gestational diabetes ICD-9 Description 648.250.84 Abnormal Glucose Tolerance Of Mother. Childbirth.8 Abnormal Glucose Tolerance Of Mother. Fifth-digit 2 is for use with type two patients.02 362.0 Secondary diabetes mellitus without mention of complication 139 . Type Two or unspecified type.0 362.91 250. Childbirth. With Delivery 648. Type One [juvenile type]. Complicating Pregnancy.9 250.

249.11 249. not stated as uncontrolled.71 249. not stated as uncontrolled or unspecified Secondary diabetes mellitus without mention of complication.40 249.50 249.8 249.4 249. uncontrolled Secondary diabetes mellitus with other coma Secondary diabetes mellitus with other coma.01 249.2 249. Active RxNORM Description Alph-glucosides 199149 Acarbose 50 MG Oral Tablet 199150 Acarbose 100 MG Oral Tablet 200132 Acarbose 25 MG Oral Tablet 140 . or unspecified Secondary diabetes mellitus with renal manifestations.3 249. uncontrolled Secondary diabetes mellitus with renal manifestations Secondary diabetes mellitus with renal manifestations. uncontrolled Secondary diabetes mellitus with peripheral circulatory disorders Secondary diabetes mellitus with peripheral circulatory disorders.5 249.60 249.81 249. or unspecified Secondary diabetes mellitus with ophthalmic manifestations. uncontrolled Secondary diabetes mellitus with ophthalmic manifestations Secondary diabetes mellitus with ophthalmic manifestations.31 249.21 249.91 251. not stated as uncontrolled. uncontrolled Other Specified Disorders Of Pancreatic Internal Secretion Poisoning By Adrenal Cortical Steroids Medications Ordered. not stated as uncontrolled. not stated as uncontrolled. or unspecified Secondary diabetes mellitus with ketoacidosis. or unspecified Secondary diabetes mellitus with other coma.0 Secondary diabetes mellitus without mention of complication.80 249.00 249.51 249. uncontrolled Secondary diabetes mellitus with neurological manifestations Secondary diabetes mellitus with neurological manifestations.9 249.41 249. or unspecified Secondary diabetes mellitus with peripheral circulatory disorders.8 962. uncontrolled Secondary diabetes mellitus without mention of complication Secondary diabetes mellitus with ketoacidosis.1 249. not stated as uncontrolled.90 249. not stated as uncontrolled. not stated as uncontrolled.7 249.61 249.70 249. uncontrolled Secondary diabetes mellitus with other specified manifestations Secondary diabetes mellitus with other specified manifestations.249.6. Dispensed. uncontrolled Secondary diabetes mellitus with unspecified complication Secondary diabetes mellitus with unspecified complication. not stated as uncontrolled. or unspecified Secondary diabetes mellitus with neurological manifestations.30 249. not stated as uncontrolled.20 249. or unspecified Secondary diabetes mellitus with hyperosmolarity. or unspecified Secondary diabetes mellitus with unspecified complication. uncontrolled Secondary diabetes mellitus with hyperosmolarity Secondary diabetes mellitus with hyperosmolarity. or unspecified Secondary diabetes mellitus with other specified manifestations.10 249.

7 ML pramlintide acetate 1 MG/ML Prefilled Syringe 1.005 MG/ACTUAT Prefilled Syringe Antidiabetic Combination glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / pioglitazone 30 MG Oral Tablet glimepiride 4 MG / pioglitazone 30 MG Oral Tablet glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet Glipizide 2.6 MG/ML Injectable Solution 2.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.5 ML pramlintide acetate 1 MG/ML Prefilled Syringe Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Antidiabetic Agents exenatide 0.205329 205330 205331 401938 200256 200257 200258 311919 314142 389139 861035 861039 861042 861044 861787 861790 744863 847910 847915 602544 602549 602550 647237 647239 706895 706896 861731 861736 861740 861743 861748 861753 861760 861763 861769 861783 861787 861790 861795 861806 miglitol 25 MG Oral Tablet miglitol 50 MG Oral Tablet miglitol 100 MG Oral Tablet Miglustat 100 MG Oral Capsule Amylin analogs repaglinide 1 MG Oral Tablet repaglinide 0.5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.5 MG Oral Tablet repaglinide 2 MG Oral Tablet nateglinide 120 MG Oral Tablet nateglinide 60 MG Oral Tablet nateglinide 180 MG Oral Tablet pramlintide acetate 1 MG/ML Injectable Solution pramlintide acetate 0.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet 141 .25 MG/ML Injectable Solution pioglitazone 15 MG Oral Tablet 60 ACTUAT exenatide 0.

861816 861819 861822 665033 665038 665042 860975 860978 860981 860984 860996 860999 861004 861007 861010 861021 861025 861731 861736 861740 861743 861748 861753 861760 861763 861769 861783 861787 861790 861795 861806 861816 861819 861822 Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Biguanides sitagliptin 100 MG Oral Tablet sitagliptin 25 MG Oral Tablet sitagliptin 50 MG Oral Tablet 24 HR Metformin hydrochloride 500 MG Extended Release Tablet Metformin hydrochloride 500 MG Extended Release Tablet 24 HR Metformin hydrochloride 750 MG Extended Release Tablet Metformin hydrochloride 750 MG Extended Release Tablet 24 HR Metformin hydrochloride 1000 MG Extended Release Tablet Metformin hydrochloride 1000 MG Extended Release Tablet Metformin hydrochloride 1000 MG Oral Tablet Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 850 MG Oral Tablet Metformin hydrochloride 625 MG Oral Tablet Metformin hydrochloride 100 MG/ML Oral Solution Glipizide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Insulin 142 .5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.

Pork 100 UNT/ML Injectable Suspension Insulin. Protamine Lispro. Pork 30 UNT/ML / NPH Insulin. Protamine Zinc. Pork 40 UNT/ML Injectable Solution 90 ACTUAT insulin human. Zinc. Human 50 UNT/ML / Insulin. Beef-Pork 40 UNT/ML Injectable Suspension Insulin. Regular. Pork 40 UNT/ML Injectable Solution Insulin. rDNA origin 3 MG/ACTUAT Dry Powder Inhaler insulin human. Zinc. Pork 500 UNT/ML Injectable Solution Insulin. Beef-Pork 100 UNT/ML Injectable Suspension Insulin. Aspart. Prompt Zinc. Human 100 UNT/ML Injectable Solution Insulin. rDNA origin 3 MG/ACTUAT Inhalant Powder Insulin. Beef 100 UNT/ML Injectable Suspension Insulin. Regular. Regular. Human 100 UNT/ML Injectable Solution Insulin Glargine 100 UNT/ML Injectable Solution Insulin. Aspart Protamine. Beef-Pork 40 UNT/ML Inhalant Solution Insulin. Beef 100 UNT/ML Injectable Solution Insulin. Glulisine. Prompt Zinc. Protamine Zinc. Protamine Zinc. Pork 100 UNT/ML Injectable Solution Insulin. Human 50 UNT/ML Injectable Suspension Insulin. rDNA origin 1 MG/ACTUAT Inhalant Powder insulin human. Regular. Prompt Zinc. Beef-Pork 100 UNT/ML Injectable Suspension Insulin. Regular. Prompt Zinc. Beef-Pork 100 UNT/ML Injectable Solution Insulin. Regular. Aspart. Protamine Lispro. Pork 100 UNT/ML Injectable Suspension Insulin Lispro 25 UNT/ML / Insulin. Aspart Protamine. beef 100 UNT/ML Injectable Suspension Insulin. Zinc. Human 75 UNT/ML Injectable Suspension Insulin Lispro 50 UNT/ML / Insulin. protamine zinc. Beef-Pork 40 UNT/ML Injectable Suspension Insulin. Human 50 UNT/ML Injectable Suspension 143 . Human 70 UNT/ML / Insulin. Human 100 UNT/ML Injectable Suspension Insulin Lispro 100 UNT/ML Injectable Solution insulin. Human 30 UNT/ML Injectable Suspension Insulin. Pork 100 UNT/ML Injectable Suspension Insulin.205314 237527 242120 242916 242917 259111 260265 283394 311040 311041 311053 311054 311055 311056 311057 311058 311059 311060 311061 314038 317800 351297 358349 484322 485210 544614 763002 763007 763013 763014 833159 Insulin. Aspart. rDNA origin 1 MG/ACTUAT Dry Powder Inhaler 90 ACTUAT insulin human. Regular. Pork 70 UNT/ML Injectable Suspension insulin detemir 100 UNT/ML Injectable Solution Insulin.

Human 100 UNT/ML Prefilled Syringe 3 ML Insulin. Glulisine. Human 100 UNT/ML Prefilled Syringe 1. Aspart Protamine. Human 70 UNT/ML / Insulin. Protamine Lispro. Aspart.5 ML Insulin Lispro 100 UNT/ML Prefilled Syringe Meglitinides repaglinide 1 MG Oral Tablet repaglinide 0. Human 75 UNT/ML Prefilled Syringe 3 ML Insulin. Protamine Lispro.847191 847207 847211 847230 847239 847252 847259 847263 847416 3 ML Insulin. Human 30 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 100 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 50 UNT/ML / Insulin.25 MG Oral Tablet Tolazamide 100 MG Oral Tablet Tolazamide 250 MG Oral Tablet Tolazamide 500 MG Oral Tablet Tolbutamide 500 MG Oral Tablet glimepiride 1 MG Oral Tablet glimepiride 2 MG Oral Tablet glimepiride 4 MG Oral Tablet Gliclazide 80 MG Oral Tablet troglitazone 200 MG Oral Tablet troglitazone 400 MG Oral Tablet 200256 200257 200258 311919 314142 389139 105374 153842 197306 197307 197495 197496 197737 198291 198292 198293 198294 199245 199246 199247 199825 199984 199985 144 . Aspart. Human 50 UNT/ML Prefilled Syringe 3 ML Insulin Glargine 100 UNT/ML Prefilled Syringe 3 ML insulin detemir 100 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 25 UNT/ML / Insulin.5 MG Oral Tablet repaglinide 2 MG Oral Tablet nateglinide 120 MG Oral Tablet nateglinide 60 MG Oral Tablet nateglinide 180 MG Oral Tablet Sulfonylureas gliquidone 30 MG Oral Tablet glimepiride 3 MG Oral Tablet Acetohexamide 250 MG Oral Tablet Acetohexamide 500 MG Oral Tablet Chlorpropamide 100 MG Oral Tablet Chlorpropamide 250 MG Oral Tablet Glyburide 1.

5 MG Extended Release Tablet Glipizide 5 MG Oral Tablet Glyburide 2.5 MG Oral Tablet 24 HR Glipizide 5 MG Extended Release Tablet 24 HR Glipizide 10 MG Extended Release Tablet Tolbutamide 50 MG/ML Injectable Solution pioglitazone 15 MG Oral Tablet Glipizide 2.5 MG Oral Tablet Glipizide 10 MG Oral Tablet 24 HR Glipizide 2.5 MG Oral Tablet Glyburide 3 MG Oral Tablet Glyburide 5 MG Oral Tablet Glyburide 6 MG Oral Tablet pioglitazone 30 MG Oral Tablet pioglitazone 45 MG Oral Tablet rosiglitazone 2 MG Oral Tablet rosiglitazone 4 MG Oral Tablet rosiglitazone 8 MG Oral Tablet Tolazamide 250 MG Oral Capsule Tolbutamide 250 MG Oral Tablet Glyburide 1.5 MG Oral Tablet Gliclazide 30 MG Extended Release Tablet glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / pioglitazone 30 MG Oral Tablet glimepiride 4 MG / pioglitazone 30 MG Oral Tablet glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet vildagliptin 100 MG Oral Tablet .200065 252960 310488 310489 310490 310534 310536 310537 310539 312440 312441 312859 312860 312861 313418 313419 314000 314006 315107 315239 317573 379804 389137 602544 602549 602550 647237 647239 706895 706896 757710 145 troglitazone 300 MG Oral Tablet Glyburide 4.

25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Thiazolidinediones 312440 312441 312859 312860 312861 317573 pioglitazone 30 MG Oral Tablet pioglitazone 45 MG Oral Tablet rosiglitazone 2 MG Oral Tablet rosiglitazone 4 MG Oral Tablet rosiglitazone 8 MG Oral Tablet pioglitazone 15 MG Oral Tablet 146 .5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.5 MG Extended Release Tablet Glipizide 5 MG Extended Release Tablet Glipizide 10 MG Extended Release Tablet Glipizide 2.757712 844809 844824 844827 861731 861736 861740 861743 861748 861753 861760 861763 861783 861806 861816 861822 vildagliptin 50 MG Oral Tablet Glipizide 2.

Encounter Codes Accepted for appointment outside of Physician using MU: Encount CPT Encounter ED Encounter Encounter CPT CPT CPT er Acute Non-Acute Outpatient Inpatient Inpatient Opthamolog ical services 99221 1ST HOSP CARE PR D 30 MIN 99222 1ST HOSP CARE PR D 50 MIN 99281 EMER DEPT SELF LIMITED/MINO R 99304 1ST NF CARE PR D E/M LW SEVERITY 92002 OPH MEDICAL XM&EVAL INTRM NEW PT OPH MEDICAL XM&EVAL COMPRE NEW PT 1+ VST OPH MEDICAL XM&EVAL INTRM EST PT OPH MEDICAL XM&EVAL COMPRE EST PT 1+ VST 99282 EMER DEPT LOW TO MODERATE SEVERITY 99305 1ST NF CARE PR D E/M MOD SEVERITY 92004 99223 1ST HOSP CARE PR D 70 MIN 99231 SBSQ HOSP CARE PR D 15 MIN 99283 EMER DEPT MODERATE SEVERITY 99306 1ST NF CARE PR D E/M HI SEVERITY 92012 99284 EMER DEPT HI SEVERITY&UR GENT EVAL 99307 SBSQ NF CARE PR D E/M STABLE 92014 99232 SBSQ HOSP CARE PR D 25 MIN 99233 SBSQ HOSP CARE PR D 35 MIN 99238 HOSP DSCHRG D MGMT 30 MIN/< 99285 EMER DEPT HIGH SEVERITY&TH REAT FUNCJ 99308 SBSQ NF CARE PR D E/M MINOR COMPLCTJ 99309 SBSQ NF CARE PR D E/M NEW PROBLEM 99310 SBSQ NF CARE PR D E/M UNSTABLE/ NEW PROBLEM 147 .

99239 HOSP DSCHRG D MGMT > 30 MIN 99251 1ST 99252 INPT CONSLT J 20 MIN 1ST INPT CONSLT J 40 MIN 99253 1ST INPT CONSLT J 55 MIN 99254 1ST INPT CONSLT J 80 MIN 99255 1ST INPT CONSLT J 110 MIN 99315 NF DSCHRG D MGMT 30 MIN/< NF DSCHRG D MGMT > 30 MIN 99316 99318 E/M PT INVG ANNUAL NF ASSMT DOM/RHOME LW SEVERITY 99324 99325 DOM/RHOME E/M NEW PT MOD SEVERITY DOM/RHOME E/M NEW PT MOD HI SEVERITY DOM/RHOME E/M NEW PT HI SEVERITY DOM/RHOME E/M NEW PT SIGNIFICA NT NEW PROBLEM DOM/R- 99326 99327 99328 99334 148 .

HOME E/M EST PT SELFLMTD/MIN OR 99335 DOM/RHOME E/M EST PT LW MOD SEVERITY DOM/RHOME E/M EST PT SIGNIFICA NT NEW PROBLEM 99337 149 .

Fifth digit 0 is for use with type two patients. even if the patient requires insulin 250. Type two or unspecified type.4 Diabetes With Renal Manifestations 250.23 Diabetes Mellitus With Hyperosmolar Coma. Uncontrolled 250. Type Two or unspecified type.30 Diabetes Mellitus With Other Coma.10 Diabetes Mellitus With Ketoacidosis.Diabetes: Urine Screening (NQF 0062) (Additional Measure . 250. Type Two or unspecified type. Type Two or unspecified type. uncontrolled.13 Diabetes Mellitus With Ketoacidosis. Not Stated As Uncontrolled. even if the patient requires insulin 250. Not Stated As Uncontrolled. Uncontrolled 250. Type One [juvenile type] Not Stated As Uncontrolled 250. even if the patient requires insulin 250. Type one [juvenile type]. Type Two or unspecified type. Not Stated As Uncontrolled 250. Fifth digit 0 is for use with type two patients.MENU) Description: This measure facilitates the prevention and long-term management of kidney disease (Real-Time Rule). uncontrolled 250. Type One [juvenile type]. Fifth digit 2 is for use with type two patients. type two or unspecified type. not stated as uncontrolled. even if the patient requires insulin 250.11 Diabetes Mellitus With Ketoacidosis.01 Diabetes Mellitus Without Mention Of Complication. even if the patient requires insulin 250. Uncontrolled. Fifth digit 2 is for use with type two patients.12 Diabetes Mellitus With Ketoacidosis. Not Stated As Uncontrolled. Fifth digit 2 is for use with type two patients.32 Diabetes Mellitus With Other Coma.03 Diabetes Mellitus Without Mention Of Complication. Type One [juvenile]. Type One [juvenile].31 Diabetes Mellitus With Other Coma. even if the patient requires insulin 250. not stated as uncontrolled. even if the patient requires insulin.00 Diabetes Mellitus Without Mention Of Complication.33 Diabetes Mellitus With Other Coma. Fifth digit 0 is for use with type two patients. Type Two or unspecified type. Type Two or unspecified type. Type Two or unspecified type. Uncontrolled. 250. Fifth digit 2 is for use with type two patients. Type One [juvenile type]. even if the patient requires insulin 250. Fifth digit 0 is for use with type two patients. Type one [juvenile type].21 Diabetes Mellitus With Hyperosmolar Coma. Type One [juvenile type]. Not Stated As Uncontrolled 250.22 Diabetes Mellitus With Hyperosmolar Coma.0 Diabetes Mellitus Without Mention Of Complication 250. Uncontrolled 250. 150 . Uncontrolled. Diagnosis Active – Diagnosis/Condition/Problem ICD-9Description CM 250 Diabetes Mellitus 250.02 Diabetes Mellitus Without Mention Of Complication.40 Diabetes Mellitus With Renal Manifestations.20 Diabetes Mellitus With Hyperosmolar Coma.

50 250.82 Not Stated As Uncontrolled. Type One [juvenile type]. even if the patient requires insulin Diabetes Mellitus With Other Specified Manifestations.8 250. Type Two or unspecified type.43 250. Fifth-digit 2 is for use with type two patients. Type One [juvenile type] Uncontrolled Diabetes With Peripheral Circulatory Disorders Diabetes Mellitus With Peripheral Circulatory Disorders. Fifth digit 0 is for use with type two patients.73 250. Type Two or unspecified type. even if the patient requires insulin Diabetes Mellitus With Renal Manifestations. Type One [juvenile type]. Type Two or unspecified type.63 250. Uncontrolled Diabetes Mellitus With Neurological Manifestations. Type Two or unspecified type. Uncontrolled.42 250. even if the patient requires insulin Diabetes Mellitus With Renal Manifestations. Fifth-digit 2 is for use with type two patients. even if the patient requires insulin Diabetes Mellitus With Ophthalmic Manifestations.72 250.250. Not Stated As Uncontrolled Diabetes Mellitus With Ophthalmic Manifestations. Type One [juvenile type]. Fifth-digit 0 is for use with type two patients.52 250.71 250. Type Two or unspecified type. Uncontrolled Diabetes Mellitus With Ophthalmic Manifestations.80 250.81 250. Fifth-digit 2 is for use with type two patients. Not Stated As Uncontrolled. Fifth digit 2 is for use with type two patients. Uncontrolled. Type Two or unspecified type. even if the patient requires insulin Diabetes Mellitus With Peripheral Circulatory Disorders. Fifth-digit 0 is for use with type two patients.51 250. Type One [juvenile type]. even if the patient requires insulin 151 . Not Stated As Uncontrolled Diabetes Mellitus With Other Specified Manifestations. Type One [juvenile type].7 250.41 250. Type One [juvenile type]. even if the patient requires insulin Diabetes Mellitus With Ophthalmic Manifestations. Not Stated As Uncontrolled.61 250. Type One [juvenile type] Not Stated As Uncontrolled Diabetes Mellitus With Neurological Manifestations. even if the patient requires insulin Diabetes Mellitus With Neurological Manifestations. Not Stated As Uncontrolled Diabetes Mellitus With Renal Manifestations. Fifth-digit 2 is for use with type two patients. Uncontrolled Diabetes With Other Specified Manifestations Diabetes Mellitus With Other Specified Manifestations. Uncontrolled.53 250. Uncontrolled.62 250. Type Two or unspecified type. Not Stated As Uncontrolled Diabetes Mellitus With Peripheral Circulatory Disorders. Fifth-digit 0 is for use with type two patients. Type Two or unspecified type. Type One [juvenile type]. Not Stated As Uncontrolled. even if the patient requires insulin Diabetes Mellitus With Peripheral Circulatory Disorders. Not Stated As Uncontrolled.70 250. Uncontrolled. Type Two or unspecified type. even if the patient requires insulin Diabetes Mellitus With Neurological Manifestations.60 250. Fifth-digit 0 is for use with type two patients.

Or The Puerperium 648.06 Severe nonproliferative diabetic retinopathy 362. Or The Puerperium. Childbirth.04 postpartum condition or complication Diagnosis Active – gestational diabetes ICD-9Description CM 648.07 Diabetic macular edema 366.02 delivered. Complicating Pregnancy. childbirth. With Delivery.8 Abnormal Glucose Tolerance Of Mother. Uncontrolled 357. or the puerperium.83 Abnormal Glucose Tolerance Of Mother. childbirth.93 Diabetes Mellitus With Unspecified Complication.03 antepartum condition or complication Diabetes mellitus complicating pregnancy. Type Two or unspecified type. childbirth. With Delivery Diabetes mellitus complicating pregnancy. Unspecified As To Episode Of Care 648.0 Diabetes Mellitus Complicating Pregnancy. Uncontrolled. even if the patient requires insulin 250. Type One [juvenile type].91 Diabetes Mellitus With Unspecified Complication. Type Two or unspecified type. Type One [juvenile type]. Unspecified As To Episode Of Care 648.03 Nonproliferative diabetic retinopathy NOS 362.2 Polyneuropathy In Diabetes 362. Uncontrolled 250.02 Proliferative Diabetic Retinopathy 362. Or The Puerperium.01 Diabetes Mellitus Of Mother. Complicating Pregnancy. Fifth-digit 2 is for use with type two patients. Complicating Pregnancy. With Mention Of Postpartum Complication 648. Not Stated As Uncontrolled 250. or the puerperium. Type One [juvenile type].81 Abnormal Glucose Tolerance Of Mother.0 Diabetic Retinopathy 362. even if the patient requires insulin 250. With Delivery 648.41 Diabetic Cataract 648. Postpartum Diagnosis Active – nephropathy ICD-9Description 152 .04 Mild nonproliferative diabetic retinopathy 362.90 Diabetes Mellitus With Unspecified Complication. Antepartum 648. 648. Childbirth. or the puerperium. Fifth-digit 0 is for use with type two patients. Childbirth.80 Abnormal Glucose Tolerance Of Mother. with mention of postpartum complication Diabetes mellitus complicating pregnancy.92 Diabetes Mellitus With Unspecified Complication.9 Diabetes With Unspecified Complication 250.05 Moderate nonproliferative diabetic retinopathy 362.82 Abnormal Glucose Tolerance Of Mother. Or The Puerperium 648.00 Diabetes Mellitus Of Mother. 648. Not Stated As Uncontrolled.83 Diabetes Mellitus With Other Specified Manifestations.250.84 Abnormal Glucose Tolerance Of Mother. 648. Childbirth.01 Background Diabetic Retinopathy 362.

not 250. or unspecified Hypertensive heart and chronic kidney disease.01 and with chronic kidney disease stage I through stage IV.0 Hypertensive heart and chronic kidney disease.4 Diabetes with renal manifestations Diabetes mellitus with renal manifestations.1 Hypertensive heart and chronic kidney disease.02 and with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease. malignant Hypertensive chronic kidney disease. malignant.9 Hypertensive heart and chronic kidney disease.11 with chronic kidney disease stage I through stage IV. unspecified Hypertensive heart and chronic kidney disease. with heart failure 404. type II or unspecified type.11 stage V or end stage renal disease 403.10 stage I through stage IV. malignant Hypertensive heart and chronic kidney disease.9 Hypertensive chronic kidney disease. benign.40 stated as uncontrolled Diabetes mellitus with renal manifestations. unspecified. benign. or unspecified Hypertensive chronic kidney disease. or unspecified Hypertensive heart and chronic kidney disease.91 and with chronic kidney disease stage I through stage IV. malignant.91 stage V or end stage renal disease 404 Hypertensive heart and chronic kidney disease 404. without heart 404.43 Diabetes mellitus with renal manifestations. with chronic kidney disease 403. without heart failure 404. without heart failure 404. or unspecified Hypertensive heart and chronic kidney disease. benign. benign Hypertensive heart and chronic kidney disease. with heart failure and 404. type I [juvenile type]. with heart failure 404. with heart failure 404. benign Hypertensive chronic kidney disease.41 uncontrolled Diabetes mellitus with renal manifestations. or unspecified Hypertensive chronic kidney disease. malignant.00 and with chronic kidney disease stage I through stage IV. unspecified Hypertensive chronic kidney disease.90 failure and with chronic kidney disease stage I through stage IV.0 Hypertensive chronic kidney disease. unspecified. malignant.12 and with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease.CM 250. unspecified.1 Hypertensive chronic kidney disease. without heart failure 404. malignant. with chronic kidney disease 403. or unspecified Hypertensive chronic kidney disease. unspecified. type I [juvenile type]. with chronic kidney disease 403. benign. 250.90 stage I through stage IV. or unspecified 153 . with chronic kidney disease 403.42 uncontrolled 250. malignant. with heart failure and 404.03 and with chronic kidney disease stage V or end stage renal disease 404. with chronic kidney disease 403. type II or unspecified type. or unspecified Hypertensive heart and chronic kidney disease. benign.10 and with chronic kidney disease stage I through stage IV. with chronic kidney disease 403. without heart failure 404. or unspecified Hypertensive heart and chronic kidney disease.13 chronic kidney disease stage V or end stage renal disease 404. not stated as 250.00 stage I through stage IV. uncontrolled 403 Hypertensive chronic kidney disease 403.01 stage V or end stage renal disease 403. benign.

81 classified elsewhere Nephritis and nephropathy.89 Acute glomerulonephritis with other specified pathological lesion in kidney 581 Nephrotic syndrome 581. not specified as acute or chronic.8 Acute kidney failure with other specified pathological lesion in kidney 584. with other 583. with unspecified 583.01 Malignant renovascular hypertension 405. in diseases 583.3 Nephrotic syndrome with lesion of minimal change glomerulonephritis 581.6 renal cortical necrosis Nephritis and nephropathy. unspecified.1 Chronic kidney disease. not specified as acute or chronic. not specified as acute or chronic.1 Chronic glomerulonephritis with lesion of membranous glomerulonephritis Chronic glomerulonephritis with lesion of membranoproliferative 582. without heart 404. with other 583.81 Nephrotic syndrome with lesion of minimal change glomerulonephritis 581.0 Nephritis and nephropathy. with lesion of 583. with lesion of 583.93 and chronic kidney disease stage V or end stage renal disease 405.2 glomerulonephritis 582. unspecified. not specified as acute or chronic. not specified as acute or chronic Nephritis and nephropathy. not specified as acute or chronic.9 Acute kidney failure. not specified as acute or chronic.5 Acute kidney failure with lesion of tubular necrosis 584. not specified as acute or chronic.81 Chronic glomerulonephritis in diseases classified elsewhere 582. not specified as acute or chronic 583.8 Chronic glomerulonephritis with other specified pathological lesion in kidney 582.92 failure and with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease.89 specified pathological lesion in kidney Nephritis and nephropathy.8 specified pathological lesion in kidney Nephritis and nephropathy. with lesion of 583.89 Chronic glomerulonephritis with other specified pathological lesion in kidney 582. with lesion of 583.0 Acute glomerulonephritis with lesion of proliferative glomerulonephritis 580. with heart failure 404.1 membranous glomerulonephritis Nephritis and nephropathy.1 Nephrotic syndrome with lesion of membranous glomerulonephritis 581.9 Nephrotic syndrome with unspecified pathological lesion in kidney 582 Chronic glomerulonephritis 582.0 Chronic glomerulonephritis with lesion of proliferative glomerulonephritis 582. unspecified 585 Chronic kidney disease (CKD) 585. not specified as acute or chronic. not specified as acute or chronic.9 pathological lesion in kidney 584.8 Acute glomerulonephritis with other specified pathological lesion in kidney 580.9 Chronic glomerulonephritis with unspecified pathological lesion in kidney 583 Nephritis and nephropathy.91 Unspecified renovascular hypertension 580. Stage I 154 .7 Acute kidney failure with lesion of renal medullary [papillary] necrosis 584.4 rapidly progressive glomerulonephritis Nephritis and nephropathy.7 renal medullary necrosis Nephritis and nephropathy.2 membranoproliferative glomerulonephritis Nephritis and nephropathy. with lesion of 583.Hypertensive heart and chronic kidney disease.

Stage II (mild) Chronic kidney disease.10 753. unspecified Congenital single renal cyst Polycystic kidney.1 V45.3 585. unspecified Disorders resulting from impaired renal function Renal osteodystrophy Nephrogenic diabetes insipidus Other specified disorders resulting from impaired renal function Secondary hyperparathyroidism (of renal origin) Other specified disorders resulting from impaired renal function Unspecified disorder resulting from impaired renal function Renal agenesis and dysgenesis Cystic kidney disease Cystic kidney disease.0 V42.12 V56 V56.32 V56.0 753.14 753.11 753.3 V56.2 585.0 V45.1 588. autosomal recessive Renal dysplasia Medullary cystic kidney Medullary sponge kidney Other specified cystic kidney disease Proteinuria Kidney replaced by transplant Postsurgical renal dialysis status Renal dialysis status Noncompliance with renal dialysis Encounter for dialysis and dialysis catheter care Encounter for extracorporeal dialysis Fitting and adjustment of extracorporeal dialysis catheter Fitting and adjustment of peritoneal dialysis catheter Encounter for adequacy testing for dialysis Encounter for adequacy testing for hemodialysis Encounter for adequacy testing for peritoneal dialysis Encounter for other dialysis Diagnosis Active – polycystic ovaries ICD-9Description CM 256.2 V56.89 588.9 753. Stage III (moderate) Chronic kidney disease.12 753. Stage IV (severe) Chronic kidney disease.31 V56. unspecified Renal failure. Stage V End stage renal disease Chronic kidney disease.19 791.4 585.11 V45.585.6 585. unspecified type Polycystic kidney.81 588.15 753.0 588. autosomal dominant Polycystic kidney.0 V56. unspecified Renal sclerosis.13 753.8 588.9 586 587 588 588.17 753.16 753.5 585.4 Polycystic Ovaries 155 .8 Chronic kidney disease.1 753.1 V56.

2 Secondary diabetes mellitus with hyperosmolarity 249. uncontrolled 249.50 Secondary diabetes mellitus with ophthalmic manifestations.90 Secondary diabetes mellitus with unspecified complication. not stated as uncontrolled. not stated as uncontrolled.7 Secondary diabetes mellitus with peripheral circulatory disorders 249. not stated as uncontrolled.Diagnosis Active – steroid induced diabetes ICD-9Description CM 249 Secondary Diabetes Mellitus 249. not stated as uncontrolled. or unspecified 249.21 Secondary diabetes mellitus with hyperosmolarity. or unspecified 249.30 Secondary diabetes mellitus with other coma. uncontrolled 251.0 Poisoning by adrenal cortical steroids 156 . or unspecified 249.61 Secondary diabetes mellitus with neurological manifestations.10 Secondary diabetes mellitus with ketoacidosis. uncontrolled 249.70 Secondary diabetes mellitus with peripheral circulatory disorders. not stated as uncontrolled.5 Secondary diabetes mellitus with ophthalmic manifestations 249.80 Secondary diabetes mellitus with other specified manifestations.81 Secondary diabetes mellitus with other specified manifestations. or unspecified 249. not stated as uncontrolled.91 Secondary diabetes mellitus with unspecified complication. or unspecified 249.6 Secondary diabetes mellitus with neurological manifestations 249.01 Secondary diabetes mellitus without mention of complication. or unspecified 249. not stated as uncontrolled.0 Secondary diabetes mellitus without mention of complication 249.31 Secondary diabetes mellitus with other coma.41 Secondary diabetes mellitus with renal manifestations. not stated as uncontrolled or unspecified 249. uncontrolled 249. or unspecified 249. or unspecified 249.9 Secondary diabetes mellitus with unspecified complication 249. uncontrolled 249.8 Secondary diabetes mellitus with other specified manifestations 249.71 Secondary diabetes mellitus with peripheral circulatory disorders. not stated as uncontrolled. uncontrolled 249.4 Secondary diabetes mellitus with renal manifestations 249.3 Secondary diabetes mellitus with other coma 249.51 Secondary diabetes mellitus with ophthalmic manifestations. uncontrolled 249.40 Secondary diabetes mellitus with renal manifestations.60 Secondary diabetes mellitus with neurological manifestations.1 Secondary diabetes mellitus without mention of complication 249.8 Other Specified Disorders Of Pancreatic Internal Secretion 962.00 Secondary diabetes mellitus without mention of complication. uncontrolled 249. not stated as uncontrolled.20 Secondary diabetes mellitus with hyperosmolarity. uncontrolled 249. uncontrolled 249. or unspecified 249.11 Secondary diabetes mellitus with ketoacidosis.

Procedure Performed – nephropathy-related procedures CPT Description 36145 INTRO NDL/INTRACATH ARVEN SHUNT CREATED DIAL 36800 INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN 36810 INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL 36815 INSJ CANNULA HEMO OTH SPX ARVEN XTRNL REVJ/CLSR 36818 ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS 36819 ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS 36821 ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT 36831 THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF 36832 REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF 36833 REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF 50300 DON NFRCT FROM CDVR DON UNI/BI 50320 DON NFRCT OPN FROM LIV DON 50340 RCP NFRCT SPX 50360 RNL ALTRNSPLJ IMPLTJ GRF W/O RCP NFRCT 50365 RNL ALTRNSPLJ IMPLTJ GRF W/RCP NFRCT 50370 RMVL TRNSPLED RNL ALGRFT 50380 RNL AUTOTRNSPLJ RIMPLTJ KDN 90920 ESRD FULL MO 12-19 YR 90921 ESRD FULL MO 20 YR&> 90924 ESRD <FULL MO PR D 12-19YR 90925 ESRD < FULL MO PR D 20YR&> 90935 HEMO PX W/1 PHYS EVAL 90937 HEMO REPEATED EVAL +-REVJ DIAL RX 90940 HEMO ACCESS FLO STD 90945 DIAL OTH/THN HEMO 1 PHYS EVAL 90947 DIAL OTH/THN HEMO REPEATED PHYS EVALS 90957 ESRD RELATED SVC MONTHLY 12-19 YR OLD 4/>VISITS 90958 ESRD RELATED SVC MONTHLY 12-19 YR OLD 2/3 VISITS 90959 ESRD RELATED SVC MONTHLY 12-19 YR OLD 1 VISIT 90960 ESRD RELATED SVC MONTHLY 20&> YR OLD 4/> VISITS 90961 ESRD RELATED SVC MONTHLY 20&> YR OLD 2/3 VISITS 90962 ESRD RELATED SVC MONTHLY 20&> YR OLD 1 VISIT 90965 ESRD SVC HOME DIALYSIS FULL MONTH 12-19 YR OLD 90966 ESRD SVC HOME DIALYSIS FULL MONTH 20 YR OLD 90969 ESRD RELATED SVC <FULL MONTH 12-19 YR OLD 90970 ESRD RELATED SVC <FULL MONTH 20&> YR OLD 90989 DIAL TRAINJ COMPLD COURSE 90993 DIAL TRAINJ COURSE X COMPLD PR SESS 90997 HEMOPRFJ 90999 UNLIS DIAL I/P/O/P 99512 HOME VST HEMO Laboratory Test Performed .nephropathy screening LOINC Description 11218-5 Microalbumin [Mass/volume] in Urine by Test strip 12842-1 Protein [Mass/volume] in 12 hour Urine 157 .

total in 24 hour Urine Microalbumin [Mass/time] in unspecified time Urine Albumin [Presence] in Urine by Test strip Protein [Mass/time] in 1 hour Urine Microalbumin [Mass/volume] in 24 hour Urine by Detection limit <= 1.13705-9 138016 14585-4 14956-7 14957-5 149583 149591 1753-3 1754-1 1755-8 1757-4 18373-1 20621-9 21059-1 21482-5 26801-1 27298-9 2887-8 2888-6 2889-4 2890-2 30000-4 30001-2 30003-8 322099 32294-1 32551-4 34366-5 35663-4 404863 40662-9 406637 436055 43606-3 43607-1 44292-1 47558-2 49023-5 509497 53121-0 53530158 Albumin/Creatinine [Mass ratio] in 24 hour Urine Protein/Creatinine [Mass ratio] in 24 hour Urine Albumin/Creatinine [Molar ratio] in Urine Microalbumin [Mass/time] in 24 hour Urine Microalbumin [Mass/volume] in Urine Microalbumin/Creatinine [Mass ratio] in 24 hour Urine Microalbumin/Creatinine [Mass ratio] in Urine Albumin [Presence] in Urine Albumin [Mass/volume] in Urine Albumin [Mass/time] in 24 hour Urine Albumin renal clearance in 24 hour Protein [Mass/time] in 6 hour Urine Albumin/Creatinine [Presence] in Urine by Test strip Albumin [Mass/volume] in 24 hour Urine Protein [Mass/volume] in 24 hour Urine Protein [Mass/time] in 12 hour Urine Protein [Units/volume] in Urine Protein [Presence] in Urine Protein [Mass/volume] in Urine Protein [Mass/time] in 24 hour Urine Protein/Creatinine [Mass ratio] in Urine Microalbumin/Creatinine [Ratio] in Urine Microalbumin/Creatinine [Ratio] in Urine by Test strip Microalbumin [Mass/volume] in 24 hour Urine Protein [Presence] in 24 hour Urine by Test strip Albumin/Creatinine [Ratio] in Urine Protein [Mass] in unspecified time Urine Protein/Creatinine [Ratio] in Urine Protein [Mass/volume] in unspecified time Urine Protein/Creatinine [Ratio] in 24 hour Urine Protein [Mass/time] in 12 hour Urine --resting Protein [Mass/time] in 12 hour Urine –upright Microalbumin [Mass/volume] in 4 hour Urine Microalbumin [Mass/time] in 4 hour Urine Microalbumin [Mass/time] in 12 hour Urine Microalbumin/Creatinine [Mass ratio] in 12 hour Urine Microalbumin/Protein.0 mg/L .

5 MG / quinapril 10 MG Oral Tablet 310797 Hydrochlorothiazide 12.2 535310 Microalbumin [Mass/volume] in Urine by Detection limit <= 1.5 MG / moexipril 7.5 MG / quinapril 20 MG Oral Tablet 310805 Hydrochlorothiazide 25 MG / moexipril 15 MG Oral Tablet 310809 Hydrochlorothiazide 25 MG / quinapril 20 MG Oral Tablet 311353 Lisinopril 2.5 MG Oral Tablet 197436 Captopril 25 MG / Hydrochlorothiazide 15 MG Oral Tablet 197437 Captopril 25 MG / Hydrochlorothiazide 25 MG Oral Tablet 197438 Captopril 50 MG / Hydrochlorothiazide 15 MG Oral Tablet 197439 Captopril 50 MG / Hydrochlorothiazide 25 MG Oral Tablet 197884 Lisinopril 40 MG Oral Tablet 197885 Hydrochlorothiazide 12.5 MG Oral Capsule 199816 trandolapril 1 MG Oral Capsule 199817 trandolapril 2 MG Oral Capsule 205326 Lisinopril 30 MG Oral Tablet 251856 Ramipril 2. Dispensed – ACE inhibitors RxNorm Description 104370 Captopril 25 MG / Hydrochlorothiazide 12.5 MG / Lisinopril 20 MG Oral Tablet 197887 Hydrochlorothiazide 25 MG / Lisinopril 20 MG Oral Tablet 198188 Ramipril 2.0 mg/L 53532-8 Microalbumin [Mass/time] in 24 hour Urine by Detection limit <= 1.5 MG / Lisinopril 10 MG Oral Tablet 197886 Hydrochlorothiazide 12.5 MG Oral Capsule 198189 Ramipril 5 MG Oral Capsule 199351 trandolapril 2 MG Oral Tablet 199353 trandolapril 1 MG Oral Tablet 199622 trandolapril 0.5 MG Oral Tablet 310796 Hydrochlorothiazide 12.5 MG Oral Tablet 251857 Ramipril 5 MG Oral Tablet 261962 Ramipril 10 MG Oral Capsule 308962 Captopril 100 MG Oral Tablet 308963 Captopril 12.5 MG Oral Tablet 308964 Captopril 50 MG Oral Tablet 310795 Hydrochlorothiazide 12.5 MG Oral Tablet 311354 Lisinopril 5 MG Oral Tablet 311734 moexipril 15 MG Oral Tablet 311735 moexipril 7.5 MG Oral Tablet 159 .urine macroalbumin LOINC Description 20454-5 Protein [Presence] in Urine by Test strip 50561-0 Protein [Mass/volume] in Urine by Automated test strip 535252 Protein [Presence] in Urine by SSA method 5804-0 Protein [Mass/volume] in Urine by Test strip Medication Active.0 mg/L 9318-7 Albumin/Creatinine [Mass ratio] in Urine Laboratory Test Performed . Ordered.

Dispensed – Alph-glucosides inhibitors RxNorm Description 199149 Acarbose 50 MG Oral Tablet 199150 Acarbose 100 MG Oral Tablet 200132 Acarbose 25 MG Oral Tablet 205329 miglitol 25 MG Oral Tablet 205330 miglitol 50 MG Oral Tablet 205331 miglitol 100 MG Oral Tablet 401938 Miglustat 100 MG Oral Capsule 160 .25 MG Oral Capsule Perindopril Erbumine 8 MG Oral Tablet Perindopril Erbumine 2 MG Oral Tablet Perindopril Erbumine 4 MG Oral Tablet Indapamide 1.5 MG Oral Tablet Enalapril Maleate 20 MG Oral Tablet Enalapril Maleate 5 MG Oral Tablet Enalapril Maleate 10 MG Oral Tablet Enalapril Maleate 1.25 MG/ML Injectable Solution Enalapril Maleate 5 MG / Hydrochlorothiazide 12.312748 312749 312750 314076 314077 314203 317173 349443 389180 389181 401965 401968 833237 845488 854925 854984 854988 854993 857166 857169 857174 857183 857187 858618 858621 858804 858810 858813 858817 858821 858824 858828 858921 858926 quinapril 10 MG Oral Tablet quinapril 20 MG Oral Tablet quinapril 5 MG Oral Tablet Lisinopril 10 MG Oral Tablet Lisinopril 20 MG Oral Tablet quinapril 40 MG Oral Tablet Captopril 25 MG Oral Tablet Hydrochlorothiazide 12.5 MG Oral Tablet Felodipine 5 MG / Ramipril 5 MG Oral Tablet Ramipril 1.5 MG Oral Tablet Fosinopril Sodium 20 MG Oral Tablet Fosinopril Sodium 40 MG Oral Tablet Enalapril Maleate 5 MG / Felodipine 2.5 MG / moexipril 15 MG Oral Tablet Felodipine 2.25 MG / Perindopril Erbumine 4 MG Oral Tablet Fosinopril Sodium 10 MG / Hydrochlorothiazide 12.5 MG Oral Tablet Enalapril Maleate 10 MG / Hydrochlorothiazide 25 MG Oral Tablet Enalapril Maleate 20 MG / Hydrochlorothiazide 12. Ordered.5 MG / Ramipril 2.5 MG Extended Release Tablet Enalapril Maleate 5 MG / Felodipine 5 MG Extended Release Tablet Enalapril Maleate 2.5 MG Oral Tablet Fosinopril Sodium 10 MG Oral Tablet Fosinopril Sodium 20 MG / Hydrochlorothiazide 12.25 MG Oral Tablet Ramipril 10 MG Oral Tablet Diltiazem Hydrochloride 180 MG / Enalapril Maleate 5 MG Extended Release Tablet Ramipril 1.5 MG Oral Tablet Enalapril Maleate 20 MG Chewable Tablet Medication Active.

5 MG / irbesartan 150 MG Oral Tablet 310793 Hydrochlorothiazide 12.6 MG/ML Injectable Solution 861042 2. Ordered.7 ML pramlintide acetate 1 MG/ML Prefilled Syringe 861044 1. Dispensed – Amylin analogs RxNorm Description 200256 repaglinide 1 MG Oral Tablet 200257 repaglinide 0.Medication Active.5 MG / valsartan 160 MG Oral Tablet 205304 telmisartan 40 MG Oral Tablet 205305 telmisartan 80 MG Oral Tablet 282755 telmisartan 20 MG Oral Tablet 283316 Hydrochlorothiazide 12.5 MG / telmisartan 80 MG Oral Tablet 310139 eprosartan 400 MG Oral Tablet 310140 eprosartan 600 MG Oral Tablet 310792 Hydrochlorothiazide 12.5 MG / Olmesartan medoxomil 40 MG Oral Tablet 161 .5 MG / telmisartan 40 MG Oral Tablet 283317 Hydrochlorothiazide 12.5 ML pramlintide acetate 1 MG/ML Prefilled Syringe Medication Active.5 MG / valsartan 80 MG Oral Tablet 200285 Hydrochlorothiazide 12. Ordered.5 MG / Olmesartan medoxomil 20 MG Oral Tablet 403854 Hydrochlorothiazide 12.5 MG Oral Tablet 200258 repaglinide 2 MG Oral Tablet 311919 nateglinide 120 MG Oral Tablet 314142 nateglinide 60 MG Oral Tablet 389139 nateglinide 180 MG Oral Tablet 861035 pramlintide acetate 1 MG/ML Injectable Solution 861039 pramlintide acetate 0.5 MG Oral Tablet 351293 eprosartan 600 MG / Hydrochlorothiazide 25 MG Oral Tablet 389185 eprosartan 300 MG Oral Tablet 401971 Olmesartan medoxomil 10 MG Oral Tablet 403853 Hydrochlorothiazide 12. Dispensed – Angiotension II inhibitors RxNorm Description 153077 valsartan 40 MG Oral Capsule 153822 candesartan cilexetil 4 MG Oral Tablet 153823 candesartan cilexetil 8 MG Oral Tablet 199850 valsartan 80 MG Oral Capsule 199919 valsartan 160 MG Oral Capsule 200094 irbesartan 75 MG Oral Tablet 200095 irbesartan 150 MG Oral Tablet 200096 irbesartan 300 MG Oral Tablet 200284 Hydrochlorothiazide 12.5 MG / irbesartan 300 MG Oral Tablet 349199 valsartan 80 MG Oral Tablet 349200 valsartan 320 MG Oral Tablet 349201 valsartan 160 MG Oral Tablet 349353 Hydrochlorothiazide 25 MG / valsartan 160 MG Oral Tablet 349373 Olmesartan medoxomil 5 MG Oral Tablet 349401 Olmesartan medoxomil 20 MG Oral Tablet 349405 Olmesartan medoxomil 40 MG Oral Tablet 349483 valsartan 40 MG Oral Tablet 351292 eprosartan 600 MG / Hydrochlorothiazide 12.

5 MG Oral Tablet candesartan cilexetil 32 MG / Hydrochlorothiazide 12.5 MG / valsartan 160 MG Oral Tablet Amlodipine 10 MG / Hydrochlorothiazide 25 MG / valsartan 320 MG Oral Tablet Amlodipine 5 MG / Hydrochlorothiazide 12. Ordered.5 MG / valsartan 160 MG Oral Tablet Amlodipine 5 MG / Hydrochlorothiazide 25 MG / valsartan 160 MG Oral Tablet Amlodipine 10 MG / Hydrochlorothiazide 25 MG / valsartan 160 MG Oral Tablet Amlodipine 10 MG / telmisartan 40 MG Oral Tablet Amlodipine 10 MG / telmisartan 80 MG Oral Tablet Amlodipine 5 MG / telmisartan 40 MG Oral Tablet Amlodipine 5 MG / telmisartan 80 MG Oral Tablet Medication Active.403855 477130 485471 577776 578325 578330 636042 636045 639536 639537 722126 722131 722134 722137 730861 730866 730869 730872 802749 848131 848135 848140 848145 848151 876514 876519 876524 876529 Hydrochlorothiazide 25 MG / Olmesartan medoxomil 40 MG Oral Tablet Hydrochlorothiazide 25 MG / telmisartan 80 MG Oral Tablet Hydrochlorothiazide 25 MG / irbesartan 300 MG Oral Tablet candesartan cilexetil 16 MG Oral Tablet candesartan cilexetil 16 MG / Hydrochlorothiazide 12.25 MG/ML Injectable Solution 847910 pioglitazone 15 MG Oral Tablet 847915 60 ACTUAT exenatide 0.005 MG/ACTUAT Prefilled Syringe Medication Active. Dispensed – Antidiabetic Combination RxNorm Description 602544 glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet 602549 glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet 602550 glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet 647237 glimepiride 2 MG / pioglitazone 30 MG Oral Tablet 647239 glimepiride 4 MG / pioglitazone 30 MG Oral Tablet 706895 glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet 706896 glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet 162 .5 MG Oral Tablet Hydrochlorothiazide 12.5 MG / valsartan 320 MG Oral Tablet Hydrochlorothiazide 25 MG / valsartan 320 MG Oral Tablet candesartan cilexetil 2 MG Oral Tablet candesartan cilexetil 32 MG Oral Tablet Amlodipine 10 MG / valsartan 160 MG Oral Tablet Amlodipine 10 MG / valsartan 320 MG Oral Tablet Amlodipine 5 MG / valsartan 160 MG Oral Tablet Amlodipine 5 MG / valsartan 320 MG Oral Tablet Amlodipine 10 MG / Olmesartan medoxomil 20 MG Oral Tablet Amlodipine 10 MG / Olmesartan medoxomil 40 MG Oral Tablet Amlodipine 5 MG / Olmesartan medoxomil 20 MG Oral Tablet Amlodipine 5 MG / Olmesartan medoxomil 40 MG Oral Tablet candesartan cilexetil 32 MG / Hydrochlorothiazide 25 MG Oral Tablet Amlodipine 10 MG / Hydrochlorothiazide 12. Dispensed – Antidiabetic Agents RxNorm Description 744863 exenatide 0. Ordered.

5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.5 MG Oral Tablet 351293 eprosartan 600 MG / Hydrochlorothiazide 25 MG Oral Tablet 403853 Hydrochlorothiazide 12.5 MG / Olmesartan medoxomil 20 MG Oral Tablet 163 .5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Medication Active.5 MG / valsartan 80 MG Oral Tablet 200285 Hydrochlorothiazide 12.5 MG / irbesartan 150 MG Oral Tablet 310793 Hydrochlorothiazide 12.5 MG / quinapril 10 MG Oral Tablet 310797 Hydrochlorothiazide 12.5 MG / Lisinopril 10 MG Oral Tablet 197887 Hydrochlorothiazide 25 MG / Lisinopril 20 MG Oral Tablet 200284 Hydrochlorothiazide 12. Dispensed – Antihypertensive combinations RxNorm Description 104370 Captopril 25 MG / Hydrochlorothiazide 12.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.5 MG Oral Tablet 310796 Hydrochlorothiazide 12. Ordered.5 MG / quinapril 20 MG Oral Tablet 310805 Hydrochlorothiazide 25 MG / moexipril 15 MG Oral Tablet 310809 Hydrochlorothiazide 25 MG / quinapril 20 MG Oral Tablet 312748 quinapril 10 MG Oral Tablet 312749 quinapril 20 MG Oral Tablet 312750 quinapril 5 MG Oral Tablet 314203 quinapril 40 MG Oral Tablet 349353 Hydrochlorothiazide 25 MG / valsartan 160 MG Oral Tablet 349443 Hydrochlorothiazide 12.5 MG / telmisartan 80 MG Oral Tablet 310140 eprosartan 600 MG Oral Tablet 310792 Hydrochlorothiazide 12.5 MG / valsartan 160 MG Oral Tablet 283316 Hydrochlorothiazide 12.5 MG Oral Tablet 197436 Captopril 25 MG / Hydrochlorothiazide 15 MG Oral Tablet 197437 Captopril 25 MG / Hydrochlorothiazide 25 MG Oral Tablet 197438 Captopril 50 MG / Hydrochlorothiazide 15 MG Oral Tablet 197439 Captopril 50 MG / Hydrochlorothiazide 25 MG Oral Tablet 197885 Hydrochlorothiazide 12.861731 861736 861740 861743 861748 861753 861760 861763 861769 861783 861787 861790 861795 861806 861816 861819 861822 Glipizide 2.5 MG / moexipril 15 MG Oral Tablet 351292 eprosartan 600 MG / Hydrochlorothiazide 12.5 MG / telmisartan 40 MG Oral Tablet 283317 Hydrochlorothiazide 12.5 MG / moexipril 7.5 MG / irbesartan 300 MG Oral Tablet 310795 Hydrochlorothiazide 12.

5 MG Oral Tablet Hydrochlorothiazide 12.5 MG / valsartan 160 MG Oral Tablet Amlodipine 10 MG / Hydrochlorothiazide 25 MG / valsartan 320 MG Oral Tablet Amlodipine 5 MG / Hydrochlorothiazide 12.25 MG / Perindopril Erbumine 4 MG Oral Tablet Fosinopril Sodium 10 MG / Hydrochlorothiazide 12.25 MG/ML Injectable Solution Enalapril Maleate 5 MG / Hydrochlorothiazide 12.5 MG Oral Tablet candesartan cilexetil 32 MG / Hydrochlorothiazide 12.5 MG / valsartan 160 MG Oral Tablet Amlodipine 5 MG / Hydrochlorothiazide 25 MG / valsartan 160 MG Oral Tablet Amlodipine 10 MG / Hydrochlorothiazide 25 MG / valsartan 160 MG Oral Tablet Indapamide 1.5 MG Oral Tablet Fosinopril Sodium 20 MG / Hydrochlorothiazide 12.5 MG Extended Release Tablet Enalapril Maleate 5 MG / Felodipine 5 MG Extended Release Tablet Enalapril Maleate 1.403854 403855 477130 485471 578325 578330 636042 636045 722126 722131 722134 722137 730861 730866 730869 730872 802749 833237 848131 848135 848140 848145 848151 854993 857166 857174 858618 858621 858821 858824 858828 876514 876519 876524 876529 Hydrochlorothiazide 12. Dispensed – Biguanides RxNorm Description 665033 sitagliptin 100 MG Oral Tablet 665038 sitagliptin 25 MG Oral Tablet 665042 sitagliptin 50 MG Oral Tablet 860975 24 HR Metformin hydrochloride 500 MG Extended Release Tablet 860978 Metformin hydrochloride 500 MG Extended Release Tablet 164 . Ordered.5 MG Oral Tablet Enalapril Maleate 5 MG / Felodipine 2.5 MG / Olmesartan medoxomil 40 MG Oral Tablet Hydrochlorothiazide 25 MG / Olmesartan medoxomil 40 MG Oral Tablet Hydrochlorothiazide 25 MG / telmisartan 80 MG Oral Tablet Hydrochlorothiazide 25 MG / irbesartan 300 MG Oral Tablet candesartan cilexetil 16 MG / Hydrochlorothiazide 12.5 MG / valsartan 320 MG Oral Tablet Hydrochlorothiazide 25 MG / valsartan 320 MG Oral Tablet Amlodipine 10 MG / valsartan 160 MG Oral Tablet Amlodipine 10 MG / valsartan 320 MG Oral Tablet Amlodipine 5 MG / valsartan 160 MG Oral Tablet Amlodipine 5 MG / valsartan 320 MG Oral Tablet Amlodipine 10 MG / Olmesartan medoxomil 20 MG Oral Tablet Amlodipine 10 MG / Olmesartan medoxomil 40 MG Oral Tablet Amlodipine 5 MG / Olmesartan medoxomil 20 MG Oral Tablet Amlodipine 5 MG / Olmesartan medoxomil 40 MG Oral Tablet candesartan cilexetil 32 MG / Hydrochlorothiazide 25 MG Oral Tablet Diltiazem Hydrochloride 180 MG / Enalapril Maleate 5 MG Extended Release Tablet amLODIPine 10 MG / Hydrochlorothiazide 12.5 MG Oral Tablet Enalapril Maleate 10 MG / Hydrochlorothiazide 25 MG Oral Tablet Amlodipine 10 MG / telmisartan 40 MG Oral Tablet Amlodipine 10 MG / telmisartan 80 MG Oral Tablet Amlodipine 5 MG / telmisartan 40 MG Oral Tablet Amlodipine 5 MG / telmisartan 80 MG Oral Tablet Medication Active.

Regular.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2. beef 100 UNT/ML Injectable Suspension 242917 Insulin.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Medication Active.860981 860984 860996 860999 861004 861007 861010 861021 861025 861731 861736 861740 861743 861748 861753 861760 861763 861769 861783 861787 861790 861795 861806 861816 861819 861822 24 HR Metformin hydrochloride 750 MG Extended Release Tablet Metformin hydrochloride 750 MG Extended Release Tablet 24 HR Metformin hydrochloride 1000 MG Extended Release Tablet Metformin hydrochloride 1000 MG Extended Release Tablet Metformin hydrochloride 1000 MG Oral Tablet Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 850 MG Oral Tablet Metformin hydrochloride 625 MG Oral Tablet Metformin hydrochloride 100 MG/ML Oral Solution Glipizide 2. Zinc. Beef-Pork 100 UNT/ML Injectable Suspension 165 . Human 50 UNT/ML Injectable Suspension 283394 Insulin. Human 75 UNT/ML Injectable Suspension 260265 Insulin Lispro 50 UNT/ML / Insulin. Protamine Lispro. Regular. Pork 500 UNT/ML Injectable Solution 237527 Insulin. Regular. Protamine Lispro. Beef-Pork 40 UNT/ML Inhalant Solution 311056 Insulin. Pork 40 UNT/ML Injectable Solution 311059 Insulin. Regular. Prompt Zinc. Protamine Zinc. Beef-Pork 100 UNT/ML Injectable Suspension 311054 Insulin. Beef 100 UNT/ML Injectable Suspension 311040 Insulin.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1. Beef-Pork 100 UNT/ML Injectable Solution 311055 Insulin. Dispensed – Insulin RxNorm Description 205314 Insulin. Protamine Zinc. protamine zinc. Regular. Pork 100 UNT/ML Injectable Suspension 259111 Insulin Lispro 25 UNT/ML / Insulin.5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2. Regular. Beef 100 UNT/ML Injectable Solution 311057 Insulin. Prompt Zinc. Pork 100 UNT/ML Injectable Solution 311058 Insulin. Human 100 UNT/ML Injectable Solution 311041 Insulin Glargine 100 UNT/ML Injectable Solution 311053 Insulin. Human 100 UNT/ML Injectable Suspension 242120 Insulin Lispro 100 UNT/ML Injectable Solution 242916 insulin. Aspart. Ordered.

311060 311061 314038 317800 351297 358349 484322 485210 544614 763002 763007 763013 763014 833159 847191 847207 847211 847230 847239 847252 847259 847263 847416

Insulin, Prompt Zinc, Beef-Pork 40 UNT/ML Injectable Suspension Insulin, Prompt Zinc, Pork 100 UNT/ML Injectable Suspension Insulin, Protamine Zinc, Beef-Pork 40 UNT/ML Injectable Suspension Insulin, Zinc, Pork 100 UNT/ML Injectable Suspension Insulin, Aspart Protamine, Human 70 UNT/ML / Insulin, Aspart, Human 30 UNT/ML Injectable Suspension Insulin, Regular, Pork 30 UNT/ML / NPH Insulin, Pork 70 UNT/ML Injectable Suspension insulin detemir 100 UNT/ML Injectable Solution Insulin, Glulisine, Human 100 UNT/ML Injectable Solution Insulin, Zinc, Pork 40 UNT/ML Injectable Solution 90 ACTUAT insulin human, rDNA origin 1 MG/ACTUAT Dry Powder Inhaler 90 ACTUAT insulin human, rDNA origin 3 MG/ACTUAT Dry Powder Inhaler insulin human, rDNA origin 1 MG/ACTUAT Inhalant Powder insulin human, rDNA origin 3 MG/ACTUAT Inhalant Powder Insulin, Aspart Protamine, Human 50 UNT/ML / Insulin, Aspart, Human 50 UNT/ML Injectable Suspension 3 ML Insulin, Aspart Protamine, Human 70 UNT/ML / Insulin, Aspart, Human 30 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 100 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 50 UNT/ML / Insulin, Protamine Lispro, Human 50 UNT/ML Prefilled Syringe 3 ML Insulin Glargine 100 UNT/ML Prefilled Syringe 3 ML insulin detemir 100 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 25 UNT/ML / Insulin, Protamine Lispro, Human 75 UNT/ML Prefilled Syringe 3 ML Insulin, Glulisine, Human 100 UNT/ML Prefilled Syringe 3 ML Insulin, Aspart, Human 100 UNT/ML Prefilled Syringe 1.5 ML Insulin Lispro 100 UNT/ML Prefilled Syringe

Medication Active, Ordered, Dispensed – Meglitinides RxNorm Description 200256 repaglinide 1 MG Oral Tablet 200257 repaglinide 0.5 MG Oral Tablet 200258 repaglinide 2 MG Oral Tablet 311919 nateglinide 120 MG Oral Tablet 314142 nateglinide 60 MG Oral Tablet 389139 nateglinide 180 MG Oral Tablet Medication Active, Ordered, Dispensed – Sulfonylureas RxNorm Description 105374 gliquidone 30 MG Oral Tablet 153842 glimepiride 3 MG Oral Tablet 197306 Acetohexamide 250 MG Oral Tablet 197307 Acetohexamide 500 MG Oral Tablet 197495 Chlorpropamide 100 MG Oral Tablet 197496 Chlorpropamide 250 MG Oral Tablet 197737 Glyburide 1.25 MG Oral Tablet

166

198291 198292 198293 198294 199245 199246 199247 199825 199984 199985 200065 252960 310488 310489 310490 310534 310536 310537 310539 312440 312441 312859 312860 312861 313418 313419 314000 314006 315107 315239 317573 379804 389137 602544 602549 602550 647237 647239 706895 706896 757710 757712 844809 844824 844827 861731 861736 861740

Tolazamide 100 MG Oral Tablet Tolazamide 250 MG Oral Tablet Tolazamide 500 MG Oral Tablet Tolbutamide 500 MG Oral Tablet glimepiride 1 MG Oral Tablet glimepiride 2 MG Oral Tablet glimepiride 4 MG Oral Tablet Gliclazide 80 MG Oral Tablet troglitazone 200 MG Oral Tablet troglitazone 400 MG Oral Tablet troglitazone 300 MG Oral Tablet Glyburide 4.5 MG Oral Tablet Glipizide 10 MG Oral Tablet 24 HR Glipizide 2.5 MG Extended Release Tablet Glipizide 5 MG Oral Tablet Glyburide 2.5 MG Oral Tablet Glyburide 3 MG Oral Tablet Glyburide 5 MG Oral Tablet Glyburide 6 MG Oral Tablet pioglitazone 30 MG Oral Tablet pioglitazone 45 MG Oral Tablet rosiglitazone 2 MG Oral Tablet rosiglitazone 4 MG Oral Tablet rosiglitazone 8 MG Oral Tablet Tolazamide 250 MG Oral Capsule Tolbutamide 250 MG Oral Tablet Glyburide 1.5 MG Oral Tablet 24 HR Glipizide 5 MG Extended Release Tablet 24 HR Glipizide 10 MG Extended Release Tablet Tolbutamide 50 MG/ML Injectable Solution pioglitazone 15 MG Oral Tablet Glipizide 2.5 MG Oral Tablet Gliclazide 30 MG Extended Release Tablet glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / pioglitazone 30 MG Oral Tablet glimepiride 4 MG / pioglitazone 30 MG Oral Tablet glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet vildagliptin 100 MG Oral Tablet vildagliptin 50 MG Oral Tablet Glipizide 2.5 MG Extended Release Tablet Glipizide 5 MG Extended Release Tablet Glipizide 10 MG Extended Release Tablet Glipizide 2.5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet

167

861743 861748 861753 861760 861763 861783 861806 861816 861822

Glyburide 1.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet

Medication Active, Ordered, Dispensed – Thiazolidinediones RxNorm Description 312440 pioglitazone 30 MG Oral Tablet 312441 pioglitazone 45 MG Oral Tablet 312859 rosiglitazone 2 MG Oral Tablet 312860 rosiglitazone 4 MG Oral Tablet 312861 rosiglitazone 8 MG Oral Tablet 317573 pioglitazone 15 MG Oral Tablet Encounter – acute inpatient CPT Description 99221 1ST HOSP CARE PR D 30 MIN 99222 1ST HOSP CARE PR D 50 MIN 99223 1ST HOSP CARE PR D 70 MIN 99231 SBSQ HOSP CARE PR D 15 MIN 99232 SBSQ HOSP CARE PR D 25 MIN 99233 SBSQ HOSP CARE PR D 35 MIN 99238 HOSP DSCHRG D MGMT 30 MIN/< 99239 HOSP DSCHRG D MGMT > 30 MIN 99251 1ST INPT CONSLTJ 20 MIN 99252 1ST INPT CONSLTJ 40 MIN 99253 1ST INPT CONSLTJ 55 MIN 99254 1ST INPT CONSLTJ 80 MIN 99255 1ST INPT CONSLTJ 110 MIN 99291 CC E/M CRITICALLY ILL/INJURED 1ST 30-74 MIN Encounter – ED CPT Description 99281 EMER DEPT SELF LIMITED/MINOR 99282 EMER DEPT LOW TO MODERATE SEVERITY 99283 EMER DEPT MODERATE SEVERITY 99284 EMER DEPT HI SEVERITY&URGENT EVAL 99285 EMER DEPT HIGH SEVERITY&THREAT FUNCJ Encounter – non-acute inpatient CPT Description 99304 1ST NF CARE PR D E/M LW SEVERITY 99305 1ST NF CARE PR D E/M MOD SEVERITY 168

99306 99307 99308 99309 99310 99315 99316 99318 99324 99325 99326 99327 99328 99334 99335 99336 99337

1ST NF CARE PR D E/M HI SEVERITY SBSQ NF CARE PR D E/M STABLE SBSQ NF CARE PR D E/M MINOR COMPLCTJ SBSQ NF CARE PR D E/M NEW PROBLEM SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM NF DSCHRG D MGMT 30 MIN/< NF DSCHRG D MGMT > 30 MIN E/M PT INVG ANNUAL NF ASSMT DOM/R-HOME LW SEVERITY DOM/R-HOME E/M NEW PT MOD SEVERITY DOM/R-HOME E/M NEW PT MOD HI SEVERITY DOM/R-HOME E/M NEW PT HI SEVERITY DOM/R-HOME E/M NEW PT SIGNIFICANT NEW PROBLEM DOM/R-HOME E/M EST PT SELF-LMTD/MINOR DOM/R-HOME E/M EST PT LW MOD SEVERITY DOM/R-HOME E/M EST PT MOD HI SEVERITY DOM/R-HOME E/M EST PT SIGNIFICANT NEW PROBLEM

Encounter – outpatient - opthamological services CPT Description 92002 OPH MEDICAL XM&EVAL INTRM NEW PT 92004 OPH MEDICAL XM&EVAL COMPRE NEW PT 1+ VST 92012 OPH MEDICAL XM&EVAL INTRM EST PT 92014 OPH MEDICAL XM&EVAL COMPRE EST PT 1+ VST

169

Diabetes: LDL Management & Control (NQF 0064) (Additional Measure MENU)
Description: The percentage of patients 18–75 years of age with diabetes (type 1 or type 2) who had LDL‐C <100mg/dL. Active diagnosis: Diabetes ICD-9 Description 250 Diabetes Mellitus 250.0 Diabetes Mellitus Without Mention Of Complication 250.00 Diabetes Mellitus Without Mention Of Complication, type two or unspecified type, not stated as uncontrolled; Fifth digit 0 is for use with type two patients, even if the patient requires insulin, 250.01 Diabetes Mellitus Without Mention Of Complication, Type one [juvenile type], not stated as uncontrolled, 250.02 Diabetes Mellitus Without Mention Of Complication, Type two or unspecified type, uncontrolled; Fifth digit 2 is for use with type two patients, even if the patient requires insulin 250.03 Diabetes Mellitus Without Mention Of Complication, Type one [juvenile type], uncontrolled 250.10 Diabetes Mellitus With Ketoacidosis, Type Two or unspecified type, Not Stated As Uncontrolled; Fifth digit 0 is for use with type two patients, even if the patient requires insulin 250.11 Diabetes Mellitus With Ketoacidosis, Type One [juvenile type] Not Stated As Uncontrolled 250.12 Diabetes Mellitus With Ketoacidosis, Type Two or unspecified type, Uncontrolled; Fifth digit 2 is for use with type two patients, even if the patient requires insulin 250.13 Diabetes Mellitus With Ketoacidosis, Type One [juvenile type], Uncontrolled 250.20 Diabetes Mellitus With Hyperosmolar Coma, Type Two or unspecified type, Not Stated As Uncontrolled; Fifth digit 0 is for use with type two patients, even if the patient requires insulin 250.21 Diabetes Mellitus With Hyperosmolar Coma, Type One [juvenile type], Not Stated As Uncontrolled 250.22 Diabetes Mellitus With Hyperosmolar Coma, Type Two or unspecified type, Uncontrolled; Fifth digit 2 is for use with type two patients, even if the patient requires insulin 250.23 Diabetes Mellitus With Hyperosmolar Coma, Type One [juvenile type], Uncontrolled 250.30 Diabetes Mellitus With Other Coma, Type Two or unspecified type, Not Stated As Uncontrolled; Fifth digit 0 is for use with type two patients, even if the patient requires insulin 250.31 Diabetes Mellitus With Other Coma, Type One [juvenile], Not Stated As Uncontrolled 250.32 Diabetes Mellitus With Other Coma, Type Two or unspecified type, Uncontrolled; Fifth digit 2 is for use with type two patients, even if the patient requires insulin 250.33 Diabetes Mellitus With Other Coma, Type One [juvenile], Uncontrolled 250.4 Diabetes With Renal Manifestations 170

250.40

250.41 250.42

250.43 250.50

250.51 250.52

250.53 250.60

250.61 250.62

250.63 250.7 250.70

250.71 250.72

250.73 250.8 250.80

Diabetes Mellitus With Renal Manifestations, Type Two or unspecified type, Not Stated As Uncontrolled; Fifth digit 0 is for use with type two patients, even if the patient requires insulin Diabetes Mellitus With Renal Manifestations, Type One [juvenile type], Not Stated As Uncontrolled Diabetes Mellitus With Renal Manifestations, Type Two or unspecified type, Uncontrolled; Fifth digit 2 is for use with type two patients, even if the patient requires insulin Diabetes Mellitus With Renal Manifestations, Type One [juvenile type]. Uncontrolled Diabetes Mellitus With Ophthalmic Manifestations, Type Two or unspecified type, Not Stated As Uncontrolled; Fifth-digit 0 is for use with type two patients, even if the patient requires insulin Diabetes Mellitus With Ophthalmic Manifestations, Type One [juvenile type], Not Stated As Uncontrolled Diabetes Mellitus With Ophthalmic Manifestations, Type Two or unspecified type, Uncontrolled; Fifth-digit 2 is for use with type two patients, even if the patient requires insulin Diabetes Mellitus With Ophthalmic Manifestations, Type One [juvenile type], Uncontrolled Diabetes Mellitus With Neurological Manifestations, Type Two or unspecified type, Not Stated As Uncontrolled; Fifth-digit 0 is for use with type two patients, even if the patient requires insulin Diabetes Mellitus With Neurological Manifestations, Type One [juvenile type] Not Stated As Uncontrolled Diabetes Mellitus With Neurological Manifestations, Type Two or unspecified type, Uncontrolled; Fifth-digit 2 is for use with type two patients, even if the patient requires insulin Diabetes Mellitus With Neurological Manifestations, Type One [juvenile type] Uncontrolled Diabetes With Peripheral Circulatory Disorders Diabetes Mellitus With Peripheral Circulatory Disorders, Type Two or unspecified type, Not Stated As Uncontrolled; Fifth-digit 0 is for use with type two patients, even if the patient requires insulin Diabetes Mellitus With Peripheral Circulatory Disorders, Type One [juvenile type], Not Stated As Uncontrolled Diabetes Mellitus With Peripheral Circulatory Disorders, Type Two or unspecified type, Uncontrolled; Fifth-digit 2 is for use with type two patients, even if the patient requires insulin Diabetes Mellitus With Peripheral Circulatory Disorders, Type One [juvenile type], Uncontrolled Diabetes With Other Specified Manifestations Diabetes Mellitus With Other Specified Manifestations, Type Two or unspecified type, Not Stated As Uncontrolled; Fifth-digit 0 is for use with type two patients, even if the patient requires insulin Diabetes Mellitus With Other Specified Manifestations, Type One [juvenile type], Not Stated As Uncontrolled Diabetes Mellitus With Other Specified Manifestations, Type Two or unspecified type, Uncontrolled; Fifth-digit 2 is for use with type two patients,

250.81 250.82

171

Uncontrolled Polyneuropathy In Diabetes Diabetic Retinopathy Background Diabetic Retinopathy Proliferative Diabetic Retinopathy Nonproliferative diabetic retinopathy NOS Mild nonproliferative diabetic retinopathy Moderate nonproliferative diabetic retinopathy Diabetic macular edema Diabetic Cataract Diabetes Mellitus Complicating Pregnancy.91 250. Antepartum 648. With Delivery 648.2 362.250. Not Stated As Uncontrolled. even if the patient requires insulin Diabetes Mellitus With Unspecified Complication.0 Secondary diabetes mellitus without mention of complication 172 .92 250.04 362. Childbirth. even if the patient requires insulin Diabetes Mellitus With Unspecified Complication. Complicating Pregnancy.01 Active diagnosis of polycystic ovaries ICD-9 Description 256.83 250.0 648.82 Abnormal Glucose Tolerance Of Mother. Childbirth. With Delivery. Or The Puerperium.9 250. Or The Puerperium Diabetes Mellitus Of Mother.4 Polycystic Ovaries Actice Diagnosis of gestational diabetes ICD-9 Description 648. Fifth-digit 0 is for use with type two patients.81 Abnormal Glucose Tolerance Of Mother.05 362.02 362. Not Stated As Uncontrolled Diabetes Mellitus With Unspecified Complication. Uncontrolled. Unspecified As To Episode Of Care Diabetes Mellitus Of Mother.00 648. Postpartum Active Diagnosis of Steroid induced diabetes ICD-9 Description 249 Secondary Diabetes Mellitus 249. Type One [juvenile type].41 648. Childbirth. Type One [juvenile type].0 362.03 362.07 366.80 Abnormal Glucose Tolerance Of Mother. With Delivery 250. Childbirth. Complicating Pregnancy. Type Two or unspecified type.8 Abnormal Glucose Tolerance Of Mother. Type One [juvenile type].84 Abnormal Glucose Tolerance Of Mother. With Mention Of Postpartum Complication 648. Type Two or unspecified type.83 Abnormal Glucose Tolerance Of Mother. Uncontrolled Diabetes With Unspecified Complication Diabetes Mellitus With Unspecified Complication.93 357. Fifth-digit 2 is for use with type two patients. Or The Puerperium 648.90 even if the patient requires insulin Diabetes Mellitus With Other Specified Manifestations. Or The Puerperium.01 362. Complicating Pregnancy. Unspecified As To Episode Of Care 648.

0 Secondary diabetes mellitus without mention of complication. uncontrolled Secondary diabetes mellitus with peripheral circulatory disorders Secondary diabetes mellitus with peripheral circulatory disorders.60 249. uncontrolled Secondary diabetes mellitus without mention of complication Secondary diabetes mellitus with ketoacidosis.4 249.7 249. uncontrolled Secondary diabetes mellitus with ophthalmic manifestations Secondary diabetes mellitus with ophthalmic manifestations.90 249.8 249.5 249.20 249.10 249.50 249. or unspecified Secondary diabetes mellitus with peripheral circulatory disorders.70 249. uncontrolled Secondary diabetes mellitus with other specified manifestations Secondary diabetes mellitus with other specified manifestations.41 249. uncontrolled Secondary diabetes mellitus with renal manifestations Secondary diabetes mellitus with renal manifestations.1 249. uncontrolled Secondary diabetes mellitus with other coma Secondary diabetes mellitus with other coma.51 249. uncontrolled Secondary diabetes mellitus with hyperosmolarity Secondary diabetes mellitus with hyperosmolarity.81 249. not stated as uncontrolled.8 962.61 249.80 249. uncontrolled Other Specified Disorders Of Pancreatic Internal Secretion Poisoning By Adrenal Cortical Steroids 173 .31 249. not stated as uncontrolled or unspecified Secondary diabetes mellitus without mention of complication.11 249.3 249.30 249. not stated as uncontrolled. or unspecified Secondary diabetes mellitus with other coma. or unspecified Secondary diabetes mellitus with ophthalmic manifestations.01 249. not stated as uncontrolled. not stated as uncontrolled.91 251.21 249. not stated as uncontrolled. or unspecified Secondary diabetes mellitus with renal manifestations. or unspecified Secondary diabetes mellitus with hyperosmolarity. not stated as uncontrolled.249. 249. or unspecified Secondary diabetes mellitus with unspecified complication.00 249.9 249. or unspecified Secondary diabetes mellitus with neurological manifestations. uncontrolled Secondary diabetes mellitus with neurological manifestations Secondary diabetes mellitus with neurological manifestations. or unspecified Secondary diabetes mellitus with other specified manifestations. uncontrolled Secondary diabetes mellitus with unspecified complication Secondary diabetes mellitus with unspecified complication.71 249. not stated as uncontrolled.40 249. not stated as uncontrolled. or unspecified Secondary diabetes mellitus with ketoacidosis. not stated as uncontrolled.6.2 249.

Active RxNORM Description Alph-glucosides 199149 Acarbose 50 MG Oral Tablet 199150 Acarbose 100 MG Oral Tablet 200132 Acarbose 25 MG Oral Tablet 205329 miglitol 25 MG Oral Tablet 205330 miglitol 50 MG Oral Tablet 205331 miglitol 100 MG Oral Tablet 401938 Miglustat 100 MG Oral Capsule Amylin analogs 200256 repaglinide 1 MG Oral Tablet 200257 repaglinide 0. Dispensed.6 MG/ML Injectable Solution 861042 2.25 MG/ML Injectable Solution 847910 pioglitazone 15 MG Oral Tablet 847915 60 ACTUAT exenatide 0.005 MG/ACTUAT Prefilled Syringe Antidiabetic Combination 602544 glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet 602549 glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet 602550 glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet 647237 glimepiride 2 MG / pioglitazone 30 MG Oral Tablet 647239 glimepiride 4 MG / pioglitazone 30 MG Oral Tablet 706895 glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet 706896 glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet 861731 Glipizide 2.7 ML pramlintide acetate 1 MG/ML Prefilled Syringe 861044 1.5 MG / Metformin hydrochloride 250 MG Oral Tablet 174 .LDL LOINC 12773-8 13457-7 18261-8 18262-6 2089-1 39469-2 49132-4 55440-2 22748-8 Description Cholesterol in LDL [Un ts/volume] in Serum or Plasma by Electrophoresis Cholesterol in LDL [Mass/volume] in Serum or Plasma by calculation Cholesterol in LDL [Mass/volume] in Serum or Plasma ltracentrifugate Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay Cholesterol in LDL [Mass/volume] in Serum or Plasma Cholesterol in LDL [Moles/volume] in Serum or Plasma by calculation Cholesterol in LDL [Mass/volume] in Serum or Plasma by Electrophoresis Cholesterol.5 ML pramlintide acetate 1 MG/ML Prefilled Syringe 861787 Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet 861790 Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Antidiabetic Agents 744863 exenatide 0.in LDL (real) [Mass/volume] in Serum or Plasma by VAP Cholesterol in LDL [Moles/volume] in Serum or Plasma Medications Ordered.5 MG Oral Tablet 200258 repaglinide 2 MG Oral Tablet 311919 nateglinide 120 MG Oral Tablet 314142 nateglinide 60 MG Oral Tablet 389139 nateglinide 180 MG Oral Tablet 861035 pramlintide acetate 1 MG/ML Injectable Solution 861039 pramlintide acetate 0.

25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.861736 861740 861743 861748 861753 861760 861763 861769 861783 861787 861790 861795 861806 861816 861819 861822 665033 665038 665042 860975 860978 860981 860984 860996 860999 861004 861007 861010 861021 861025 861731 861736 861740 861743 861748 Glipizide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet 175 .5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Biguanides sitagliptin 100 MG Oral Tablet sitagliptin 25 MG Oral Tablet sitagliptin 50 MG Oral Tablet 24 HR Metformin hydrochloride 500 MG Extended Release Tablet Metformin hydrochloride 500 MG Extended Release Tablet 24 HR Metformin hydrochloride 750 MG Extended Release Tablet Metformin hydrochloride 750 MG Extended Release Tablet 24 HR Metformin hydrochloride 1000 MG Extended Release Tablet Metformin hydrochloride 1000 MG Extended Release Tablet Metformin hydrochloride 1000 MG Oral Tablet Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 850 MG Oral Tablet Metformin hydrochloride 625 MG Oral Tablet Metformin hydrochloride 100 MG/ML Oral Solution Glipizide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.

Protamine Zinc. Zinc. Human 75 UNT/ML Injectable Suspension Insulin Lispro 50 UNT/ML / Insulin. Protamine Lispro. Regular. Prompt Zinc. Regular. Beef 100 UNT/ML Injectable Suspension Insulin. Pork 500 UNT/ML Injectable Solution Insulin. Prompt Zinc. Human 100 UNT/ML Injectable Suspension Insulin Lispro 100 UNT/ML Injectable Solution insulin. Beef-Pork 40 UNT/ML Injectable Suspension Insulin. Beef-Pork 100 UNT/ML Injectable Suspension Insulin. protamine zinc. Regular. Zinc. Prompt Zinc. Regular. Pork 40 UNT/ML Injectable Solution Insulin. Human 50 UNT/ML Injectable Suspension Insulin. Regular. Protamine Zinc. beef 100 UNT/ML Injectable Suspension Insulin. Beef-Pork 40 UNT/ML Inhalant Solution Insulin. Pork 100 UNT/ML Injectable Suspension Insulin Lispro 25 UNT/ML / Insulin. Beef 100 UNT/ML Injectable Solution Insulin. Pork 100 UNT/ML Injectable Suspension Insulin. Beef-Pork 40 UNT/ML Injectable Suspension Insulin. Pork 100 UNT/ML Injectable Suspension 205314 237527 242120 242916 242917 259111 260265 283394 311040 311041 311053 311054 311055 311056 311057 311058 311059 311060 311061 314038 317800 176 . Protamine Zinc. Human 100 UNT/ML Injectable Solution Insulin Glargine 100 UNT/ML Injectable Solution Insulin. Regular. Beef-Pork 100 UNT/ML Injectable Solution Insulin.861753 861760 861763 861769 861783 861787 861790 861795 861806 861816 861819 861822 Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Insulin Insulin. Aspart. Protamine Lispro. Prompt Zinc. Pork 100 UNT/ML Injectable Solution Insulin. Beef-Pork 100 UNT/ML Injectable Suspension Insulin.

351297 358349 484322 485210 544614 763002 763007 763013 763014 833159 847191 847207 847211 847230 847239 847252 847259 847263 847416 200256 200257 200258 311919 314142 389139 105374 153842 197306 197307 197495 Insulin. Human 100 UNT/ML Prefilled Syringe 3 ML Insulin. Aspart. Human 50 UNT/ML / Insulin. Aspart Protamine. Human 100 UNT/ML Injectable Solution Insulin. Human 100 UNT/ML Prefilled Syringe 1. rDNA origin 3 MG/ACTUAT Dry Powder Inhaler insulin human. Aspart. Glulisine. Human 30 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 100 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 50 UNT/ML / Insulin. Human 50 UNT/ML Prefilled Syringe 3 ML Insulin Glargine 100 UNT/ML Prefilled Syringe 3 ML insulin detemir 100 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 25 UNT/ML / Insulin. Regular. Human 50 UNT/ML Injectable Suspension 3 ML Insulin. rDNA origin 1 MG/ACTUAT Inhalant Powder insulin human. Glulisine. Pork 70 UNT/ML Injectable Suspension insulin detemir 100 UNT/ML Injectable Solution Insulin. Protamine Lispro. Protamine Lispro. Human 70 UNT/ML / Insulin. Pork 40 UNT/ML Injectable Solution 90 ACTUAT insulin human. rDNA origin 3 MG/ACTUAT Inhalant Powder Insulin.5 ML Insulin Lispro 100 UNT/ML Prefilled Syringe Meglitinides repaglinide 1 MG Oral Tablet repaglinide 0. Human 30 UNT/ML Injectable Suspension Insulin. Human 70 UNT/ML / Insulin. Aspart.5 MG Oral Tablet repaglinide 2 MG Oral Tablet nateglinide 120 MG Oral Tablet nateglinide 60 MG Oral Tablet nateglinide 180 MG Oral Tablet Sulfonylureas gliquidone 30 MG Oral Tablet glimepiride 3 MG Oral Tablet Acetohexamide 250 MG Oral Tablet Acetohexamide 500 MG Oral Tablet Chlorpropamide 100 MG Oral Tablet 177 . Aspart Protamine. Aspart. Aspart Protamine. Zinc. Human 75 UNT/ML Prefilled Syringe 3 ML Insulin. rDNA origin 1 MG/ACTUAT Dry Powder Inhaler 90 ACTUAT insulin human. Pork 30 UNT/ML / NPH Insulin.

5 MG Oral Tablet Glipizide 10 MG Oral Tablet 24 HR Glipizide 2.5 MG Oral Tablet Glyburide 3 MG Oral Tablet Glyburide 5 MG Oral Tablet Glyburide 6 MG Oral Tablet pioglitazone 30 MG Oral Tablet pioglitazone 45 MG Oral Tablet rosiglitazone 2 MG Oral Tablet rosiglitazone 4 MG Oral Tablet rosiglitazone 8 MG Oral Tablet Tolazamide 250 MG Oral Capsule Tolbutamide 250 MG Oral Tablet Glyburide 1.197496 197737 198291 198292 198293 198294 199245 199246 199247 199825 199984 199985 200065 252960 310488 310489 310490 310534 310536 310537 310539 312440 312441 312859 312860 312861 313418 313419 314000 314006 315107 315239 317573 379804 389137 602544 178 Chlorpropamide 250 MG Oral Tablet Glyburide 1.25 MG Oral Tablet Tolazamide 100 MG Oral Tablet Tolazamide 250 MG Oral Tablet Tolazamide 500 MG Oral Tablet Tolbutamide 500 MG Oral Tablet glimepiride 1 MG Oral Tablet glimepiride 2 MG Oral Tablet glimepiride 4 MG Oral Tablet Gliclazide 80 MG Oral Tablet troglitazone 200 MG Oral Tablet troglitazone 400 MG Oral Tablet troglitazone 300 MG Oral Tablet Glyburide 4.5 MG Extended Release Tablet Glipizide 5 MG Oral Tablet Glyburide 2.5 MG Oral Tablet 24 HR Glipizide 5 MG Extended Release Tablet 24 HR Glipizide 10 MG Extended Release Tablet Tolbutamide 50 MG/ML Injectable Solution pioglitazone 15 MG Oral Tablet Glipizide 2.5 MG Oral Tablet Gliclazide 30 MG Extended Release Tablet glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet .

5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Thiazolidinediones pioglitazone 30 MG Oral Tablet pioglitazone 45 MG Oral Tablet rosiglitazone 2 MG Oral Tablet rosiglitazone 4 MG Oral Tablet rosiglitazone 8 MG Oral Tablet pioglitazone 15 MG Oral Tablet Encounter Codes Accepted for appointment outside of Physician using MU: Encount CPT Encounter ED Encounter Encounter CPT CPT CPT er Acute Non-Acute Outpatient Inpatient Inpatient Opthamolog ical services 99221 1ST HOSP CARE PR D 30 MIN 99222 1ST 99281 EMER DEPT SELF LIMITED/MINO R 99304 1ST NF CARE PR D E/M LW SEVERITY 92002 OPH MEDICAL XM&EVAL INTRM NEW PT OPH 99282 EMER DEPT 99305 1ST NF 92004 179 .5 MG Extended Release Tablet Glipizide 5 MG Extended Release Tablet Glipizide 10 MG Extended Release Tablet Glipizide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.602549 602550 647237 647239 706895 706896 757710 757712 844809 844824 844827 861731 861736 861740 861743 861748 861753 861760 861763 861783 861806 861816 861822 312440 312441 312859 312860 312861 317573 glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / pioglitazone 30 MG Oral Tablet glimepiride 4 MG / pioglitazone 30 MG Oral Tablet glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet vildagliptin 100 MG Oral Tablet vildagliptin 50 MG Oral Tablet Glipizide 2.

HOSP CARE PR D 50 MIN LOW TO MODERATE SEVERITY CARE PR D E/M MOD SEVERITY MEDICAL XM&EVAL COMPRE NEW PT 1+ VST 92012 OPH MEDICAL XM&EVAL INTRM EST PT OPH MEDICAL XM&EVAL COMPRE EST PT 1+ VST 99223 1ST HOSP CARE PR D 70 MIN 99231 SBSQ HOSP CARE PR D 15 MIN 99283 EMER DEPT MODERATE SEVERITY 99306 1ST NF CARE PR D E/M HI SEVERITY 99284 EMER DEPT HI SEVERITY&UR GENT EVAL 99307 SBSQ NF CARE PR D E/M STABLE 92014 99232 SBSQ HOSP CARE PR D 25 MIN 99233 SBSQ HOSP CARE PR D 35 MIN 99238 HOSP DSCHRG D MGMT 30 MIN/< 99285 EMER DEPT HIGH SEVERITY&TH REAT FUNCJ 99308 SBSQ NF CARE PR D E/M MINOR COMPLCTJ 99309 SBSQ NF CARE PR D E/M NEW PROBLEM 99310 SBSQ NF CARE PR D E/M UNSTABLE/ NEW PROBLEM NF DSCHRG D MGMT 30 MIN/< 99239 HOSP DSCHRG D MGMT > 30 MIN 99251 1ST 99252 INPT CONSLT J 20 MIN 1ST INPT CONSLT 180 99315 99316 NF DSCHRG D MGMT > 30 MIN .

J 40 MIN 99253 1ST INPT CONSLT J 55 MIN 99254 1ST INPT CONSLT J 80 MIN 99255 1ST INPT CONSLT J 110 MIN 99318 E/M PT INVG ANNUAL NF ASSMT DOM/RHOME LW SEVERITY 99324 99325 DOM/RHOME E/M NEW PT MOD SEVERITY DOM/RHOME E/M NEW PT MOD HI SEVERITY DOM/RHOME E/M NEW PT HI SEVERITY DOM/RHOME E/M NEW PT SIGNIFICAN T NEW PROBLEM DOM/RHOME E/M EST PT SELFLMTD/MINO R DOM/RHOME E/M EST PT LW MOD SEVERITY 99326 99327 99328 99334 99335 181 .

subsequent episode of care 410.51 Acute myocardial infarction.8 Acute myocardial infarction. true posterior wall infarction. of other anterior wall 410. of other specified sites.42 Acute myocardial infarction.81 Acute coronary occlusion without myocardial infarction 411.6 Acute myocardial infarction.91 Acute myocardial infarction.Coronary Artery Disease (CAD): Oral Antiplatelet Therapy Prescribed for Patients with CAD (NQF 0067) (Additional Measure . of other specified sites.62 of care 410. of other inferior wall. initial episode of care Acute myocardial infarction.89 Other acute and subacute forms of ischemic heart disease 412 Old myocardial infarction 182 . of inferolateral wall 410. initial episode of care 410.52 Acute myocardial infarction. subsequent episode of care 410. of anterolateral wall.61 care Acute myocardial infarction.4 Acute myocardial infarction. of inferolateral wall.Enter in SOAP Note or Past Medical History ICD-9 Description 410 Acute myocardial infarction 410. of inferoposterior wall 410. of other inferior wall 410. subendocardial infarction. initial episode of 410.2 Acute myocardial infarction. of inferoposterior wall.5 Acute myocardial infarction.7 Acute myocardial infarction. true posterior wall infarction Acute myocardial infarction. of other anterior wall. subendocardial infarction. of anterolateral wall. of other specified sites 410.02 Acute myocardial infarction. unspecified site. of other lateral wall 410.1 Intermediate coronary syndrome 411. subsequent episode of care 410. initial episode of care 410. subsequent episode of 410. subsequent episode of 410. subsequent episode of care 410.MENU) Description: Percentage of patients aged 18 years and older with a diagnosis of CAD who were prescribed oral antiplatelet therapy. subsequent episode of care 411 Other acute and subacute forms of ischemic heart disease 411. initial episode of care 410.21 Acute myocardial infarction. Active diagnosis of coronary artery disease .31 Acute myocardial infarction.1 Acute myocardial infarction. of other lateral wall. of other inferior wall.22 Acute myocardial infarction. subsequent episode of care 410. subendocardial infarction 410. of inferoposterior wall. initial episode of care 410. initial episode of care Acute myocardial infarction.82 care 410.92 Acute myocardial infarction. of other anterior wall.11 Acute myocardial infarction. unspecified site.32 care 410.01 Acute myocardial infarction.71 Acute myocardial infarction.72 care 410. subsequent episode of 410. initial episode of care Acute myocardial infarction. true posterior wall infarction.9 Acute myocardial infarction. of inferolateral wall.3 Acute myocardial infarction.81 Acute myocardial infarction. subsequent episode 410.12 Acute myocardial infarction.41 Acute myocardial infarction. unspecified site 410. of other lateral wall. initial episode of care 410. initial episode of care 410.

06 414.5 287.81 V45.3 286.413 413.32 287.6 286. unspecified Postsurgical aortocoronary bypass status Percutaneous transluminal coronary angioplasty. unspecified Other specified hemorrhagic conditions Unspecified hemorrhagic conditions Primary hypercoagulable state Secondary hypercoagulable state Heparin-induced thrombocytopenia (HIT) Unspecified diseases of blood and blood-forming organs 183 .82 Angina pectoris Prinzmetal angina Other and unspecified angina pectoris Other forms of chronic ischemic heart disease Coronary atherosclerosis of native coronary artery Coronary atherosclerosis of autologous vein bypass graft Coronary atherosclerosis of nonautologous biological bypass graft Coronary atherosclerosis of artery bypass graft Coronary atherosclerosis of unspecified type of bypass graft Coronary atherosclerosis of native coronary artery of transplanted heart Coronary atherosclerosis of bypass graft (artery) (vein) of transplanted heart Other specified forms of chronic ischemic heart disease Chronic ischemic heart disease.9 V45. postsurgical status Diagnosis of bleeding coagulation disorders ICD-9 Description 286 Coagulation defects 286.9 414 414.8 287.39 287.4 286.33 287.1 287.01 414.02 414.31 287.1 413.07 414.7 286.1 Congenital factor IX disorder 286.4 287.9 Congenital factor XI deficiency Congenital deficiency of other clotting factors von Willebrand's disease Hemorrhagic disorder due to intrinsic circulating anticoagulants Defibrination syndrome Acquired coagulation factor deficiency Other and unspecified coagulation defects Purpura and other hemorrhagic conditions Qualitative platelet defects Primary thrombocytopenia Immune thrombocytopenic purpura Evans' syndrome Congenital and hereditary thrombocytopenic purpura Other primary thrombocytopenia Secondary thrombocytopenia Thrombocytopenia.05 414.8 414.03 414.81 289.2 286.5 286.9 287 287.04 414.3 287.82 289.84 289.9 289.

Procedure performed of cardiac surgery.Enter in past surgical history CPT Description 33140 TRANSMYOCRD LASER REVSC THORCOM SPX 33510 CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT 33511 CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS 33512 CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS 33513 CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS 33514 CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS 33516 CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT 33517 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 1 VEIN 33518 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 2 VEIN 33519 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 3 VEIN 33521 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 4 VEIN 33522 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 5 VEIN 33523 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 6 VEIN 33533 CAB W/ARTL GRF 1 ARTL GRF 33534 CAB W/ARTL GRF 2 C ARTL GRFS 33535 CAB W/ARTL GRF 3 C ARTL GRFS 33536 CAB W/ARTL GRF 4/> C ARTL GRFS 92980 TCAT PLMT AN INTRAC STENT PRQ 1 VSL 92981 TCAT PLMT INTRAC STENT PRQ EA VSL 92982 PRQ TRLUML C BALO ANGIOP 1 VSL 92984 PRQ TRLUML C BALO ANGIOP EA VSL 92995 PRQ TRLUML C ATHRC 1 VSL 92996 PRQ TRLUML C ATHRC EA VSL Antiplatelet therapy medication (ordered or active) RxNORM Description 197374 Aspirin 800 MG Extended Release Tablet 198461 Aspirin 120 MG Rectal Suppository 198462 Aspirin 125 MG Rectal Suppository 198463 Aspirin 200 MG Rectal Suppository 198464 Aspirin 300 MG Rectal Suppository 198466 Aspirin 325 MG Oral Capsule 198467 Aspirin 325 MG Enteric Coated Tablet 198468 Aspirin 325 MG Rectal Suppository 198470 Aspirin 486 MG Oral Tablet 198471 Aspirin 500 MG Oral Tablet 198472 Aspirin 60 MG Rectal Suppository 198473 Aspirin 600 MG Rectal Suppository 198474 Aspirin 650 MG Rectal Suppository 198475 Aspirin 650 MG Oral Tablet 198479 Aspirin 400 MG / Caffeine 32 MG Oral Tablet 199281 Aspirin 300 MG Oral Tablet 204906 Aspirin 1200 MG Rectal Suppository 206789 Aspirin 975 MG Enteric Coated Tablet [Easprin] 206790 Aspirin 975 MG Enteric Coated Tablet [Entaprin] 206974 Aspirin 800 MG Extended Release Tablet [Sloprin] 184 .

Joseph Aspirin] Aspirin 81 MG Enteric Coated Tablet [Ascriptin Enteric] Aspirin 81 MG Enteric Coated Tablet [Ecotrin Low Strength Adult] Aspirin 81 MG Enteric Coated Tablet [Halfprin] Aspirin 325 MG Oral Tablet [Bayer Aspirin] Aspirin 325 MG Oral Tablet [Empirin] Aspirin 325 MG Enteric Coated Tablet [Entercote] Aspirin 325 MG Oral Tablet [Gennin-FC] Aspirin 325 MG Oral Tablet [Genprin] Aspirin 325 MG Oral Tablet [Norwich Aspirin] Aspirin 325 MG Oral Tablet [Ridiprin] Aspirin 325 MG Oral Tablet [Uni-Tren] Aspirin 500 MG Oral Tablet [Bayer Aspirin] Aspirin 500 MG Enteric Coated Tablet [Genacote] Aspirin 500 MG Oral Tablet [Norwich Aspirin] Aspirin 500 MG Oral Tablet [Valomag] Aspirin 81 MG Oral Tablet [Acuprin 81] Aspirin 81 MG Oral Tablet [Halfprin] Aspirin 81 MG Oral Tablet [Minitabs] Aspirin 650 MG Oral Tablet [Bayer Aspirin] Aspirin 325 MG Oral Tablet Aspirin 325 MG Enteric Coated Tablet [Ascriptin Enteric] Aspirin 325 MG Enteric Coated Tablet [Ecotrin] 185 .206975 209468 209470 210864 211292 211295 211297 211310 211311 211312 211313 211314 211332 211333 211334 211335 211337 211338 211339 211822 211830 211832 211833 211834 211835 211874 211877 211878 211879 211880 211881 211882 211884 211887 211890 211891 211892 211893 211898 211900 211902 212033 212085 212086 Aspirin 800 MG Extended Release Tablet [Zorprin] Acetaminophen 250 MG / Aspirin 250 MG / Caffeine 65 MG Oral Tablet [Excedrin] Acetaminophen 250 MG / Aspirin 250 MG / Caffeine 65 MG Oral Tablet [Goody's Cool Orange Extra Strength] Acetaminophen 115 MG / Aspirin 210 MG / Caffeine 16 MG / salicylamide 65 MG Oral Tablet [Saleto] Aspirin 400 MG / Caffeine 32 MG Oral Tablet [Anacin] Aspirin 400 MG / Caffeine 32 MG Oral Tablet [Genasan] Aspirin 400 MG / Caffeine 32 MG Oral Tablet [P-A-C Analgesic] Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Capsule [Fiorinal] Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Capsule [Fiormor] Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Capsule [Fiortal] Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Capsule [Isollyl] Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Capsule [Laniroif] Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Tablet [Butalbital Compound] Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Tablet [Fiorinal] Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Tablet [Fiormor] Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Tablet [Fiortal] Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Tablet [Idenal] Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Tablet [Isollyl] Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Tablet [Laniroif] Aspirin 162 MG Enteric Coated Tablet [Halfprin] Aspirin 81 MG Chewable Tablet [Med Aspirin] Aspirin 81 MG Chewable Tablet [St.

Joseph Aspirin] Aspirin 488 MG Enteric Coated Tablet Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Tablet [Farbital] Aspirin 81 MG / Calcium Carbonate 750 MG Oral Tablet [Bayer Aspirin Plus Calcium] Aspirin 81 MG Chewable Tablet [Bayer Aspirin] Aspirin 81 MG Oral Tablet [Bayer Aspirin] Aspirin 500 MG Oral Tablet [Ascriptin] Aspirin 325 MG Oral Tablet [Ascriptin] Aspirin 325 MG Oral Tablet [Aspidrox] Aspirin 325 MG Oral Tablet [Aspir-Mox] Aspirin 325 MG Oral Tablet [Magnaprin] Acetaminophen 194 MG / Aspirin 227 MG / Caffeine 30 MG Oral Tablet .212476 213169 213290 238134 238135 238144 238145 243670 247138 260847 260848 260849 260851 284282 284463 307677 308278 308281 308297 308363 308409 308411 308412 308413 308416 308417 308418 313807 318272 387090 404658 608696 749795 795728 809445 825178 825180 825181 830525 830530 830533 830538 830541 830545 186 Aspirin 500 MG / Diphenhydramine 25 MG Oral Tablet [Bayer Aspirin PM Extra Strength] clopidogrel 75 MG Oral Tablet [Plavix] Acetaminophen 160 MG / Aspirin 230 MG / Caffeine 33 MG Oral Tablet [Supac] Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Capsule Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Tablet Aspirin 130 MG Rectal Suppository Aspirin 195 MG Rectal Suppository ASA 81 MG Oral Tablet Aspirin 850 MG Oral Powder Aspirin 325 MG Oral Tablet [Bufferin] Aspirin 325 MG Oral Tablet [Buffex] Aspirin 325 MG Oral Tablet [Uni-Buff] Aspirin 325 MG Enteric Coated Tablet [Genacote] Acetaminophen 250 MG / Aspirin 250 MG / Caffeine 65 MG Oral Tablet [Ex-Pain] Aspirin 500 MG Enteric Coated Tablet [Ecotrin Maximum Strength] Acetaminophen 325 MG / Aspirin 325 MG Oral Tablet Acetaminophen 115 MG / Aspirin 210 MG / Caffeine 16 MG / salicylamide 65 MG Oral Tablet Acetaminophen 125 MG / Aspirin 240 MG / Caffeine 32 MG Oral Tablet Acetaminophen 250 MG / Aspirin 250 MG / Caffeine 65 MG Oral Tablet Aspirin 325 MG / Caffeine 16 MG / salicylamide 95 MG Oral Tablet Aspirin 500 MG Enteric Coated Tablet Aspirin 650 MG Enteric Coated Tablet Aspirin 650 MG Extended Release Tablet Aspirin 65 MG Chewable Tablet Aspirin 81 MG Enteric Coated Tablet Aspirin 975 MG Enteric Coated Tablet Aspirin 975 MG Extended Release Tablet Aspirin 65 MG Rectal Suppository Aspirin 81 MG Chewable Tablet Aspirin 325 MG Enteric Coated Tablet [Bayer Aspirin] Aspirin 81 MG Enteric Coated Capsule [YSP Aspirin] Aspirin 500 MG / Caffeine 32 MG Oral Tablet [Anacin] Aspirin 81 MG Enteric Coated Tablet [St.

3 MG / salicylamide 195 MG Oral Powder [BC Powder 650/33.Enter in past medical history CPT Description 99304 1ST NF CARE PR D E/M LW SEVERITY 99305 1ST NF CARE PR D E/M MOD SEVERITY 99306 1ST NF CARE PR D E/M HI SEVERITY 99307 SBSQ NF CARE PR D E/M STABLE 99308 SBSQ NF CARE PR D E/M MINOR COMPLCTJ 99309 SBSQ NF CARE PR D E/M NEW PROBLEM 99310 SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM Encounter (inpatient discharge) – Enter in past medical history CPT Description 99238 HOSP DSCHRG D MGMT 30 MIN/< 99239 HOSP DSCHRG D MGMT > 30 MIN 187 .33 MG/ML / Sodium Bicarbonate 15.42 MG/ML / Citric Acid 8.3/195] Aspirin 742 MG / Caffeine 38 MG / salicylamide 222 MG Oral Powder Aspirin 325 MG / Caffeine 16 MG / salicylamide 95 MG Oral Tablet [BC Headache] Encounter (nursing facility) .[Vanquish] 848166 860161 864026 896876 896884 896893 Aspirin 500 MG Oral Tablet [Bufferin] 12 HR Aspirin 25 MG / Dipyridamole 200 MG Extended Release Capsule [Aggrenox] Aspirin 5.8 MG/ML Oral Solution Aspirin 650 MG / Caffeine 33.

Active Diagnosis of Acute Myocardial Infarction ICD-9Description CM 410.91 Acute myocardial infarction. unspecified site.81 Acute myocardial infarction. of other inferior wall.2 Cardiovascular disease.0 Postmyocardial infarction syndrome 411. true posterior wall infarction. of other specified sites. initial episode of care 410.02 Coronary atherosclerosis of autologous vein bypass graft 414.01 Acute myocardial infarction.Ischemic Vascular Disease (IVD): Use of Aspirin or another Antithrombotic (NQF 0068) (Additional Measure .21 Acute myocardial infarction.00 Coronary atherosclerosis of unspecified type of vessel. initial episode of care 410.06 Coronary atherosclerosis of native coronary artery of transplanted heart 414. initial episode of care 410.1 Intermediate coronary syndrome 411.9 Chronic ischemic heart disease.61 care 410.01 Coronary atherosclerosis of native coronary artery 414. of inferoposterior wall.07 Coronary atherosclerosis of bypass graft (artery) (vein) of transplanted heart 414. of other lateral wall.MENU) Description: This measure facilitates long-term management of IVD through aspirin or another anti-thrombotic to prevent CHD (Real-Time Rule). initial episode of care 410.00 Cerebral thrombosis.89 Other acute and subacute forms of ischemic heart disease 413.41 Acute myocardial infarction.9 Other and unspecified angina pectoris 414.0 Angina decubitus 413. unspecified 188 .04 Coronary atherosclerosis of artery bypass graft 414. subendocardial infarction. initial episode of care 410. without mention of cerebral infarction 411.8 Other specified forms of chronic ischemic heart disease 414. unspecified 429. initial episode of 410. native or graft 414.05 Coronary atherosclerosis of unspecified type of bypass graft 414.31 Acute myocardial infarction. of inferolateral wall.1 Prinzmetal angina 413. of other anterior wall. initial episode of care Acute myocardial infarction. of anterolateral wall.51 Acute myocardial infarction. initial episode of care 410.11 Acute myocardial infarction.03 Coronary atherosclerosis of nonautologous biological bypass graft 414.2 Chronic total occlusion of coronary artery 414.81 Acute coronary occlusion without myocardial infarction 411. initial episode of care 410.71 Acute myocardial infarction. initial episode of care Active Diagnosis of Ischemic Vascular Disease ICD-9Description CM 434.

10 infarction 434.21 claudication 440.22 Arterial embolism and thrombosis of lower extremity 444.02 Atheroembolism. with cerebral infarction Occlusion and stenosis of carotid artery.23 Atherosclerosis of native arteries of the extremities with ulceration 440.4 Chronic total occlusion of artery of the extremities 444.433.10 infarction 433.0 Embolism and thrombosis of abdominal aorta 444. with cerebral infarction 434.01 Occlusion and stenosis of basilar artery. without mention 433. without mention of 433.0 Occlusion and stenosis of basilar artery 433.01 Atheroembolism. upper extremity 445.24 Atherosclerosis of native arteries of the extremities with gangrene 440.31 cerebral infarction Occlusion and stenosis of other specified precerebral artery. with cerebral 433. with 433. unspecified. lower extremity 189 .81 infarction Occlusion and stenosis of unspecified precerebral artery. with cerebral 433.89 Embolism and thrombosis of other artery 444. without mention of cerebral infarction 434.91 Cerebral artery occlusion.20 infarction 433.01 Cerebral thrombosis.11 Cerebral embolism.90 Cerebral artery occlusion. with cerebral infarction Occlusion and stenosis of multiple and bilateral precerebral arteries.91 infarction 434.11 Occlusion and stenosis of carotid artery. with cerebral infarction Occlusion and stenosis of carotid artery.30 mention of cerebral infarction Occlusion and stenosis of multiple and bilateral precerebral arteries. without mention of cerebral 433. with cerebral infarction Occlusion and stenosis of vertebral artery. without mention of cerebral 433.21 Occlusion and stenosis of vertebral artery. with cerebral infarction 440.22 Atherosclerosis of the extremities with rest pain 440.90 cerebral infarction Occlusion and stenosis of unspecified precerebral artery.81 Embolism and thrombosis of iliac artery 444. unspecified.20 Atherosclerosis of native arteries of the extremities. unspecified Atherosclerosis of native arteries of the extremities with intermittent 440.80 of cerebral infarction Occlusion and stenosis of other specified precerebral artery.29 Other atherosclerosis of native arteries of the extremities 440.1 Atherosclerosis of renal artery 440.1 Embolism and thrombosis of thoracic aorta 444.9 Embolism and thrombosis of unspecified artery 445. without 433.21 Arterial embolism and thrombosis of upper extremity 444. without mention of cerebral 434.

or dispensed RXNORM Description 103954 104474 104475 104899 197374 198465 198466 198467 198470 198471 198475 198476 198477 Aspirin 75 MG Enteric Coated Tablet Aspirin 75 MG Oral Tablet Aspirin 75 MG Disintegrating Tablet Aspirin 300 MG Enteric Coated Tablet Aspirin 800 MG Extended Release Tablet Aspirin 324 MG Oral Tablet Aspirin 325 MG Oral Capsule Aspirin 325 MG Enteric Coated Tablet Aspirin 486 MG Oral Tablet Aspirin 500 MG Oral Tablet Aspirin 650 MG Oral Tablet Aspirin 80 MG Chewable Tablet Aspirin 162 MG Enteric Coated Tablet 190 .445. ordered.8 Atheroembolism of other sites Procedure performed of CABG CPT Description 33510 CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT 33511 CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS 33512 CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS 33513 CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS 33514 CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS 33516 CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT 33517 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 1 VEIN 33518 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 2 VEIN 33519 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 3 VEIN 33521 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 4 VEIN 33522 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 5 VEIN 33523 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 6 VEIN 33533 CAB W/ARTL GRF 1 ARTL GRF 33534 CAB W/ARTL GRF 2 C ARTL GRFS 33535 CAB W/ARTL GRF 3 C ARTL GRFS 33536 CAB W/ARTL GRF 4/> C ARTL GRFS 33510 CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT Procedure Performed – PTCA CPT Description 33140 92980 92982 92995 TRANSMYOCRD LASER REVSC THORCOM SPX TCAT PLMT AN INTRAC STENT PRQ 1 VSL PRQ TRLUML C BALO ANGIOP 1 VSL PRQ TRLUML C ATHRC 1 VSL Oral anti-platelet therapy medication active.

5 MG/ML Oral Solution Aspirin 2.199281 212033 243663 243670 246460 247137 247138 252380 259081 308402 308403 308405 308409 308411 308412 308413 308414 308415 308416 308417 308418 309362 313406 318272 349516 359458 391930 392294 403924 432389 435504 435521 646434 685589 688214 747211 749196 795728 853499 855812 855818 191 Aspirin 300 MG Oral Tablet Aspirin 325 MG Oral Tablet Aspirin 65 MG Oral Tablet ASA 81 MG Oral Tablet Aspirin 500 MG Oral Capsule Aspirin 650 MG Oral Powder Aspirin 850 MG Oral Powder Aspirin 80 MG Enteric Coated Tablet Aspirin 25 MG / Dipyridamole 200 MG Oral Capsule Aspirin 165 MG Oral Tablet Aspirin 165 MG Enteric Coated Tablet Aspirin 25 MG / Dipyridamole 200 MG Extended Release Capsule Aspirin 500 MG Enteric Coated Tablet Aspirin 650 MG Enteric Coated Tablet Aspirin 650 MG Extended Release Tablet Aspirin 65 MG Chewable Tablet Aspirin 75 MG Chewable Tablet Aspirin 800 MG Extended Release Capsule Aspirin 81 MG Enteric Coated Tablet Aspirin 975 MG Enteric Coated Tablet Aspirin 975 MG Extended Release Tablet clopidogrel 75 MG Oral Tablet Ticlopidine 250 MG Oral Tablet Aspirin 81 MG Chewable Tablet Aspirin 800 MG Oral Tablet 12 HR Aspirin 25 MG / Dipyridamole 200 MG Extended Release Capsule Aspirin 975 MG Oral Tablet Aspirin 81 MG Extended Release Tablet Aspirin 81 MG Enteric Coated Capsule Aspirin 80 MG Oral Tablet Aspirin 488 MG Oral Tablet Aspirin 500 MG Enteric Coated Capsule Aspirin 325 MG Enteric Coated Capsule Aspirin 1.5 MG/ML Oral Solution Aspirin 81 MG Disintegrating Tablet clopidogrel 300 MG Oral Tablet Aspirin 488 MG Enteric Coated Tablet Aspirin 228 MG Chewing Gum prasugrel 10 MG Oral Tablet prasugrel 5 MG Oral Tablet .

Enter in past medical history Description CPT 99221 99222 99223 99231 99232 99233 99238 99239 99251 99252 99253 99254 99255 99291 1ST HOSP CARE PR D 30 MIN 1ST HOSP CARE PR D 50 MIN 1ST HOSP CARE PR D 70 MIN SBSQ HOSP CARE PR D 15 MIN SBSQ HOSP CARE PR D 25 MIN SBSQ HOSP CARE PR D 35 MIN HOSP DSCHRG D MGMT 30 MIN/< HOSP DSCHRG D MGMT > 30 MIN 1ST INPT CONSLTJ 20 MIN 1ST INPT CONSLTJ 40 MIN 1ST INPT CONSLTJ 55 MIN 1ST INPT CONSLTJ 80 MIN 1ST INPT CONSLTJ 110 MIN CC E/M CRITICALLY ILL/INJURED 1ST 30-74 MIN 192 .891136 Aspirin 31200 MG Oral Tablet 892160 Aspirin 3900 MG Oral Tablet 900470 Aspirin 1 MG/MG Oral Powder Encounter acute inpatient .

subsequent episode of care Acute myocardial infarction. initial episode of care Acute myocardial infarction.Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI) (NQF 0070) (Additional Measure MENU) Description: Percentage of patients aged 18 and older with a diagnosis of CAD and prior MI who were prescribed beta-blocker therapy.21 410. subsequent episode 410.06 Coronary atherosclerosis of native coronary artery of transplanted heart 414.82 Coronary atherosclerosis of bypass graft (artery) (vein) of transplanted heart Other specified forms of chronic ischemic heart disease Chronic ischemic heart disease.9 V45.01 Coronary atherosclerosis of native coronary artery 414.12 410.1 Acute myocardial infarction.81 V45.3 410. Diagnosis of coronary artery disease with no MI ICD-9 Description 411 Other acute and subacute forms of ischemic heart disease 411.07 414.89 Other acute and subacute forms of ischemic heart disease 413 Angina pectoris 413. of other anterior wall.03 Coronary atherosclerosis of nonautologous biological bypass graft 414.8 414.2 410.31 193 Acute myocardial infarction.01 Acute myocardial infarction.02 of care 410.9 Other and unspecified angina pectoris 414 Other forms of chronic ischemic heart disease 414. of inferolateral wall. of anterolateral wall. of other anterior wall. initial episode of care Acute myocardial infarction. unspecified Postsurgical aortocoronary bypass status Percutaneous transluminal coronary angioplasty.1 Prinzmetal angina 413. initial episode of care 410. of inferolateral wall.22 410.04 Coronary atherosclerosis of artery bypass graft 414. of inferoposterior wall Acute myocardial infarction. postsurgical status Resolved diagnosis of myocardial infarction ICD-9 Description 410 Acute myocardial infarction 410.02 Coronary atherosclerosis of autologous vein bypass graft 414. subsequent episode of care Acute myocardial infarction.11 Acute myocardial infarction.81 Acute coronary occlusion without myocardial infarction 411. of anterolateral wall.05 Coronary atherosclerosis of unspecified type of bypass graft 414. of inferoposterior wall. of other anterior wall 410.1 Intermediate coronary syndrome 411. initial episode of . of inferolateral wall Acute myocardial infarction.

unspecified site. unspecified site Acute myocardial infarction.42 410. of other specified sites.8 410. initial episode of care Acute myocardial infarction.91 410.61 410. of other specified sites.92 412 Arrythmia ICD-9 427. of other lateral wall. subendocardial infarction Acute myocardial infarction. subsequent episode of care Acute myocardial infarction. subsequent episode of care Old myocardial infarction Description Sinoatrial node dysfunction Other specified cardiac dysrhythmias Description Hypotension Chronic hypotension Hypotension of hemodialysis 194 .81 410.89 Hypotension ICD-9 458 458.21 care Acute myocardial infarction. subsequent episode of care Acute myocardial infarction.82 410.1 458. of other lateral wall Acute myocardial infarction. of other inferior wall Acute myocardial infarction. of other lateral wall. subsequent episode of care Acute myocardial infarction. of other inferior wall. initial episode of care Acute myocardial infarction.52 410.72 410. true posterior wall infarction Acute myocardial infarction. initial episode of care Acute myocardial infarction.6 410.81 427.5 410.9 410. subendocardial infarction. subsequent episode of care Acute myocardial infarction.4 410. initial episode of care Acute myocardial infarction.41 410.71 410. of other inferior wall. of other specified sites Acute myocardial infarction. true posterior wall infarction.62 410. unspecified site. true posterior wall infarction.51 410. subendocardial infarction. subsequent episode of care Acute myocardial infarction. of inferoposterior wall. initial episode of care Acute myocardial infarction. subsequent episode of care Acute myocardial infarction.7 410.410.32 410. initial episode of care Acute myocardial infarction.

1 493.09 427.22 Congenital atresia and stenosis of aorta Atrioventricular block ICD-9 Description 426 Conduction disorders 426. unspecified type.13 Other second degree atrioventricular block Cardiac pacer nor cardiac pacer in situ ICD-9 Description Cardiac Pacer 14106009 Cardiac pacemaker 360127006 Intravenous cardiac pacemaker system 360128001 Intravenous triggered cardiac pacemaker system 195 .91 493. unspecified with (acute) exacerbation Description Other idiopathic peripheral autonomic neuropathy Sinoatrial node dysfunction Other specified cardiac dysrhythmias Atresia and stenosis of aorta ICD-9 Description 440 Atherosclerosis 747.92 Bradycardia ICD-9 337.8 458.2 493.458.9 Asthma ICD-9 493 493.82 493.21 493.89 Other iatrogenic hypotension Other specified hypotension Hypotension.29 458.9 493. with (acute) exacerbation Intrinsic asthma Intrinsic asthma with status asthmaticus Intrinsic asthma.81 427. with (acute) exacerbation Chronic obstructive asthma Chronic obstructive asthma. unspecified Description Asthma Extrinsic asthma with status asthmaticus Extrinsic asthma. with status asthmaticus Chronic obstructive asthma. unspecified Asthma.81 493.12 Mobitz (type) II atrioventricular block 426. with status asthmaticus Asthma.22 493.02 493. with (acute) exacerbation Exercise induced bronchospasm Cough variant asthma Asthma.12 493.11 493.01 493.

424921004 56961003 V45. device Cardiac transvenous pacemaker Cardiac Pacer in Situ Cardiac pacemaker in situ At least 1 count of physical exam finding of heart rate less than 50 bpm procedure performed of cardiac monitoring 134377004 Atrial fibrillation monitoring 170576007 Cardiac treatment changed 170599006 24 hr blood pressure monitoring 23852006 Cardiac monitoring 268509003 Cardiac disease monitoring 281568006 Fetal heart monitoring 309877008 Intrapartum cardiotochogram monitoring 38001000 Monitoring of pacemaker 395148004 Cardiac event recording 408804006 Continuous fetal heart monitoring during labor 417206009 Cardiovascular disease monitoring 417287002 Cardiovascular disease interim monitoring 417322008 Cardiovascular disease annual review 422952004 Cardiac telemetry 47101004 Cardiotachometry 50072001 Monitoring of pulse 63818009 Cardiotachometer monitoring 85038003 Tracing of carotid pulse with ECG lead 88140007 Cardiac monitor surveillance Procedure performed of cardiac surgery CPT Description 33140 TRANSMYOCRD LASER REVSC THORCOM SPX 33510 CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT 33511 CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS 33512 CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS 33513 CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS 33514 CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS 33516 CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT 33517 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 1 VEIN 33518 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 2 VEIN 33519 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 3 VEIN 33521 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 4 VEIN 33522 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 5 VEIN 33523 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 6 VEIN 33533 CAB W/ARTL GRF 1 ARTL GRF 196 .01 Permanent cardiac pacemaker.

5 MG/ML Injectable Solution [Tenormin] 201337 Nadolol 40 MG Oral Tablet [Corgard] 201338 Nadolol 40 MG Oral Tablet [Corgard] 201340 Timolol 10 MG Oral Tablet [Blocadren] 206961 Nadolol 20 MG Oral Tablet [Corgard] 206964 Nadolol 120 MG Oral Tablet [Corgard] 206968 Nadolol 160 MG Oral Tablet [Corgard] 207367 Penbutolol 20 MG Oral Tablet [Levatol] 197 .33534 33535 33536 92980 92981 92982 92984 92995 92996 CAB W/ARTL GRF 2 C ARTL GRFS CAB W/ARTL GRF 3 C ARTL GRFS CAB W/ARTL GRF 4/> C ARTL GRFS TCAT PLMT AN INTRAC STENT PRQ 1 VSL TCAT PLMT INTRAC STENT PRQ EA VSL PRQ TRLUML C BALO ANGIOP 1 VSL PRQ TRLUML C BALO ANGIOP EA VSL PRQ TRLUML C ATHRC 1 VSL PRQ TRLUML C ATHRC EA VSL Medication (ordered or active) of beta blocker therapy RxNorm Description 104302 Acebutolol 200 MG Oral Capsule [Sectral] 141882 Betaxolol 20 MG Oral Tablet [Kerlone] 150750 Atenolol 25 MG Oral Tablet [Tenormin] 152414 Atenolol 50 MG Oral Tablet [Tenormin] 197296 Acebutolol 200 MG Oral Capsule 197297 Acebutolol 400 MG Oral Capsule 197379 Atenolol 100 MG Oral Tablet 197380 Atenolol 25 MG Oral Tablet 197381 Atenolol 50 MG Oral Tablet 197382 Atenolol 100 MG / Chlorthalidone 25 MG Oral Tablet 197383 Atenolol 50 MG / Chlorthalidone 25 MG Oral Tablet 198004 Nadolol 120 MG Oral Tablet 198005 Nadolol 160 MG Oral Tablet 198006 Nadolol 20 MG Oral Tablet 198007 Nadolol 40 MG Oral Tablet 198008 Nadolol 80 MG Oral Tablet 198104 Pindolol 10 MG Oral Tablet 198105 Pindolol 5 MG Oral Tablet 198284 Timolol 10 MG Oral Tablet 198285 Timolol 20 MG Oral Tablet 198286 Timolol 5 MG Oral Tablet 200857 Pindolol 5 MG Oral Tablet [Visken] 201322 Atenolol 100 MG Oral Tablet [Tenormin] 201327 Atenolol 0.

25 MG Oral Tablet Bisoprolol Fumarate 2.5/6.5 MG / Hydrochlorothiazide 6.5 MG / Hydrochlorothiazide 6.25] Bisoprolol Fumarate 5 MG / Hydrochlorothiazide 6.25 MG Oral Tablet [Ziac 2.25] Hydrochlorothiazide 25 MG / Propranolol Hydrochloride 40 MG Oral Tablet Hydrochlorothiazide 25 MG / Propranolol Hydrochloride 40 MG Oral Tablet [Inderide 40/25] Hydrochlorothiazide 25 MG / Propranolol Hydrochloride 80 MG Oral Tablet Hydrochlorothiazide 25 MG / Propranolol Hydrochloride 80 MG Oral Tablet [Inderide 80/25] Propranolol Hydrochloride 1 MG/ML Injectable Solution Propranolol Hydrochloride 1 MG/ML Injectable Solution [Inderal] Propranolol Hydrochloride 10 MG Oral Tablet Propranolol Hydrochloride 10 MG Oral Tablet [Inderal] Propranolol Hydrochloride 20 MG Oral Tablet 24 HR Propranolol Hydrochloride 120 MG Extended Release Capsule 24 HR Propranolol Hydrochloride 120 MG Extended Release Capsule [Inderal] 198 .13 MG Oral Tablet [Coreg] Bisoprolol Fumarate 10 MG Oral Tablet Atenolol 100 MG / Chlorthalidone 25 MG Oral Tablet [Tenoretic 100] Bisoprolol Fumarate 10 MG Oral Tablet [Zebeta] Bisoprolol Fumarate 5 MG Oral Tablet Bisoprolol Fumarate 5 MG Oral Tablet [Zebeta] Bisoprolol Fumarate 10 MG / Hydrochlorothiazide 6.208003 208029 208140 208375 208575 208576 211773 212388 212389 212390 213731 260346 260348 261397 261398 686926 854901 746023 854903 854905 854907 854908 854910 854916 854918 854919 854921 856422 856426 856429 856433 856443 856445 856448 856450 856457 856460 856462 Bendroflumethiazide 5 MG / Nadolol 40 MG Oral Tablet [Corzide 40/5] Bendroflumethiazide 5 MG / Nadolol 80 MG Oral Tablet [Corzide 80/5] Pindolol 10 MG Oral Tablet [Visken] Acebutolol 400 MG Oral Capsule [Sectral] Timolol 5 MG Oral Tablet [Blocadren] Timolol 20 MG Oral Tablet [Blocadren] Atenolol 50 MG Oral Tablet [Senormin] carvedilol 6.5 MG Oral Tablet [Coreg] carvedilol 25 MG Oral Tablet [Coreg] Betaxolol 10 MG Oral Tablet [Kerlone] Sotalol 80 MG Oral Tablet Sotalol 160 MG Oral Tablet Betaxolol 10 MG Oral Tablet Betaxolol 20 MG Oral Tablet carvedilol 3.25 MG Oral Tablet [Coreg] carvedilol 12.25 MG Oral Tablet [Ziac 5/6.25 MG Oral Tablet [Ziac 10/6.25 MG Oral Tablet Bisoprolol Fumarate 10 MG / Hydrochlorothiazide 6.25 MG Oral Tablet Bisoprolol Fumarate 5 MG / Hydrochlorothiazide 6.25] Bisoprolol Fumarate 2.

856471 856481 856483 856508 856519 856521 856535 856537 856556 856557 856569 856571 856576 856578 856579 856586 856591 856596 856724 856733 856737 856739 866414 866421 866429 866438 866479 866482 866491 866498 866502 866506 866508 866510 866511 866513 24 HR Propranolol Hydrochloride 120 MG Extended Release Capsule [InnoPran] 24 HR Propranolol Hydrochloride 160 MG Extended Release Capsule 24 HR Propranolol Hydrochloride 160 MG Extended Release Capsule [Inderal] Propranolol Hydrochloride 20 MG Oral Tablet [Inderal] Propranolol Hydrochloride 40 MG Oral Tablet Propranolol Hydrochloride 40 MG Oral Tablet [Inderal] 24 HR Propranolol Hydrochloride 60 MG Extended Release Capsule 24 HR Propranolol Hydrochloride 60 MG Extended Release Capsule [Inderal] Propranolol Hydrochloride 60 MG Oral Tablet Propranolol Hydrochloride 60 MG Oral Tablet [Inderal] 24 HR Propranolol Hydrochloride 80 MG Extended Release Capsule 24 HR Propranolol Hydrochloride 80 MG Extended Release Capsule [Inderal] 24 HR Propranolol Hydrochloride 80 MG Extended Release Capsule [InnoPran] Propranolol Hydrochloride 80 MG Oral Tablet Propranolol Hydrochloride 80 MG Oral Tablet [Inderal] 24 HR Hydrochlorothiazide 50 MG / Propranolol Hydrochloride 120 MG Extended Release Capsule [Inderide 120/50] 24 HR Hydrochlorothiazide 50 MG / Propranolol Hydrochloride 160 MG Extended Release Capsule [Inderide 160/50] 24 HR Hydrochlorothiazide 50 MG / Propranolol Hydrochloride 80 MG Extended Release Capsule [Inderide 80/50] Propranolol Hydrochloride 4 MG/ML Oral Solution Propranolol Hydrochloride 8 MG/ML Oral Solution Propranolol Hydrochloride 80 MG/ML Oral Solution Propranolol Hydrochloride 90 MG Oral Tablet 24 HR Toprol XL 100 MG Extended Release Tablet 24 HR Metoprolol Tartrate 200 MG Extended Release Tablet [Toprol] 24 HR Metoprolol Tartrate 25 MG Extended Release Tablet [Toprol] 24 HR Metoprolol Tartrate 50 MG Extended Release Tablet [Toprol] Hydrochlorothiazide 25 MG / Metoprolol Tartrate 100 MG Oral Tablet Hydrochlorothiazide 25 MG / Metoprolol Tartrate 50 MG Oral Tablet Hydrochlorothiazide 50 MG / Metoprolol Tartrate 100 MG Oral Tablet Hydrochlorothiazide 25 MG / Metoprolol Tartrate 100 MG Oral Tablet [Lopressor HCT 100/25] Hydrochlorothiazide 25 MG / Metoprolol Tartrate 50 MG Oral Tablet [Lopressor HCT 50/25] Hydrochlorothiazide 50 MG / Metoprolol Tartrate 100 MG Oral Tablet [Lopressor HCT 100/50] Metoprolol Tartrate 1 MG/ML Injectable Solution Metoprolol Tartrate 1 MG/ML Injectable Solution [Lopressor] Metoprolol Tartrate 100 MG Oral Tablet Lopressor 100 MG Oral Tablet 199 .

Enter in past medical history CPT Description 99238 99239 HOSP DSCHRG D MGMT 30 MIN/< HOSP DSCHRG D MGMT > 30 MIN Encounter nursing facility CPT Description 99304 1ST NF CARE PR D E/M LW SEVERITY 99305 1ST NF CARE PR D E/M MOD SEVERITY 99306 1ST NF CARE PR D E/M HI SEVERITY 99307 SBSQ NF CARE PR D E/M STABLE 99308 SBSQ NF CARE PR D E/M MINOR COMPLCTJ 99309 SBSQ NF CARE PR D E/M NEW PROBLEM 99310 SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM 200 .866514 866516 866924 896758 896760 896762 896764 896766 896768 896771 896773 896775 896777 896781 896783 Metoprolol Tartrate 50 MG Oral Tablet Metoprolol Tartrate 50 MG Oral Tablet [Lopressor] Metoprolol Tartrate 25 MG Oral Tablet Labetalol hydrochloride 100 MG Oral Tablet Labetalol hydrochloride 100 MG Oral Tablet [Normodyne] Labetalol hydrochloride 200 MG Oral Tablet Labetalol hydrochloride 200 MG Oral Tablet [Normodyne] Labetalol hydrochloride 300 MG Oral Tablet Labetalol hydrochloride 300 MG Oral Tablet [Normodyne] Labetalol hydrochloride 5 MG/ML Injectable Solution Labetalol hydrochloride 5 MG/ML Injectable Solution [Normodyne] Labetalol hydrochloride 5 MG/ML Injectable Solution [Trandate] Labetalol hydrochloride 100 MG Oral Tablet [Trandate] Labetalol hydrochloride 200 MG Oral Tablet [Trandate] Labetalol hydrochloride 300 MG Oral Tablet [Trandate] Encounter inpatient .

with cerebral 433.1 Prinzmetal angina 413.2 Chronic total occlusion of coronary artery 414.31 cerebral infarction Occlusion and stenosis of other specified precerebral artery. without mention of 433. with 433. without mention 433. with cerebral infarction Occlusion and stenosis of multiple and bilateral precerebral arteries.0 Occlusion and stenosis of basilar artery 433. without mention of cerebral 433.30 mention of cerebral infarction Occlusion and stenosis of multiple and bilateral precerebral arteries. native or graft 414.81 Acute coronary occlusion without myocardial infarction 411.07 Coronary atherosclerosis of bypass graft (artery) (vein) of transplanted heart 414.01 Coronary atherosclerosis of native coronary artery 414.03 Coronary atherosclerosis of nonautologous biological bypass graft 414.1 Intermediate coronary syndrome 411.MENU) Description: In the absence of contraindication.8 Other specified forms of chronic ischemic heart disease 414.00 Cerebral thrombosis. unspecified 429.91 infarction 201 .10 Occlusion and stenosis of carotid artery.04 Coronary atherosclerosis of artery bypass graft 414. without mention of cerebral infarction 411. with cerebral 433.2 Cardiovascular disease. unspecified 433. with cerebral infarction 433.0 Postmyocardial infarction syndrome 411. beta-blocker therapy has been shown to reduce the risk of a recurrent MI and decrease mortality for those patients with a prior MII (Real-Time Rule). Active Diagnosis – ischemic vascular disease ICD-9CM Description 434.0 Angina decubitus 413.89 Other acute and subacute forms of ischemic heart disease 413.80 of cerebral infarction Occlusion and stenosis of other specified precerebral artery. with cerebral infarction Occlusion and stenosis of vertebral artery.02 Coronary atherosclerosis of autologous vein bypass graft 414.21 Occlusion and stenosis of vertebral artery.06 Coronary atherosclerosis of native coronary artery of transplanted heart 414.11 Occlusion and stenosis of carotid artery.20 infarction 433. without 433. without mention of cerebral infarction 433.01 Occlusion and stenosis of basilar artery.Ischemic Vascular Disease (IVD): Blood Pressure Management (NQF 0073) (Additional Measure .00 Coronary atherosclerosis of unspecified type of vessel.81 infarction Occlusion and stenosis of unspecified precerebral artery.05 Coronary atherosclerosis of unspecified type of bypass graft 414.90 cerebral infarction Occlusion and stenosis of unspecified precerebral artery.9 Chronic ischemic heart disease.9 Other and unspecified angina pectoris 414.

41 Acute myocardial infarction.434.24 440. of other inferior wall.CABG CPT Description 33510 CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT 33511 CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS 33512 CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS 33513 CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS 33514 CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS 202 . of other specified sites.4 444. initial episode of care 410. initial episode of care 410.01 445. initial episode of care Acute myocardial infarction. with cerebral infarction Cerebral embolism. of other lateral wall. of inferoposterior wall.02 445. unspecified Atherosclerosis of native arteries of the extremities with intermittent claudication Atherosclerosis of the extremities with rest pain Atherosclerosis of native arteries of the extremities with ulceration Atherosclerosis of native arteries of the extremities with gangrene Other atherosclerosis of native arteries of the extremities Chronic total occlusion of artery of the extremities Embolism and thrombosis of abdominal aorta Embolism and thrombosis of thoracic aorta Arterial embolism and thrombosis of upper extremity Arterial embolism and thrombosis of lower extremity Embolism and thrombosis of iliac artery Embolism and thrombosis of other artery Embolism and thrombosis of unspecified artery Atheroembolism.1 444.29 440.91 440. unspecified. unspecified. initial episode of 410.22 444. kidney Active Diagnosis – acute myocardial infarction ICD-9CM Description 410.11 Acute myocardial infarction.8 445.10 434. initial episode of care 410.1 440. initial episode of care 410.21 440.22 440. of anterolateral wall. lower extremity Atheroembolism of other sites Atheroembolism.11 434. initial episode of care 410.21 Acute myocardial infarction. initial episode of care Procedure Performed .51 Acute myocardial infarction.90 434.20 440. of inferolateral wall.61 care 410.81 Acute myocardial infarction. initial episode of care 410. unspecified site. of other anterior wall. true posterior wall infarction. without mention of cerebral infarction Cerebral artery occlusion.81 444. with cerebral infarction Cerebral artery occlusion.9 445. subendocardial infarction.23 440.01 Acute myocardial infarction. without mention of cerebral infarction Cerebral embolism. initial episode of care 410.91 Acute myocardial infarction.89 444.81 Cerebral thrombosis.31 Acute myocardial infarction.21 444.0 444. with cerebral infarction Atherosclerosis of renal artery Atherosclerosis of native arteries of the extremities. upper extremity Atheroembolism.71 Acute myocardial infarction.01 434.

33516 33517 33518 33519 33521 33522 33523 33533 33534 33535 33536 CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 1 VEIN CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 2 VEIN CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 3 VEIN CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 4 VEIN CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 5 VEIN CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 6 VEIN CAB W/ARTL GRF 1 ARTL GRF CAB W/ARTL GRF 2 C ARTL GRFS CAB W/ARTL GRF 3 C ARTL GRFS CAB W/ARTL GRF 4/> C ARTL GRFS Procedure Performed .PTCA CPT Description 33140 TRANSMYOCRD LASER REVSC THORCOM SPX 92980 TCAT PLMT AN INTRAC STENT PRQ 1 VSL 92982 PRQ TRLUML C BALO ANGIOP 1 VSL 92995 PRQ TRLUML C ATHRC 1 VSL Encounter – acute inpatient CPT Description 99221 1ST HOSP CARE PR D 30 MIN 99222 1ST HOSP CARE PR D 50 MIN 99223 1ST HOSP CARE PR D 70 MIN 99231 SBSQ HOSP CARE PR D 15 MIN 99232 SBSQ HOSP CARE PR D 25 MIN 99233 SBSQ HOSP CARE PR D 35 MIN 99238 HOSP DSCHRG D MGMT 30 MIN/< 99239 HOSP DSCHRG D MGMT > 30 MIN 99251 1ST INPT CONSLTJ 20 MIN 99252 1ST INPT CONSLTJ 40 MIN 99253 1ST INPT CONSLTJ 55 MIN 99254 1ST INPT CONSLTJ 80 MIN 99255 1ST INPT CONSLTJ 110 MIN 99291 CC E/M CRITICALLY ILL/INJURED 1ST 30-74 MIN 203 .

8 Acute myocardial infarction. of other anterior wall. of other specified sites 410. subsequent episode of care 410. of other inferior wall. of other anterior wall. Diagnosis of coronary artery disease including MI ICD-9 Description 410 Acute myocardial infarction 410.71 Acute myocardial infarction. unspecified site 410. of inferolateral wall 410.32 care 410.51 Acute myocardial infarction. true posterior wall infarction. initial episode of care Acute myocardial infarction.81 Acute myocardial infarction. of other lateral wall. subsequent episode of 410.82 care 410. of inferoposterior wall 410. initial episode of care Acute myocardial infarction.89 Other acute and subacute forms of ischemic heart disease 412 Old myocardial infarction 413 Angina pectoris 413.MENU) Description: Percentage of patients aged 18 years and older with a diagnosis of CAD who were prescribed a lipid-lowering therapy (based on current ACC/AHA guidelines).Coronary Artery Disease (CAD): Drug Therapy for Lowering LDL Cholesterol (NQF 0074) (Additional Measure . subsequent episode of care 410. subendocardial infarction.61 Acute myocardial infarction.3 Acute myocardial infarction. true posterior wall infarction. true posterior wall infarction 410.1 Acute myocardial infarction. of inferolateral wall.92 Acute myocardial infarction. of other anterior wall 410.11 Acute myocardial infarction. unspecified site. subsequent episode of care 410. subsequent episode of care 410. initial episode of care 410.41 Acute myocardial infarction.2 Acute myocardial infarction. of inferoposterior wall.7 Acute myocardial infarction.91 Acute myocardial infarction. unspecified site. subendocardial infarction. initial episode of care 410. subsequent episode of 410. of other specified sites. subendocardial infarction 410.12 Acute myocardial infarction.62 of care 410. initial episode of care Acute myocardial infarction. of anterolateral wall.42 Acute myocardial infarction. of other inferior wall.22 Acute myocardial infarction. initial episode of care 410. of other lateral wall.31 Acute myocardial infarction.1 Prinzmetal angina 204 . subsequent episode 410.1 Intermediate coronary syndrome 411. subsequent episode of care 410.6 Acute myocardial infarction.9 Acute myocardial infarction. initial episode of care Acute myocardial infarction. of inferoposterior wall.52 Acute myocardial infarction.02 Acute myocardial infarction. of inferolateral wall.21 Acute myocardial infarction.01 Acute myocardial infarction. subsequent episode of care 411 Other acute and subacute forms of ischemic heart disease 411. subsequent episode of 410.4 Acute myocardial infarction. initial episode of care 410. initial episode of care 410. of other lateral wall 410.5 Acute myocardial infarction. of anterolateral wall.81 Acute coronary occlusion without myocardial infarction 411. of other specified sites. of other inferior wall 410. initial episode of care 410.72 care 410.

413.total/Cholesterol in LDL [Mass ratio] in Serum or Plasma 16616-5 Cholesterol in HDL/Cholesterol in LDL [Mass ratio] in Serum or Plasma 18261-8 Cholesterol in LDL [Mass/volume] in Serum or Plasma ultracentrifugate 205 .8 414.03 414.01 414.06 414.9 V45. unspecified Postsurgical aortocoronary bypass status Percutaneous transluminal coronary angioplasty.Enter in past surgical history CPT Description 33140 TRANSMYOCRD LASER REVSC THORCOM SPX 33510 CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT 33511 CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS 33512 CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS 33513 CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS 33514 CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS 33516 CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT 33517 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 1 VEIN 33518 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 2 VEIN 33519 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 3 VEIN 33521 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 4 VEIN 33522 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 5 VEIN 33523 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 6 VEIN 33533 CAB W/ARTL GRF 1 ARTL GRF 33534 CAB W/ARTL GRF 2 C ARTL GRFS 33535 CAB W/ARTL GRF 3 C ARTL GRFS 33536 CAB W/ARTL GRF 4/> C ARTL GRFS 92980 TCAT PLMT AN INTRAC STENT PRQ 1 VSL 92981 TCAT PLMT INTRAC STENT PRQ EA VSL 92982 PRQ TRLUML C BALO ANGIOP 1 VSL 92984 PRQ TRLUML C BALO ANGIOP EA VSL 92995 PRQ TRLUML C ATHRC 1 VSL 92996 PRQ TRLUML C ATHRC EA VSL Last LDL lab test had a value of <130 mg/dL LOINC Description 12773-8 Cholesterol in LDL [Units/volume] in Serum or Plasma by Electrophoresis 13457-7 Cholesterol in LDL [Mass/volume] in Serum or Plasma by calculation 13458-5 Cholesterol in VLDL [Mass/volume] in Serum or Plasma by calculation 14155-6 Cholesterol in LDL [Percentile] 16615-7 Cholesterol. postsurgical status Procedure of cardiac surgery .04 414.07 414.9 414 414.02 414.05 414.82 Other and unspecified angina pectoris Other forms of chronic ischemic heart disease Coronary atherosclerosis of native coronary artery Coronary atherosclerosis of autologous vein bypass graft Coronary atherosclerosis of nonautologous biological bypass graft Coronary atherosclerosis of artery bypass graft Coronary atherosclerosis of unspecified type of bypass graft Coronary atherosclerosis of native coronary artery of transplanted heart Coronary atherosclerosis of bypass graft (artery) (vein) of transplanted heart Other specified forms of chronic ischemic heart disease Chronic ischemic heart disease.81 V45.

18262-6 2089-1 2090-9 2091-7 2092-5 22748-8 24331-1 25371-6.IN LDL:MCNC:PT:SER/PLAS:QN: Cholesterol in VLDL [Mass/volume] in Serum or Plasma CHOLESTEROL.IN VLDL:MCNC:PT:SER/PLAS:QN: Cholesterol in LDL [Moles/volume] in Serum or Plasma Lipid 1996 panel in Serum or Plasma Cholesterol in VLDL [Moles/volume] in Serum or Plasma Lipids [Mass/volume] in Serum TRIGLYCERIDE+ESTER. 2569-2 3046-0 3047-8 35198-1 35199-9 39229-0 39469-2 Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay Cholesterol in LDL [Mass/volume] in Serum or Plasma CHOLESTEROL.IN LDL:MCNC:PT:SER/PLAS:QN: Triglyceride+ester in VLDL [Mass/volume] in Serum or Plasma Cholesterol in LDL [Mass or Moles/volume] in Serum or Plasma Cholesterol in VLDL [Mass or Moles/volume] in Serum or Plasma Lipid screen test status CPHS Cholesterol in LDL [Moles/volume] in Serum or Plasma by calculation Active medication of lipid lowering therapy RxNorm Description 103918 fluvastatin 20 MG Oral Capsule [Lescol] 103919 fluvastatin 40 MG Oral Capsule [Lescol] 104490 Simvastatin 10 MG Oral Tablet [Zocor] 104491 Simvastatin 20 MG Oral Tablet [Zocor] 152923 Niacin 250 MG Oral Tablet 197522 Clofibrate 500 MG Oral Capsule 197903 Lovastatin 10 MG Oral Tablet 197904 Lovastatin 20 MG Oral Tablet 197905 Lovastatin 40 MG Oral Tablet 198024 Niacin 500 MG Oral Tablet 198759 Niacin 100 MG Oral Tablet 198760 Niacin 50 MG Oral Tablet 199143 Niacin 250 MG Oral Tablet 200311 Fenofibrate 67 MG Oral Capsule 200902 Dextrothyroxine 2 MG Oral Tablet [Choloxin] 201517 Clofibrate 500 MG Oral Capsule [Atromid] 205751 Gemfibrozil 600 MG Oral Tablet [Lopid] 206257 Lovastatin 20 MG Oral Tablet [Mevacor] 206258 Lovastatin 40 MG Oral Tablet [Mevacor] 207663 Niacin 500 MG Oral Tablet [Niacor B3] 207664 Niacin 500 MG Oral Tablet [Nicolar] 207754 Colestid 1000 MG Oral Tablet 208220 Simvastatin 5 MG Oral Tablet [Zocor] 209013 Lovastatin 10 MG Oral Tablet [Mevacor] 211682 Niacin 125 MG Extended Release Capsule [Nicobid Tempules] 211683 Niacin 500 MG Extended Release Capsule [Nicobid Tempules] 212576 Niacin 400 MG Extended Release Capsule [Nico-400] 212577 Niacin 250 MG Extended Release Capsule [Nicobid Tempules] 213276 Fenofibrate 67 MG Oral Capsule [Tricor] 213319 Simvastatin 80 MG Oral Tablet [Zocor] 206 .

247747 260852 261295 261357 262095 310288 310289 310459 311945 311946 311949 311951 311958 311959 311960 311963 314131 317015 351842 351898 351909 352030 352031 352231 352232 352304 404403 540281 541844 541846 542191 543350 543352 543354 543374 544518 544543 578797 578799 583096 583122 603834 603836 617314 617318 617320 687048 750199 Niacin 500 MG Oral Capsule Niacin 500 MG Extended Release Tablet [Slo-Niacin] Fenofibrate 200 MG Oral Capsule [Tricor] Fenofibrate 134 MG Oral Capsule [Tricor] atorvastatin 80 MG Oral Tablet [Lipitor] Fenofibrate 134 MG Oral Capsule Fenofibrate 200 MG Oral Capsule Gemfibrozil 600 MG Oral Tablet Niacin 1000 MG Extended Release Tablet [Niaspan] Niacin 500 MG Extended Release Tablet [Niaspan] Niacin 1000 MG Extended Release Tablet Niacin 125 MG Extended Release Capsule Niacin 400 MG Extended Release Capsule Niacin 500 MG Extended Release Capsule Niacin 500 MG Extended Release Tablet Niacin 750 MG Extended Release Tablet Niacin 250 MG Extended Release Capsule Niacin 750 MG Extended Release Tablet [Niaspan] Fenofibrate 67 MG Oral Capsule [Lofibra] Fenofibrate 200 MG Oral Capsule [Lofibra] Fenofibrate 134 MG Oral Capsule [Lofibra] Fenofibrate 160 MG Oral Tablet [Tricor] Fenofibrate 54 MG Oral Tablet [Tricor] Lovastatin 40 MG Extended Release Tablet [Altocor] Lovastatin 60 MG Extended Release Tablet [Altocor] ezetimibe 10 MG Oral Tablet [Zetia] Lovastatin 20 MG Extended Release Tablet [Altocor] Fenofibrate 145 MG Oral Tablet [Tricor] Lovastatin 10 MG Extended Release Tablet [Altoprev] Lovastatin 20 MG Extended Release Tablet [Altoprev] Lovastatin 40 MG Extended Release Tablet [Altoprev] ezetimibe 10 MG / Simvastatin 10 MG Oral Tablet [Vytorin] ezetimibe 10 MG / Simvastatin 20 MG Oral Tablet [Vytorin] ezetimibe 10 MG / Simvastatin 40 MG Oral Tablet [Vytorin] ezetimibe 10 MG / Simvastatin 80 MG Oral Tablet [Vytorin] Fenofibrate 48 MG Oral Tablet [Tricor] Colestipol 5000 MG Granules [Colestid] Fenofibrate 130 MG Oral Capsule [Antara] Fenofibrate 43 MG Oral Capsule [Antara] Fenofibrate 160 MG Oral Tablet [Triglide] Fenofibrate 50 MG Oral Tablet [Triglide] Fenofibrate 160 MG Oral Tablet [Lofibra] Fenofibrate 54 MG Oral Tablet [Lofibra] atorvastatin 10 MG Oral Tablet [Lipitor] atorvastatin 20 MG Oral Tablet [Lipitor] atorvastatin 40 MG Oral Tablet [Lipitor] 24 HR Lescol XL 80 MG Extended Release Tablet Amlodipine 10 MG / atorvastatin 10 MG Oral Tablet [Caduet 10/10] 207 .

750203 750207 750211 750215 750219 750223 750227 750231 750235 750239

763171 791834 791838 791842 848943 848946 848949 848951 859421 859426 859749 859753 866912 884383

Amlodipine 10 MG / atorvastatin 20 MG Oral Tablet [Caduet 10/20] Amlodipine 10 MG / atorvastatin 40 MG Oral Tablet [Caduet 10/40] Amlodipine 10 MG / atorvastatin 80 MG Oral Tablet [Caduet 10/80] Amlodipine 2.5 MG / atorvastatin 40 MG Oral Tablet [Caduet 2.5/40] Amlodipine 2.5 MG / atorvastatin 20 MG Oral Tablet [Caduet 2.5/20] Amlodipine 2.5 MG / atorvastatin 10 MG Oral Tablet [Caduet 2.5/10] Amlodipine 5 MG / atorvastatin 10 MG Oral Tablet [Caduet 5/10] Amlodipine 5 MG / atorvastatin 20 MG Oral Tablet [Caduet 5/20] Amlodipine 5 MG / atorvastatin 40 MG Oral Tablet [Caduet 5/40] Amlodipine 5 MG / atorvastatin 80 MG Oral Tablet [Caduet 5/80] {7 (Niacin 375 MG Extended Release Tablet [Niaspan]) / 7 (Niacin 500 MG Extended Release Tablet [Niaspan]) / 7 (Niacin 750 MG Extended Release Tablet [Niaspan]) } Pack [Niaspan Starter Pack] 24 HR Lovastatin 20 MG / Niacin 1000 MG Extended Release Tablet [Advicor 1000/20] 24 HR Lovastatin 20 MG / Niacin 500 MG Extended Release Tablet [Advicor 500/20] 24 HR Lovastatin 20 MG / Niacin 750 MG Extended Release Tablet [Advicor 750/20] Cholestyramine Resin 66.7 MG/ML Oral Suspension Cholestyramine Resin 66.7 MG/ML Oral Suspension [Locholest] Questran 66.7 MG/ML Oral Suspension Cholestyramine Resin 66.7 MG/ML Oral Suspension [Prevalite] Rosuvastatin calcium 40 MG Oral Tablet [Crestor] Rosuvastatin calcium 5 MG Oral Tablet [Crestor] Rosuvastatin calcium 10 MG Oral Tablet [Crestor] Rosuvastatin calcium 20 MG Oral Tablet [Crestor] Colesevelam hydrochloride 625 MG Oral Tablet [Welchol] 24 HR Lovastatin 60 MG Extended Release Tablet [Altoprev]

Encounters (Nursing Facility) - Enter in past Medical History CPT Description 99304 1ST NF CARE PR D E/M LW SEVERITY 99305 1ST NF CARE PR D E/M MOD SEVERITY 99306 1ST NF CARE PR D E/M HI SEVERITY 99307 SBSQ NF CARE PR D E/M STABLE 99308 SBSQ NF CARE PR D E/M MINOR COMPLCTJ 99309 SBSQ NF CARE PR D E/M NEW PROBLEM 99310 SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM

208

Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control (NQF 0075) (Additional Measure - MENU)
Description: Individuals with Coronary Artery Disease can reduce their risk of subsequent morbidity and premature morbidity by managing their cholesterol levels. This measure facilitates the management of LDL cholesterol levels of patients with IVD, which can result in a 30% reduction in the incidence of CHD (Real-Time Rule). Active diagnosis - acute myocardial infarction ICD-9CM Description 410.01 Acute myocardial infarction, of anterolateral wall, initial episode of care 410.11 Acute myocardial infarction, of other anterior wall, initial episode of care 410.21 Acute myocardial infarction, of inferolateral wall, initial episode of care 410.31 Acute myocardial infarction, of inferoposterior wall, initial episode of care 410.41 Acute myocardial infarction, of other inferior wall, initial episode of care 410.51 Acute myocardial infarction, of other lateral wall, initial episode of care Acute myocardial infarction, true posterior wall infarction, initial episode of 410.61 care 410.71 Acute myocardial infarction, subendocardial infarction, initial episode of care 410.81 Acute myocardial infarction, of other specified sites, initial episode of care 410.91 Acute myocardial infarction, unspecified site, initial episode of care Active diagnosis – ischemic vascular disease ICD-9CM Description 434.00 Cerebral thrombosis, without mention of cerebral infarction 411.0 Postmyocardial infarction syndrome 411.1 Intermediate coronary syndrome 411.81 Acute coronary occlusion without myocardial infarction 411.89 Other acute and subacute forms of ischemic heart disease 413.0 Angina decubitus 413.1 Prinzmetal angina 413.9 Other and unspecified angina pectoris 414.00 Coronary atherosclerosis of unspecified type of vessel, native or graft 414.01 Coronary atherosclerosis of native coronary artery 414.02 Coronary atherosclerosis of autologous vein bypass graft 414.03 Coronary atherosclerosis of nonautologous biological bypass graft 414.04 Coronary atherosclerosis of artery bypass graft 414.05 Coronary atherosclerosis of unspecified type of bypass graft 414.06 Coronary atherosclerosis of native coronary artery of transplanted heart 414.07 Coronary atherosclerosis of bypass graft (artery) (vein) of transplanted heart 414.2 Chronic total occlusion of coronary artery 414.8, Other specified forms of chronic ischemic heart disease 414.9 Chronic ischemic heart disease, unspecified 429.2 Cardiovascular disease, unspecified 433.0 Occlusion and stenosis of basilar artery 433.01 Occlusion and stenosis of basilar artery, with cerebral infarction 209

433.10 Occlusion and stenosis of carotid artery, without mention of cerebral infarction 433.11 Occlusion and stenosis of carotid artery, with cerebral infarction Occlusion and stenosis of vertebral artery, without mention of cerebral 433.20 infarction 433.21 Occlusion and stenosis of vertebral artery, with cerebral infarction Occlusion and stenosis of multiple and bilateral precerebral arteries, without 433.30 mention of cerebral infarction Occlusion and stenosis of multiple and bilateral precerebral arteries, with 433.31 cerebral infarction Occlusion and stenosis of other specified precerebral artery, without mention 433.80 of cerebral infarction Occlusion and stenosis of other specified precerebral artery, with cerebral 433.81 infarction Occlusion and stenosis of unspecified precerebral artery, without mention of 433.90 cerebral infarction Occlusion and stenosis of unspecified precerebral artery, with cerebral 433.91 infarction 434.01 Cerebral thrombosis, with cerebral infarction 434.10 Occlusion and stenosis of carotid artery, without mention of cerebral infarction 434.11 Cerebral embolism, with cerebral infarction 434.90 Cerebral artery occlusion, unspecified, without mention of cerebral infarction 434.91 Cerebral artery occlusion, unspecified, with cerebral infarction 440.1 Atherosclerosis of renal artery 440.20 Atherosclerosis of native arteries of the extremities, unspecified Atherosclerosis of native arteries of the extremities with intermittent 440.21 claudication 440.22 Atherosclerosis of the extremities with rest pain 440.23 Atherosclerosis of native arteries of the extremities with ulceration 440.24 Atherosclerosis of native arteries of the extremities with gangrene 440.29 Other atherosclerosis of native arteries of the extremities 440.4 Chronic total occlusion of artery of the extremities 444.0 Embolism and thrombosis of abdominal aorta 444.1 Embolism and thrombosis of thoracic aorta 444.21 Arterial embolism and thrombosis of upper extremity 444.22 Arterial embolism and thrombosis of lower extremity 444.81 Embolism and thrombosis of iliac artery 444.89 Embolism and thrombosis of other artery 444.9 Embolism and thrombosis of unspecified artery 445.01 Atheroembolism, upper extremity 445.02 Atheroembolism, lower extremity Procedure Performed – CABG CPT 33510 33511 33512 33513 210 Description CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS

33514 33516 33517 33518 33519 33521 33522 33523 33533 33534 33535 33536

CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 1 VEIN CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 2 VEIN CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 3 VEIN CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 4 VEIN CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 5 VEIN CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 6 VEIN CAB W/ARTL GRF 1 ARTL GRF CAB W/ARTL GRF 2 C ARTL GRFS CAB W/ARTL GRF 3 C ARTL GRFS CAB W/ARTL GRF 4/> C ARTL GRFS

Procedure Performed – PTCA CPT 33140 92980 92982 92995 Description TRANSMYOCRD LASER REVSC THORCOM SPX TCAT PLMT AN INTRAC STENT PRQ 1 VSL PRQ TRLUML C BALO ANGIOP 1 VSL PRQ TRLUML C ATHRC 1 VSL

Laboratory tests performed – High Density Lipoprotein (HDL) LOINC Description 146464 Cholesterol in HDL [Moles/volume] in Serum or Plasma 182634 Cholesterol in HDL [Mass/volume] in Serum or Plasma ultracentrifugate 2085-9 Cholesterol in HDL [Mass/volume] in Serum or Plasma Laboratory tests performed – LDL LOINC Description 127738 Cholesterol in LDL [Units/volume] in Serum or Plasma by Electrophoresis 134577 Cholesterol in LDL [Mass/volume] in Serum or Plasma by calculation 182618 Cholesterol in LDL [Mass/volume] in Serum or Plasma ultracentrifugate 182626 Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay 2089-1 Cholesterol in LDL [Mass/volume] in Serum or Plasma 227488 Cholesterol in LDL [Moles/volume] in Serum or Plasma 394692 Cholesterol in LDL [Moles/volume] in Serum or Plasma by calculation 491324 Cholesterol in LDL [Mass/volume] in Serum or Plasma by Electrophoresis 554402 Cholesterol.in LDL (real) [Mass/volume] in Serum or Plasma by VAP 211

Laboratory tests performed – Total Cholesterol LOINC Description 146472 Cholesterol [Moles/volume] in Serum or Plasma 2093-3 Cholesterol [Mass/volume] in Serum or Plasma Laboratory tests performed – Triglycerides LOINC Description 129510 Triglyceride [Mass/volume] in Serum or Plasma by calculation 149278 Triglyceride [Moles/volume] in Serum or Plasma 2571-8 Triglyceride [Mass/volume] in Serum or Plasma 472100 Triglyceride [Moles/volume] in Serum or Plasma --fasting Encounter – acute inpatient CPT 99221 99222 99223 99231 99232 99233 99238 99239 99251 99252 99253 99254 99255 99291 Description 1ST HOSP CARE PR D 30 MIN 1ST HOSP CARE PR D 50 MIN 1ST HOSP CARE PR D 70 MIN SBSQ HOSP CARE PR D 15 MIN SBSQ HOSP CARE PR D 25 MIN SBSQ HOSP CARE PR D 35 MIN HOSP DSCHRG D MGMT 30 MIN/< HOSP DSCHRG D MGMT > 30 MIN 1ST INPT CONSLTJ 20 MIN 1ST INPT CONSLTJ 40 MIN 1ST INPT CONSLTJ 55 MIN 1ST INPT CONSLTJ 80 MIN 1ST INPT CONSLTJ 110 MIN CC E/M CRITICALLY ILL/INJURED 1ST 30-74 MIN

212

benign.11 Hypertensive heart disease. or unspecified Hypertensive heart and chronic kidney disease. or unspecified Hypertensive heart and chronic kidney disease.93 428.43 428. with heart failure 402. with heart failure and with chronic kidney disease stage I through stage IV. with heart failure and chronic kidney disease stage V or end stage renal disease Left heart failure Systolic heart failure Acute systolic heart failure Chronic systolic heart failure Acute on chronic systolic heart failure Diastolic heart failure Acute diastolic heart failure Chronic diastolic heart failure Acute on chronic diastolic heart failure Combined systolic and diastolic heart failure Acute combined systolic and diastolic heart failure Chronic combined systolic and diastolic heart failure Acute on chronic combined systolic and diastolic heart failure Heart failure.Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) (NQF 0081) (Additional Measure . or unspecified Hypertensive heart and chronic kidney disease. with heart failure and with chronic kidney disease stage I through stage IV.31 428.01 404.32 428. unspecified. malignant. unspecified.13 404. unspecified. with heart failure and with chronic kidney disease stage I through stage IV.91 404.3 428.MENU) Description: Percentage of patients aged 18 years and older with a diagnosis of heart failure and LVSD (LVEF < 40%) who were prescribed ACE inhibitor or ARB therapy. with heart failure and with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease. with heart failure 404.4 428.03 404. benign. benign. malignant.91 Hypertensive heart disease. unspecified .33 428.1 428.23 428. malignant.9 213 Hypertensive heart and chronic kidney disease. with heart failure 402.41 428.01 Hypertensive heart disease.2 428.11 404.21 428. with heart failure and chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease.42 428. Active diagnosis of heart failure ICD-9 Description 402.22 428.

83 V23.0 V23.5 V23.2 V23.41 V23.82 V23.89 V23.4 V23.0 V22.81 V23.Active diagnoses pregnancy ICD-9 V22.1 V22.49 V23.1 V23.84 V23.6 Description Other deficiencies of circulating enzymes Active diagnoses disease of aortic and mitral valves ICD-9 395 395.2 396 214 Description Diseases of aortic valve Rheumatic aortic stenosis with insufficiency Diseases of mitral and aortic valves .3 V23. incidental Supervision of high-risk pregnancy with history of infertility Supervision of high-risk pregnancy with history of trophoblastic disease Supervision of high-risk pregnancy with history of abortion Supervision of high-risk pregnancy with grand multiparity Supervision of high-risk pregnancy with other poor obstetric history Pregnancy with history of pre-term labor Pregnancy with other poor obstetric history Supervision of high-risk pregnancy with other poor reproductive history Supervision of high-risk pregnancy: insufficient prenatal care Supervision of other high-risk pregnancy Elderly primigravida Elderly multigravida Young primigravida Young multigravida Other high-risk pregnancy Supervision of unspecified high-risk pregnancy Active diagnoses deficiencies of circulating enzymes ICD-9 277.9 Description Supervision of normal first pregnancy Supervision of other normal pregnancy Pregnant state.7 V23.2 V23.8 V23.

without heart failure and with chronic kidney disease stage V or end stage renal disease 215 . without heart failure and with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease. malignant. unspecified.02 404.01 403. with heart failure and with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease. malignant.91 404.11 403.11 403. with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease.93 Hypertensive chronic kidney disease. without heart failure and with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease.01 403. with chronic kidney disease stage V or end stage renal disease Hypertensive chronic kidney disease. with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease. unspecified. with heart failure and chronic kidney disease stage V or end stage renal disease Active diagnoses hypertensive renal disease with renal failure ICD-9 Description 403. with chronic kidney disease stage V or end stage renal disease Hypertensive chronic kidney disease.8 Mitral valve insufficiency and aortic valve stenosis Multiple involvement of mitral and aortic valves Active diagnoses non-rheumatic mitral (valve) disease ICD-9 424. with chronic kidney disease stage V or end stage renal disease Hypertensive chronic kidney disease. benign. unspecified. malignant. benign.0 Description Mitral valve disorders Active diagnoses chronic kidney disease with and without hypertension ICD-9 Description 403.13 404.92 404. with heart failure and chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease. benign.2 396. benign.12 404. malignant. unspecified.91 404.03 404. malignant. without heart failure and with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease. with chronic kidney disease stage V or end stage renal disease Hypertensive chronic kidney disease.02 Hypertensive chronic kidney disease.396.

with heart failure and chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease.7 584.5 584.6 586 788. without heart failure and with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease.1 Description Atherosclerosis of renal artery Active diagnoses renal failure and ESRD ICD-9 584. without heart failure and with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease.9 585. unspecified Oliguria and anuria Active diagnoses acute renal failure ICD-9 584.5 585.5 Description Acute kidney failure with lesion of tubular necrosis Acute kidney failure with lesion of renal cortical necrosis Acute kidney failure with lesion of renal medullary [papillary] necrosis Acute kidney failure with other specified pathological lesion in kidney Acute kidney failure.93 Hypertensive heart and chronic kidney disease.8 584. with heart failure and with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease. unspecified. with heart failure and chronic kidney disease stage V or end stage renal disease Active diagnoses atherosclerosis of renal artery ICD-9 440.12 404.8 584.92 404. unspecified Chronic kidney disease. benign. malignant. benign.7 584.5 584.6 584.6 584.9 Description Acute kidney failure with lesion of tubular necrosis Acute kidney failure with lesion of renal cortical necrosis Acute kidney failure with lesion of renal medullary [papillary] necrosis Acute kidney failure with other specified pathological lesion in kidney Acute kidney failure. unspecified.13 404.404. unspecified 216 .03 404. Stage V End stage renal disease Renal failure.

0 747.22 Description Atherosclerosis of aorta Congenital atresia and stenosis of aorta Diagnostic study result: LVF Assessment result < 40% CPT 78414 78451 78452 78453 78454 78468 78472 78473 78481 78483 78494 78496 93303 93304 93306 93307 93308 93312 93313 93314 93315 93316 93317 93350 93351 217 Description DETER CTR C-V HEMODYN NON-IMG +-RX 1/MLT MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS MYOCARDIAL SPECT MULTIPLE STUDIES MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ CARD BPI GTD =BRM PLNR 1 STD REST/STRS CARD BPI GTD =BRM MLT STD WALL MOTION STD CARD BPI PLNR 1ST PS 1 STD PLUS EJEC FXJ CARD BPI PLNR 1ST PS MLT STD PLUS EJEC FXJ CARD BPI GTD =BRM SPECT REST WALL MOTION CARD BPI GTD =BRM 1 STD REST R VENTR EJEC FXJ TTHRC F/CGEN CAR ANOMAL COMPL TTHRC F/CGEN CAR ANOMAL F-UP/LMTD STD ECHO TTHRC R-T 2D -+M-MODE COMPL SPEC&COLOR DOP TTHRC R-T IMG 2D +-M-MODE REC COMPL TTHRC R-T IMG 2D +-M-MODE REC F-UP/LMTD TEE R-T IMG 2D W/PRB IMG ACQUISJ I&R TEE R-T IMG 2D W/PROBE PLMT ONLY TEE R-T IMG 2D IMG ACQUISJ I&R ONLY TEE CGEN CAR ANOML PRB ACQUISJ I&R TEE CGEN CAR ANOML PLMT PRB ONLY TEE CGEN CAR ANOML IMG ACQUISJ I&R ECHO TTHRC R-T 2D -+M-MODE COMPLETE REST&STRS ECHO TTHRC R-T 2D -+M-MODE REST&STRS CONT ECG .Active diagnoses atresia and stenosis of aorta ICD-9 440.

5 MG Oral Tablet [Capoten] Captopril 25 MG / Hydrochlorothiazide 15 MG Oral Tablet Captopril 25 MG / Hydrochlorothiazide 15 MG Oral Tablet [Capozide 25/15] Captopril 25 MG / Hydrochlorothiazide 25 MG Oral Tablet Captopril 25 MG / Hydrochlorothiazide 25 MG Oral Tablet [Capozide 25/25] Captopril 25 MG Oral Tablet Captopril 25 MG Oral Tablet [Capoten] Captopril 25 MG Oral Tablet [Capoten] 218 .93352 93543 USE OF ECHO CONTRAST AGENT DURING STRESS ECHO INJECTION CARDIAC CATHJ L VENTR/L ATR ANGIOGRAPH Diagnostic study result: ejection fraction < 40% CPT 250907009 250908004 70822001 Description Left ventricular function Left ventricular ejection fraction Cardiac ejection fraction Medication (active or ordered) of ACE inhibitor or ARB RxNORM 104384 805863 639539 805859 639543 577785 577787 308962 210994 308963 201370 201370 197436 211053 197437 211072 317173 201372 201372 Description Altace 2.5 MG Oral Tablet [Capoten] Captopril 12.5] candesartan cilexetil 32 MG Oral Tablet [Atacand] candesartan cilexetil 4 MG Oral Tablet [Atacand] candesartan cilexetil 8 MG Oral Tablet [Atacand] Captopril 100 MG Oral Tablet Captopril 100 MG Oral Tablet [Capoten] Captopril 12.5 MG Oral Tablet Captopril 12.5 MG Oral Capsule candesartan cilexetil 16 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Atacand HCT 32/12.5] candesartan cilexetil 16 MG Oral Tablet [Atacand] candesartan cilexetil 32 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Atacand HCT 16/12.

5 MG Oral Tablet [Vaseretic] Enalapril Maleate 5 MG Oral Tablet Enalapril Maleate 5 MG Oral Tablet [Vasotec] Enalaprilat 1.25 MG/ML Injectable Solution eprosartan 400 MG Oral Tablet [Teveten] eprosartan 600 MG / Hydrochlorothiazide 12.5 MG Oral Tablet Enalapril Maleate 2.5 MG Oral Tablet [Teveten HCT] .5] Enalapril Maleate 5 MG / Felodipine 5 MG Extended Release Tablet [Lexxel 5/5] Enalapril Maleate 5 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Vasotec] Enalapril Maleate 20 MG Oral Tablet Enalapril Maleate 20 MG Oral Tablet [Vasotec] Enalapril Maleate 5 MG / Felodipine 2.25 MG/ML Injectable Solution [Vasotec] Enalapril Maleate 10 MG / Hydrochlorothiazide 25 MG Oral Tablet Enalapril Maleate 10 MG / Hydrochlorothiazide 25 MG Oral Tablet [Vaseretic] Enalapril Maleate 10 MG Oral Tablet Enalapril Maleate 10 MG Oral Tablet [Vasotec] Enalapril Maleate 2.5 MG Extended Release Tablet [Lexxel 5/2.5 MG Oral Tablet Enalapril Maleate 5 MG / Hydrochlorothiazide 12.25 MG/ML Injectable Solution Enalaprilat 1.197438 790297 197439 790296 308964 201374 201374 846148 352274 858823 858828 858830 858817 858819 858804 858806 858810 858812 858884 858892 858824 858827 858813 858815 204404 204404 261300 352335 219 Captopril 50 MG / Hydrochlorothiazide 15 MG Oral Tablet Captopril 50 MG / Hydrochlorothiazide 15 MG Oral Tablet [Capozide 50/15] Captopril 50 MG / Hydrochlorothiazide 25 MG Oral Tablet Captopril 50 MG / Hydrochlorothiazide 25 MG Oral Tablet [Capozide 50/25] Captopril 50 MG Oral Tablet Captopril 50 MG Oral Tablet [Capoten] Captopril 50 MG Oral Tablet [Capoten] Diltiazem Hydrochloride 180 MG / Enalapril Maleate 5 MG Extended Release Tablet [Teczem] Diovan 40 MG Oral Tablet Enalapril Maleate 1.

5 MG / Olmesartan medoxomil 20 MG Oral Tablet [Benicar HCT 20/12.5 MG Oral Tablet [Monopril-HCT 10/12.5] Hydrochlorothiazide 12.5 MG / Lisinopril 10 MG Oral Tablet [Prinzide] Hydrochlorothiazide 12.5] Hydrochlorothiazide 12.5 MG / Lisinopril 10 MG Oral Tablet Hydrochlorothiazide 12.5] Hydrochlorothiazide 12.5] Fosinopril Sodium 10 MG Oral Tablet Fosinopril Sodium 10 MG Oral Tablet [Monopril] Fosinopril Sodium 20 MG / Hydrochlorothiazide 12.5 MG Oral Tablet Fosinopril Sodium 20 MG Oral Tablet Fosinopril Sodium 20 MG Oral Tablet [Monopril] Fosinopril Sodium 40 MG Oral Tablet Fosinopril Sodium 40 MG Oral Tablet [Monopril] Hydrochlorothiazide 12.5 MG / Olmesartan medoxomil 40 MG Oral Tablet [Benicar HCT 40/12.5 MG / Lisinopril 20 MG Oral Tablet [Prinzide] Hydrochlorothiazide 12.5 MG / irbesartan 150 MG Oral Tablet [Avalide 150/12.5 MG / quinapril 10 MG Oral Tablet [Accuretic 10/12.5] Hydrochlorothiazide 12.5] Hydrochlorothiazide 12.5 MG / moexipril 15 MG Oral Tablet [Uniretic 15/12.5 MG / Lisinopril 10 MG Oral Tablet [Zestoretic 10/12.5 MG / Lisinopril 20 MG Oral Tablet [Zestoretic 20/12.5] Hydrochlorothiazide 12.5] Hydrochlorothiazide 12.5 MG / Lisinopril 10 MG Oral Tablet Hydrochlorothiazide 12.5/12.5 MG / moexipril 7.5] Hydrochlorothiazide 12.261301 857166 857182 857169 857171 857174 857183 857185 857187 857189 823934 823938 197885 197885 207961 823986 197886 197886 207963 823982 891618 891622 847060 847055 809854 809858 749833 eprosartan 600 MG Oral Tablet [Teveten] Fosinopril Sodium 10 MG / Hydrochlorothiazide 12.5 MG / irbesartan 300 MG Oral Tablet [Avalide 300/12.5 MG / Lisinopril 20 MG Oral Tablet Hydrochlorothiazide 12.5 MG Oral Tablet [Uniretic 7.5 MG / telmisartan 40 MG Oral Tablet [MicardisHCT 40/12.5] Hydrochlorothiazide 12.5] 220 .5] Hydrochlorothiazide 12.5 MG Oral Tablet Fosinopril Sodium 10 MG / Hydrochlorothiazide 12.5 MG / Lisinopril 20 MG Oral Tablet Hydrochlorothiazide 12.5 MG / quinapril 20 MG Oral Tablet [Accuretic 20/12.

5 MG / telmisartan 80 MG Oral Tablet [MicardisHCT 80/12.5 MG Oral Tablet Lisinopril 2.5] Hydrochlorothiazide 12.5] Hydrochlorothiazide 25 MG / irbesartan 300 MG Oral Tablet [Avalide 300/25] Hydrochlorothiazide 25 MG / Lisinopril 20 MG Oral Tablet Hydrochlorothiazide 25 MG / Lisinopril 20 MG Oral Tablet Hydrochlorothiazide 25 MG / Lisinopril 20 MG Oral Tablet [Prinzide] Hydrochlorothiazide 25 MG / Lisinopril 20 MG Oral Tablet [Zestoretic 20/25] Hydrochlorothiazide 25 MG / moexipril 15 MG Oral Tablet [Uniretic 15/25] Hydrochlorothiazide 25 MG / Olmesartan medoxomil 40 MG Oral Tablet [Benicar HCT 40/25] Hydrochlorothiazide 25 MG / quinapril 20 MG Oral Tablet [Accuretic 20/25] Hydrochlorothiazide 25 MG / telmisartan 80 MG Oral Tablet [MicardisHCT 80/25] Hydrochlorothiazide 25 MG / valsartan 160 MG Oral Tablet [Diovan HCT 160/25] irbesartan 150 MG Oral Tablet [Avapro] irbesartan 300 MG Oral Tablet [Avapro] irbesartan 75 MG Oral Tablet [Avapro] Lisinopril 2.5] Hydrochlorothiazide 12.5 MG / valsartan 160 MG Oral Tablet [Diovan HCT 160/12.5 MG / valsartan 80 MG Oral Tablet [Diovan HCT 80/12.5 MG Oral Tablet [Prinivil] Lisinopril 20 MG Oral Tablet Lisinopril 20 MG Oral Tablet [Prinivil] Lisinopril 20 MG Oral Tablet [Prinivil] Lisinopril 20 MG Oral Tablet [Zestril] .5 MG Oral Tablet [Zestril] Lisinopril 10 MG Oral Tablet Lisinopril 10 MG Oral Tablet [Prinivil] Lisinopril 10 MG Oral Tablet [Prinivil] Lisinopril 10 MG Oral Tablet [Zestril] Lisinopril 2.749837 809018 809014 823942 197887 197887 207965 823971 891626 847042 882559 749841 809022 153666 153667 153665 104375 314076 206765 206765 104377 311353 206763 206763 314077 206766 206766 104378 221 Hydrochlorothiazide 12.5 MG Oral Tablet [Prinivil] Lisinopril 2.

205326 205326 213482 197884 197884 206770 206770 206771 206771 311354 206764 206764 104376 210671 311734 206277 206277 311735 206313 206313 352200 352201 352199 854986 854990 854927 312748 207892 312749 Lisinopril 30 MG Oral Tablet Lisinopril 30 MG Oral Tablet Lisinopril 30 MG Oral Tablet [Zestril] Lisinopril 40 MG Oral Tablet Lisinopril 40 MG Oral Tablet Lisinopril 40 MG Oral Tablet [Prinivil] Lisinopril 40 MG Oral Tablet [Prinivil] Lisinopril 40 MG Oral Tablet [Zestril] Lisinopril 40 MG Oral Tablet [Zestril] Lisinopril 5 MG Oral Tablet Lisinopril 5 MG Oral Tablet [Prinivil] Lisinopril 5 MG Oral Tablet [Prinivil] Lisinopril 5 MG Oral Tablet [Zestril] Mavik 1 MG Oral Tablet moexipril 15 MG Oral Tablet moexipril 15 MG Oral Tablet [Univasc] moexipril 15 MG Oral Tablet [Univasc] moexipril 7.5 MG Oral Tablet moexipril 7.5 MG Oral Tablet [Univasc] Olmesartan medoxomil 20 MG Oral Tablet [Benicar] Olmesartan medoxomil 40 MG Oral Tablet [Benicar] Olmesartan medoxomil 5 MG Oral Tablet [Benicar] Perindopril Erbumine 2 MG Oral Tablet [Aceon] Perindopril Erbumine 4 MG Oral Tablet [Aceon] Perindopril Erbumine 8 MG Oral Tablet [Aceon] quinapril 10 MG Oral Tablet quinapril 10 MG Oral Tablet [Accupril] quinapril 20 MG Oral Tablet 222 .5 MG Oral Tablet [Univasc] moexipril 7.

207893 314203 207895 312750 207891 845489 260333 104385 284531 213431 213431 213432 210672 210673 153080 351762 352001 153079 351761 quinapril 20 MG Oral Tablet [Accupril] quinapril 40 MG Oral Tablet quinapril 40 MG Oral Tablet [Accupril] quinapril 5 MG Oral Tablet quinapril 5 MG Oral Tablet [Accupril] Ramipril 1.25 MG Oral Capsule [Altace] Ramipril 10 MG Oral Capsule [Altace] Ramipril 5 MG Oral Capsule [Altace] telmisartan 20 MG Oral Tablet [Micardis] telmisartan 40 MG Oral Tablet [Micardis] telmisartan 40 MG Oral Tablet [Micardis] telmisartan 80 MG Oral Tablet [Micardis] trandolapril 2 MG Oral Tablet [Mavik] trandolapril 4 MG Oral Tablet [Mavik] valsartan 160 MG Oral Capsule [Diovan] valsartan 160 MG Oral Tablet [Diovan] valsartan 320 MG Oral Tablet [Diovan] valsartan 80 MG Oral Capsule [Diovan] valsartan 80 MG Oral Tablet [Diovan] Encounters (Nursing Facility) – Enter in Past Medical History CPT 99304 99305 99306 99307 99308 99309 99310 Description 1ST NF CARE PR D E/M LW SEVERITY 1ST NF CARE PR D E/M MOD SEVERITY 1ST NF CARE PR D E/M HI SEVERITY SBSQ NF CARE PR D E/M STABLE SBSQ NF CARE PR D E/M MINOR COMPLCTJ SBSQ NF CARE PR D E/M NEW PROBLEM SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM Encounter (Inpatient Discharge) – Enter in Past Medical History CPT Description 99238 HOSP DSCHRG D MGMT 30 MIN/< 99239 HOSP DSCHRG D MGMT > 30 MIN 223 .

malignant. or 404. or unspecified Hypertensive heart and chronic kidney disease.03 failure and with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease. with heart failure Hypertensive heart and chronic kidney disease.9 Heart failure. with heart failure 402.23 Acute on chronic systolic heart failure 428. with heart 404. malignant. Active diagnosis of heart failure ICD9 Description 402. with heart failure 404. or 404. with heart 404. unspecified. with heart failure and with chronic kidney disease stage I through stage IV.31 Acute diastolic heart failure 428. benign.81 Sinoatrial node dysfunction 427.01 unspecified Hypertensive heart and chronic kidney disease.93 failure and chronic kidney disease stage V or end stage renal disease 428. unspecified. benign. unspecified.91 Hypertensive heart disease.3 Diastolic heart failure 428.11 and with chronic kidney disease stage I through stage IV. benign.32 Chronic diastolic heart failure 428.43 Acute on chronic combined systolic and diastolic heart failure 428.41 Acute combined systolic and diastolic heart failure 428.13 and chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease.91 unspecified Hypertensive heart and chronic kidney disease.89 Other specified cardiac dysrhythmias 224 .11 Hypertensive heart disease.4 Combined systolic and diastolic heart failure 428.22 Chronic systolic heart failure 428. malignant.42 Chronic combined systolic and diastolic heart failure 428.2 Systolic heart failure 428.MENU) Description: Percentage of patients aged 18 years and older with a diagnosis of heart failure who also have LVSD (LVEF < 40%) and who were prescribed beta-blocker therapy.21 Acute systolic heart failure 428.33 Acute on chronic diastolic heart failure 428. with heart failure 402.Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) (NQF 0083) (Additional Measure . with heart failure and with chronic kidney disease stage I through stage IV.1 Left heart failure 428.01 Hypertensive heart disease. with heart failure 404. unspecified Active diagnosis of arrhythmia ICD9 Description 427.

91 Asthma. with status asthmaticus 493.21 Chronic obstructive asthma.21 Hypotension of hemodialysis 458.8 Other specified hypotension 458.12 Intrinsic asthma.29 Other iatrogenic hypotension 458.12 Mobitz (type) II atrioventricular block 426.11 Intrinsic asthma with status asthmaticus 493.1 Intrinsic asthma 493. with status asthmaticus 493.1 Chronic hypotension 458.09 Other idiopathic peripheral autonomic neuropathy 427.81 Exercise induced bronchospasm 493.2 Chronic obstructive asthma 493.9 Hypotension.01 Extrinsic asthma with status asthmaticus 493. with (acute) exacerbation 493.22 Chronic obstructive asthma.81 Sinoatrial node dysfunction 427. unspecified 493.13 Other second degree atrioventricular block Active Diagnosis of cardiac pacer in situ ICD9 Description V45. unspecified Active diagnosis of asthma ICD9 Description 493 Asthma 493. unspecified with (acute) exacerbation Active diagnosis of bradycardia ICD9 Description 337.89 Other specified cardiac dysrhythmias Active Diagnosis of atrioventricular block ICD9 Description 426 Conduction disorders 426.92 Asthma.82 Cough variant asthma 493.01 Cardiac pacemaker in situ 225 . with (acute) exacerbation 493.9 Asthma.02 Extrinsic asthma. unspecified type.Active diagnosis of hypotension ICD9 Description 458 Hypotension 458. with (acute) exacerbation 493.

Active Diagnosis of cardiac pacer device applied ICD9 Description 14106009 Cardiac pacemaker 360127006 Intravenous cardiac pacemaker system 360128001 Intravenous triggered cardiac pacemaker system 424921004 Permanent cardiac pacemaker. device 56961003 Cardiac transvenous pacemaker Diagnostic study result LVF assessment (value) < 40% CPT Descripition 78414 DETER CTR C-V HEMODYN NON-IMG +-RX 1/MLT 78451 MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS 78452 MYOCARDIAL SPECT MULTIPLE STUDIES 78453 MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS 78454 MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES 78468 MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ 78472 CARD BPI GTD =BRM PLNR 1 STD REST/STRS 78473 CARD BPI GTD =BRM MLT STD WALL MOTION STD 78481 CARD BPI PLNR 1ST PS 1 STD PLUS EJEC FXJ 78483 CARD BPI PLNR 1ST PS MLT STD PLUS EJEC FXJ 78494 CARD BPI GTD =BRM SPECT REST WALL MOTION 78496 CARD BPI GTD =BRM 1 STD REST R VENTR EJEC FXJ 93303 TTHRC F/CGEN CAR ANOMAL COMPL 93304 TTHRC F/CGEN CAR ANOMAL F-UP/LMTD STD 93306 ECHO TTHRC R-T 2D -+M-MODE COMPL SPEC&COLOR DOP 93307 TTHRC R-T IMG 2D +-M-MODE REC COMPL 93308 TTHRC R-T IMG 2D +-M-MODE REC F-UP/LMTD 93312 TEE R-T IMG 2D W/PRB IMG ACQUISJ I&R 93313 TEE R-T IMG 2D W/PROBE PLMT ONLY 93314 TEE R-T IMG 2D IMG ACQUISJ I&R ONLY 93315 TEE CGEN CAR ANOML PRB ACQUISJ I&R 93316 TEE CGEN CAR ANOML PLMT PRB ONLY 93317 TEE CGEN CAR ANOML IMG ACQUISJ I&R 93350 ECHO TTHRC R-T 2D -+M-MODE COMPLETE REST&STRS 93351 ECHO TTHRC R-T 2D -+M-MODE REST&STRS CONT ECG 93352 USE OF ECHO CONTRAST AGENT DURING STRESS ECHO 93543 INJECTION CARDIAC CATHJ L VENTR/L ATR ANGIOGRAPH Diagnostic study ejection fraction (value) < 40% CPT Descripition 250907009 Left ventricular function 250908004 Left ventricular ejection fraction 226 .

5 MG/ML Injectable Solution [Tenormin] Nadolol 40 MG Oral Tablet [Corgard] Nadolol 40 MG Oral Tablet [Corgard] 227 .70822001 Cardiac ejection fraction Medication (active or ordered) of beta blocker therapy RXNorm 104302 141882 150750 152414 197296 197297 197379 197380 197381 197382 197383 198004 198005 198006 198007 198008 198104 198105 198284 198285 198286 200857 201322 201327 201337 201338 Description Acebutolol 200 MG Oral Capsule [Sectral] Betaxolol 20 MG Oral Tablet [Kerlone] Atenolol 25 MG Oral Tablet [Tenormin] Atenolol 50 MG Oral Tablet [Tenormin] Acebutolol 200 MG Oral Capsule Acebutolol 400 MG Oral Capsule Atenolol 100 MG Oral Tablet Atenolol 25 MG Oral Tablet Atenolol 50 MG Oral Tablet Atenolol 100 MG / Chlorthalidone 25 MG Oral Tablet Atenolol 50 MG / Chlorthalidone 25 MG Oral Tablet Nadolol 120 MG Oral Tablet Nadolol 160 MG Oral Tablet Nadolol 20 MG Oral Tablet Nadolol 40 MG Oral Tablet Nadolol 80 MG Oral Tablet Pindolol 10 MG Oral Tablet Pindolol 5 MG Oral Tablet Timolol 10 MG Oral Tablet Timolol 20 MG Oral Tablet Timolol 5 MG Oral Tablet Pindolol 5 MG Oral Tablet [Visken] Atenolol 100 MG Oral Tablet [Tenormin] Atenolol 0.

13 MG Oral Tablet [Coreg] Bisoprolol Fumarate 10 MG Oral Tablet Atenolol 100 MG / Chlorthalidone 25 MG Oral Tablet [Tenoretic 100] Bisoprolol Fumarate 10 MG Oral Tablet [Zebeta] Bisoprolol Fumarate 5 MG Oral Tablet Bisoprolol Fumarate 5 MG Oral Tablet [Zebeta] Bisoprolol Fumarate 10 MG / Hydrochlorothiazide 6.25 MG Oral Tablet [Ziac 10/6.5 MG Oral Tablet [Coreg] carvedilol 25 MG Oral Tablet [Coreg] Betaxolol 10 MG Oral Tablet [Kerlone] Sotalol 80 MG Oral Tablet Sotalol 160 MG Oral Tablet Betaxolol 10 MG Oral Tablet Betaxolol 20 MG Oral Tablet Hydrochlorothiazide 25 MG / Timolol 10 MG Oral Tablet [Timolide] carvedilol 3.25 MG Oral Tablet [Coreg] carvedilol 12.201340 206961 206964 206968 207367 208003 208029 208140 208375 208575 208576 211773 212388 212389 212390 213731 260346 260348 261397 261398 491234 686926 854901 746023 854903 854905 854907 854910 Timolol 10 MG Oral Tablet [Blocadren] Nadolol 20 MG Oral Tablet [Corgard] Nadolol 120 MG Oral Tablet [Corgard] Nadolol 160 MG Oral Tablet [Corgard] Penbutolol 20 MG Oral Tablet [Levatol] Bendroflumethiazide 5 MG / Nadolol 40 MG Oral Tablet [Corzide 40/5] Bendroflumethiazide 5 MG / Nadolol 80 MG Oral Tablet [Corzide 80/5] Pindolol 10 MG Oral Tablet [Visken] Acebutolol 400 MG Oral Capsule [Sectral] Timolol 5 MG Oral Tablet [Blocadren] Timolol 20 MG Oral Tablet [Blocadren] Atenolol 50 MG Oral Tablet [Senormin] carvedilol 6.25] 228 .

25] Bisoprolol Fumarate 5 MG / Hydrochlorothiazide 6.25 MG Oral Tablet Bisoprolol Fumarate 2.25] Hydrochlorothiazide 25 MG / Propranolol Hydrochloride 40 MG Oral Tablet Hydrochlorothiazide 25 MG / Propranolol Hydrochloride 40 MG Oral Tablet [Inderide 40/25] Hydrochlorothiazide 25 MG / Propranolol Hydrochloride 80 MG Oral Tablet Hydrochlorothiazide 25 MG / Propranolol Hydrochloride 80 MG Oral Tablet [Inderide 80/25] Propranolol Hydrochloride 1 MG/ML Injectable Solution Propranolol Hydrochloride 1 MG/ML Injectable Solution [Inderal] Propranolol Hydrochloride 10 MG Oral Tablet Propranolol Hydrochloride 10 MG Oral Tablet [Inderal] Propranolol Hydrochloride 20 MG Oral Tablet 854918 854919 854921 856422 856426 856429 856433 856443 856445 856448 856450 856457 856460 24 HR Propranolol Hydrochloride 120 MG Extended Release Capsule 24 HR Propranolol Hydrochloride 120 MG Extended Release Capsule [Inderal] 24 HR Propranolol Hydrochloride 120 MG Extended Release Capsule [InnoPran] 856462 856471 856481 24 HR Propranolol Hydrochloride 160 MG Extended Release Capsule 24 HR Propranolol Hydrochloride 160 MG Extended Release Capsule [Inderal] Propranolol Hydrochloride 20 MG Oral Tablet [Inderal] Propranolol Hydrochloride 40 MG Oral Tablet 856483 856508 856519 229 .854916 Bisoprolol Fumarate 2.25 MG Oral Tablet Bisoprolol Fumarate 5 MG / Hydrochlorothiazide 6.25 MG Oral Tablet [Ziac 5/6.5/6.5 MG / Hydrochlorothiazide 6.25 MG Oral Tablet [Ziac 2.5 MG / Hydrochlorothiazide 6.

856521 856535 856537 856556 856557 856569 856571 856576 856578 856579 856586 856591 856596 856724 856733 856737 856739 866414 866421 866429 Propranolol Hydrochloride 40 MG Oral Tablet [Inderal] 24 HR Propranolol Hydrochloride 60 MG Extended Release Capsule 24 HR Propranolol Hydrochloride 60 MG Extended Release Capsule [Inderal] Propranolol Hydrochloride 60 MG Oral Tablet Propranolol Hydrochloride 60 MG Oral Tablet [Inderal] 24 HR Propranolol Hydrochloride 80 MG Extended Release Capsule 24 HR Propranolol Hydrochloride 80 MG Extended Release Capsule [Inderal] 24 HR Propranolol Hydrochloride 80 MG Extended Release Capsule [InnoPran] Propranolol Hydrochloride 80 MG Oral Tablet Propranolol Hydrochloride 80 MG Oral Tablet [Inderal] 24 HR Hydrochlorothiazide 50 MG / Propranolol Hydrochloride 120 MG Extended Release Capsule [Inderide 120/50] 24 HR Hydrochlorothiazide 50 MG / Propranolol Hydrochloride 160 MG Extended Release Capsule [Inderide 160/50] 24 HR Hydrochlorothiazide 50 MG / Propranolol Hydrochloride 80 MG Extended Release Capsule [Inderide 80/50] Propranolol Hydrochloride 4 MG/ML Oral Solution Propranolol Hydrochloride 8 MG/ML Oral Solution Propranolol Hydrochloride 80 MG/ML Oral Solution Propranolol Hydrochloride 90 MG Oral Tablet 24 HR Toprol XL 100 MG Extended Release Tablet 24 HR Metoprolol Tartrate 200 MG Extended Release Tablet [Toprol] 24 HR Metoprolol Tartrate 25 MG Extended Release Tablet [Toprol] 866438 24 HR Metoprolol Tartrate 50 MG Extended Release Tablet [Toprol] 230 .

866479 Hydrochlorothiazide 25 MG / Metoprolol Tartrate 100 MG Oral Tablet 866482 Hydrochlorothiazide 25 MG / Metoprolol Tartrate 50 MG Oral Tablet 866491 Hydrochlorothiazide 50 MG / Metoprolol Tartrate 100 MG Oral Tablet Hydrochlorothiazide 25 MG / Metoprolol Tartrate 100 MG Oral Tablet [Lopressor HCT 100/25] Hydrochlorothiazide 25 MG / Metoprolol Tartrate 50 MG Oral Tablet [Lopressor HCT 50/25] Hydrochlorothiazide 50 MG / Metoprolol Tartrate 100 MG Oral Tablet [Lopressor HCT 100/50] Metoprolol Tartrate 1 MG/ML Injectable Solution Metoprolol Tartrate 1 MG/ML Injectable Solution [Lopressor] Metoprolol Tartrate 100 MG Oral Tablet Lopressor 100 MG Oral Tablet Metoprolol Tartrate 50 MG Oral Tablet Metoprolol Tartrate 50 MG Oral Tablet [Lopressor] Metoprolol Tartrate 25 MG Oral Tablet Labetalol hydrochloride 100 MG Oral Tablet Labetalol hydrochloride 100 MG Oral Tablet [Normodyne] Labetalol hydrochloride 200 MG Oral Tablet Labetalol hydrochloride 200 MG Oral Tablet [Normodyne] Labetalol hydrochloride 300 MG Oral Tablet Labetalol hydrochloride 300 MG Oral Tablet [Normodyne] Labetalol hydrochloride 5 MG/ML Injectable Solution Labetalol hydrochloride 5 MG/ML Injectable Solution [Normodyne] Labetalol hydrochloride 5 MG/ML Injectable Solution [Trandate] 866498 866502 866506 866508 866510 866511 866513 866514 866516 866924 896758 896760 896762 896764 896766 896768 896771 896773 896775 231 .

Enter in past Medical History CPT Description 99304 1ST NF CARE PR D E/M LW SEVERITY 99305 1ST NF CARE PR D E/M MOD SEVERITY 99306 1ST NF CARE PR D E/M HI SEVERITY 99307 SBSQ NF CARE PR D E/M STABLE 99308 SBSQ NF CARE PR D E/M MINOR COMPLCTJ 99309 SBSQ NF CARE PR D E/M NEW PROBLEM 99310 SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM 232 .896777 896781 896783 Labetalol hydrochloride 100 MG Oral Tablet [Trandate] Labetalol hydrochloride 200 MG Oral Tablet [Trandate] Labetalol hydrochloride 300 MG Oral Tablet [Trandate] Encounters (Nursing Facility) .

9 Hypertensive heart and chronic kidney disease.32 428. with heart failure 404. unspecified.1 Acute posthemorrhagic anemia 233 . with heart failure Hypertensive heart and chronic kidney disease.91 and with chronic kidney disease stage I through stage IV. or unspecified 404.2 428. malignant.13 chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease.1 428. malignant. malignant. unspecified 285. unspecified Active diagnosis of atrial fibrillation ICD-9 Descripition 427.31 428. Active diagnosis of heart failure ICD-9 Descripition 402.11 Hypertensive heart disease.01 and with chronic kidney disease stage I through stage IV. with heart failure and 404.93 428. unspecified. with heart failure and 404.Heart Failure (HF): Warfarin Therapy Patients with Atrial Fibrillation (NQF 0084) (Additional Measure .41 428.33 428. with heart failure 404.MENU) Description: Percentage of all patients aged 18 and older with a diagnosis of heart failure and paroxysmal or chronic atrial fibrillation who were prescribed warfarin therapy.11 with chronic kidney disease stage I through stage IV.31 Atrial fibrillation Active diagnoses anemias and bleeding disorders ICD-9 Descripition 280 Iron deficiency anemias 280. with heart failure 402.23 428. benign. benign.9 Iron deficiency anemia.03 and with chronic kidney disease stage V or end stage renal disease Hypertensive heart and chronic kidney disease. with heart failure and chronic kidney disease stage V or end stage renal disease Left heart failure Systolic heart failure Acute systolic heart failure Chronic systolic heart failure Acute on chronic systolic heart failure Diastolic heart failure Acute diastolic heart failure Chronic diastolic heart failure Acute on chronic diastolic heart failure Combined systolic and diastolic heart failure Acute combined systolic and diastolic heart failure Chronic combined systolic and diastolic heart failure Acute on chronic combined systolic and diastolic heart failure Heart failure.43 428.21 428. unspecified. with heart failure 402. or unspecified Hypertensive heart and chronic kidney disease. benign.91 Hypertensive heart disease.42 428. with heart failure 404.3 428.22 428.01 Hypertensive heart disease.4 428. or unspecified Hypertensive heart and chronic kidney disease.

32 287.2 286.7 531 531. with obstruction 234 .39 Coagulation defects Congenital factor IX disorder Congenital factor XI deficiency Congenital deficiency of other clotting factors von Willebrand's disease Hemorrhagic disorder due to intrinsic circulating anticoagulants Defibrination syndrome Acquired coagulation factor deficiency Other and unspecified coagulation defects Primary thrombocytopenia Immune thrombocytopenic purpura Evans' syndrome Congenital and hereditary thrombocytopenic purpura Secondary thrombocytopenia Thrombocytopenia.3 286.31 287. with obstruction Acute gastric ulcer with hemorrhage and perforation Acute gastric ulcer with hemorrhage and perforation. unspecified Other primary thrombocytopenia Active diagnoses esophageal and GI bleed ICD-9 530.01 531. with obstruction Chronic or unspecified gastric ulcer with hemorrhage Chronic or unspecified gastric ulcer with hemorrhage.21 531.286 286.1 286.6 531. with obstruction Duodenal ulcer Acute duodenal ulcer with hemorrhage.6 286.33 287.61 532 532.5 287.2 531.4 531.3 287.4 286.01 Descripition Gastroesophageal laceration-hemorrhage syndrome Gastric ulcer Acute gastric ulcer with hemorrhage.9 287.7 286.5 286.41 531.4 287. with obstruction Chronic or unspecified gastric ulcer with hemorrhage and perforation Chronic or unspecified gastric ulcer with hemorrhage and perforation.

01 533.61 533 533.41 533.61 534 534.21 534. with obstruction Acute peptic ulcer of unspecified site with hemorrhage and perforation Acute peptic ulcer of unspecified site with hemorrhage and perforation. with obstruction Chronic or unspecified gastrojejunal ulcer with hemorrhage 533.4 Acute duodenal ulcer with hemorrhage and perforation Acute duodenal ulcer with hemorrhage and perforation.4 235 .532. with obstruction Chronic or unspecified peptic ulcer of unspecified site with hemorrhage Chronic or unspecified peptic ulcer of unspecified site with hemorrhage.2 533. with obstruction Chronic or unspecified peptic ulcer of unspecified site with hemorrhage and perforation Chronic or unspecified peptic ulcer of unspecified site with hemorrhage and perforation.21 533.6 532. with hemorrhage. site unspecified Acute peptic ulcer of unspecified site with hemorrhage.6 533.4 532.41 532. with obstruction Chronic or unspecified duodenal ulcer with hemorrhage and perforation Chronic or unspecified duodenal ulcer with hemorrhage and perforation.2 532. with obstruction Chronic or unspecified duodenal ulcer with hemorrhage Chronic or unspecified duodenal ulcer with hemorrhage. with obstruction Acute gastrojejunal ulcer with hemorrhage and perforation Acute gastrojejunal ulcer with hemorrhage and perforation. with obstruction Peptic ulcer.21 532. with obstruction Gastrojejunal ulcer Acute gastrojejunal ulcer.2 534.01 534.

41 534.534.8 203.11 204.6 534. with hemorrhage. subacute .1 204.9 Unspecified intracranial hemorrhage 437. nonruptured Active diagnoses leukemias/myeloproliferative disorders ICD-9 203 203.81 204 204. unspecified Active diagnoses intracranial hemorrhage ICD-9 Descripition 430 Subarachnoid hemorrhage 431 Intracerebral hemorrhage 432 Other and unspecified intracranial hemorrhage 432.1 578. with obstruction Hemorrhage of rectum and anus Gastrointestinal hemorrhage Blood in stool Hemorrhage of gastrointestinal tract.3 578 578. with obstruction Chronic or unspecified gastrojejunal ulcer with hemorrhage and perforation Chronic or unspecified gastrojejunal ulcer with hemorrhage and perforation. chronic Chronic lymphoid leukemia in remission Lymphoid leukemia.01 204.01 203.3 Cerebral aneurysm.11 203.9 Chronic or unspecified gastrojejunal ulcer.2 236 Descripition Multiple myeloma and immunoproliferative neoplasms Multiple myeloma in remission Plasma cell leukemia Plasma cell leukemia in remission Other immunoproliferative neoplasms Other immunoproliferative neoplasms in remission Lymphoid leukemia Acute lymphoid leukemia in remission Lymphoid leukemia.1 203.61 569.1 Subdural hemorrhage 432.

21 204.81 204.01 206.8 204. subacute Subacute monocytic leukemia in remission Other monocytic leukemia 237 .204.91 205 205.01 205.8 Subacute lymphoid leukemia in remission Other lymphoid leukemia Other lymphoid leukemia in remission Unspecified lymphoid leukemia Unspecified lymphoid leukemia in remission Myeloid leukemia Acute myeloid leukemia in remission Myeloid leukemia.21 205.21 206.1 205.11 206.8 205. subacute Subacute myeloid leukemia in remission Myeloid sarcoma Myeloid sarcoma in remission Other myeloid leukemia Other myeloid leukemia in remission Unspecified myeloid leukemia Unspecified myeloid leukemia in remission Monocytic leukemia Acute monocytic leukemia in remission Monocytic leukemia.9 204. chronic Chronic myeloid leukemia in remission Myeloid leukemia.91 206 206.81 205.1 206.11 205.3 205.9 205.2 205.2 206. chronic Chronic monocytic leukemia in remission Monocytic leukemia.31 205.

81 208 208. chronic Chronic leukemia of unspecified cell type in remission Leukemia of unspecified cell type.91 207 207.8 208.01 207.01 208.11 207.2 208.1 208.11 208.21 208.9 208. subacute Subacute leukemia of unspecified cell type in remission Other leukemia of unspecified cell type Other leukemia of unspecified cell type in remission Unspecified leukemia Unspecified leukemia in remission Active diagnoses hematuria ICD-9 Descripition 599.8 207.91 Other monocytic leukemia in remission Unspecified monocytic leukemia Unspecified monocytic leukemia in remission Other specified leukemia Acute erythremia and erythroleukemia in remission Chronic erythremia Chronic erythremia in remission Megakaryocytic leukemia Megakaryocytic leukemia in remission Other specified leukemia Other specified leukemia in remission Leukemia of unspecified cell type Acute leukemia of unspecified cell type in remission Leukemia of unspecified cell type.21 207.206.81 206.9 206.2 207.81 208.1 207.7 Hematuria 238 .

2 Alcoholic cirrhosis of liver 571.5 Cirrhosis of liver without mention of alcohol Warfarin therapy medication (ordered or active) RxNORM Descripition 855288 855290 855292 855296 855298 855300 855302 855304 855306 855310 855312 855314 239 Warfarin Sodium 1 MG Oral Tablet Warfarin Sodium 1 MG Oral Tablet [Coumadin] Warfarin Sodium 1 MG Oral Tablet [Jantoven] Warfarin Sodium 10 MG Oral Tablet Warfarin Sodium 10 MG Oral Tablet [Coumadin] Warfarin Sodium 10 MG Oral Tablet [Jantoven] Warfarin Sodium 2 MG Oral Tablet Warfarin Sodium 2 MG Oral Tablet [Coumadin] Warfarin Sodium 2 MG Oral Tablet [Jantoven] Warfarin Sodium 2 MG/ML Injectable Solution [Coumadin] Warfarin Sodium 2.5 MG Oral Tablet [Coumadin] .3 Hemoptysis Active diagnoses hemorrhage ICD-9 Descripition 459. unspecified Active diagnoses liver disorders ICD-9 Descripition 570 Acute and subacute necrosis of liver 571.5 MG Oral Tablet Warfarin Sodium 2.Active diagnoses hemoptysis ICD-9 Descripition 786.0 Hemorrhage.

5 MG Oral Tablet Warfarin Sodium 7.855316 855318 855320 855322 855324 855326 855328 855332 855334 855336 855338 855340 855342 855344 855346 855348 Warfarin Sodium 2.5 MG Oral Tablet [Jantoven] Encounters (Nursing Facility) .5 MG Oral Tablet [Coumadin] Warfarin Sodium 7.5 MG Oral Tablet [Jantoven] Warfarin Sodium 3 MG Oral Tablet Warfarin Sodium 3 MG Oral Tablet [Coumadin] Warfarin Sodium 3 MG Oral Tablet [Jantoven] Warfarin Sodium 4 MG Oral Tablet Warfarin Sodium 4 MG Oral Tablet [Coumadin] Warfarin Sodium 4 MG Oral Tablet [Jantoven] Warfarin Sodium 5 MG Oral Tablet Warfarin Sodium 5 MG Oral Tablet [Coumadin] Warfarin Sodium 5 MG Oral Tablet [Jantoven] Warfarin Sodium 6 MG Oral Tablet Warfarin Sodium 6 MG Oral Tablet [Coumadin] Warfarin Sodium 6 MG Oral Tablet [Jantoven] Warfarin Sodium 7.Enter in past Medical History CPT Descripition 99304 1ST NF CARE PR D E/M LW SEVERITY 99305 1ST NF CARE PR D E/M MOD SEVERITY 99306 1ST NF CARE PR D E/M HI SEVERITY 99307 SBSQ NF CARE PR D E/M STABLE 99308 SBSQ NF CARE PR D E/M MINOR COMPLCTJ 99309 SBSQ NF CARE PR D E/M NEW PROBLEM 99310 SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM 240 .

12 Low tension glaucoma 365.1 Open-angle glaucoma 365.Primary Open Angle Glaucoma POAG: Optic Nerve Evaluation (NQF 0086) (Additional Measure . who have an optic nerve head evaluation during one or more office visits within 12 months.MENU) Description: Percentage of patients aged 18 years and older with a diagnosis of POAG who have been seen for at least 2 office visits.15 Residual stage of open angle glaucoma Enter in Past Medical History or procedures in SOAP note SNOMED Optic Nerve Head Evaluation 171671002 Exploration of optic nerve (II) 36228007 Ophthalmic examination and evaluation Encounter Outpatient Opthamological services .11 Primary open angle glaucoma 365.Enter Encounter in Past Medical History CPT Description 92002 OPH MEDICAL XM&EVAL INTRM NEW PT 92004 OPH MEDICAL XM&EVAL COMPRE NEW PT 1+ VST 92012 OPH MEDICAL XM&EVAL INTRM EST PT 92014 OPH MEDICAL XM&EVAL COMPRE EST PT 1+ VST Encounter Nursing Facility CPT Description 99304 1ST NF CARE PR D E/M LW SEVERITY 99304 1ST NF CARE PR D E/M LW SEVERITY 99305 1ST NF CARE PR D E/M MOD SEVERITY 99306 1ST NF CARE PR D E/M HI SEVERITY 99307 SBSQ NF CARE PR D E/M STABLE 99308 SBSQ NF CARE PR D E/M MINOR COMPLCTJ 99309 SBSQ NF CARE PR D E/M NEW PROBLEM 99310 SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM Encounter Domiciliary CPT Description 99324 DOM/R-HOME LW SEVERITY 99325 DOM/R-HOME E/M NEW PT MOD SEVERITY 99326 DOM/R-HOME E/M NEW PT MOD HI SEVERITY 99327 DOM/R-HOME E/M NEW PT HI SEVERITY 99328 DOM/R-HOME E/M NEW PT SIGNIFICANT NEW PROBLEM 99334 DOM/R-HOME E/M EST PT SELF-LMTD/MINOR 99335 DOM/R-HOME E/M EST PT LW MOD SEVERITY 99336 DOM/R-HOME E/M EST PT MOD HI SEVERITY 99337 DOM/R-HOME E/M EST PT SIGNIFICANT NEW PROBLEM 241 . Diagnosis .Primary Open Angle Glaucoma (POAG) ICD9 Description 365.

04 362.06 Description Background diabetic retinopathy Proliferative diabetic retinopathy Nonproliferative diabetic retinopathy NOS Mild nonproliferative diabetic retinopathy Moderate nonproliferative diabetic retinopathy Severe nonproliferative diabetic retinopathy Macular or fundus exam procedure performed during the encounter SNO-MED Description 410455004 Slit lamp fundus examination Macular Edema Findings SNOMED 193350004 193387007 232020009 312911008 312912001 312920004 312921000 312922007 314010006 314011005 314014002 314015001 37231002 242 Description Advanced diabetic maculopathy Cystoid macular edema Diabetic maculopathy Clinically significant macular edema Diabetic macular edema Postoperative cystoid macular edema Autosomal dominant cystoid macular edema Uveitis related cystoid macular edema Diffuse diabetic maculopathy Focal diabetic maculopathy Ischaemic diabetic maculopathy Mixed diabetic maculopathy Macular retinal edema .02 362.MENU) Description: Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months.05 362.01 362. Active diagnosis of diabetic retinopathy ICD9 362.Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy (NQF 0088) (Additional Measure .03 362.

right eye preproliferative diabetic retinopathy 408412005 O/E .left eye diabetic maculopathy O/E .399864000 408415007 408416008 414892004 414908005 420486006 421779007 432789001 Diabetic macular edema not clinically significant O/E .high risk with clinically significant macular edema Non-high-risk proliferative diabetic retinopathy with clinically significant macular edema Very severe nonproliferative diabetic retinopathy with clinically significant macular edema Ophthalmological Services Procedure CPT Code 92002 92004 92012 92014 Description OPH MEDICAL XM&EVAL INTRM NEW PT OPH MEDICAL XM&EVAL COMPRE NEW PT 1+ VST OPH MEDICAL XM&EVAL INTRM EST PT OPH MEDICAL XM&EVAL COMPRE EST PT 1+ VST Encounter Nursing Facility Procedure CPT Code 99304 99305 99306 Description 1ST NF CARE PR D E/M LW SEVERITY 1ST NF CARE PR D E/M MOD SEVERITY 1ST NF CARE PR D E/M HI SEVERITY 243 .left eye preproliferative diabetic retinopathy Severity of retinopathy and macular edema findings SNOMED 399872003 399873008 399874002 399875001 399877009 Description Severe nonproliferative diabetic retinopathy with clinically significant macular edema Severe nonproliferative diabetic retinopathy with no macular edema Proliferative diabetic retinopathy .right eye diabetic maculopathy O/E .right eye clinically significant macular edema Exudative maculopathy associated with type I diabetes mellitus Exudative maculopathy associated with type II diabetes mellitus Noncystoid edema of macula of retina Level of Severity of Retinopathy Findings SNOMED Description 193349004 Preproliferative diabetic retinopathy 312903003 Mild non-proliferative diabetic retinopathy 312904009 Moderate nonproliferative diabetic retinopathy 312905005 Severe nonproliferative diabetic retinopathy 390834004 Nonproliferative diabetic retinopathy 408411003 O/E .left eye clinically significant macular edema O/E .

99307 99308 99309 99310 SBSQ NF CARE PR D E/M STABLE SBSQ NF CARE PR D E/M MINOR COMPLCTJ SBSQ NF CARE PR D E/M NEW PROBLEM SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM Encounter Domiciliary Procedure CPT 99324 99325 99326 99327 99328 99334 99335 99336 99337 Description DOM/R-HOME LW SEVERITY DOM/R-HOME E/M NEW PT MOD SEVERITY DOM/R-HOME E/M NEW PT MOD HI SEVERITY DOM/R-HOME E/M NEW PT HI SEVERITY DOM/R-HOME E/M NEW PT SIGNIFICANT NEW PROBLEM DOM/R-HOME E/M EST PT SELF-LMTD/MINOR DOM/R-HOME E/M EST PT LW MOD SEVERITY DOM/R-HOME E/M EST PT MOD HI SEVERITY DOM/R-HOME E/M EST PT SIGNIFICANT NEW PROBLEM 244 .

Diabetic Retinopathy: Communication with Physician Managing Ongoing Diabetes Care (NQF 0089) (Additional Measure .01 362. Active diagnosis of diabetic retinopathy ICD9 362.MENU) Description: Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the on-going care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months.03 362. The applicable diagnosis in their Past Medical or Surgical History or in an encounter note procedure with the "Provider/Facility" or "Surgeon/Facility" field populated.05 362.04 362.02 362.06 Description Background diabetic retinopathy Proliferative diabetic retinopathy Nonproliferative diabetic retinopathy NOS Mild nonproliferative diabetic retinopathy Moderate nonproliferative diabetic retinopathy Severe nonproliferative diabetic retinopathy Macular or Fundus Exam procedure performed during the encounter SNOMED Description 410455004 Slit lamp fundus examination Macular Edema Findings SNOMED 193350004 193387007 232020009 312911008 312912001 312920004 312921000 312922007 314010006 314011005 245 Description Advanced diabetic maculopathy Cystoid macular edema Diabetic maculopathy Clinically significant macular edema Diabetic macular edema Postoperative cystoid macular edema Autosomal dominant cystoid macular edema Uveitis related cystoid macular edema Diffuse diabetic maculopathy Focal diabetic maculopathy .

right eye clinically significant macular edema Exudative maculopathy associated with type I diabetes mellitus Exudative maculopathy associated with type II diabetes mellitus Noncystoid edema of macula of retina Level of Severity of Retinopathy Findings SNOMED Description 193349004 Preproliferative diabetic retinopathy 312903003 Mild non-proliferative diabetic retinopathy 312904009 Moderate nonproliferative diabetic retinopathy 312905005 Severe nonproliferative diabetic retinopathy 390834004 Nonproliferative diabetic retinopathy 408411003 O/E .left eye diabetic maculopathy O/E .right eye preproliferative diabetic retinopathy 408412005 O/E .314014002 314015001 37231002 399864000 408415007 408416008 414892004 414908005 420486006 421779007 432789001 Ischaemic diabetic maculopathy Mixed diabetic maculopathy Macular retinal edema Diabetic macular edema not clinically significant O/E .right eye diabetic maculopathy O/E .left eye clinically significant macular edema O/E .left eye preproliferative diabetic retinopathy Severity of retinopathy and macular edema findings Description Severe nonproliferative diabetic retinopathy with clinically significant 399872003 macular edema 399873008 Severe nonproliferative diabetic retinopathy with no macular edema Proliferative diabetic retinopathy .high risk with clinically significant 399874002 macular edema Non-high-risk proliferative diabetic retinopathy with clinically significant 399875001 macular edema Very severe nonproliferative diabetic retinopathy with clinically significant 399877009 macular edema Communication provider to provider of the macular edema findings Communication provider to provider of the severity of retinopathy findings SNOMED 246 .

Ophthalmological Services CPT 92002 92004 92012 92014 Description OPH MEDICAL XM&EVAL INTRM NEW PT OPH MEDICAL XM&EVAL COMPRE NEW PT 1+ VST OPH MEDICAL XM&EVAL INTRM EST PT OPH MEDICAL XM&EVAL COMPRE EST PT 1+ VST Encounter Nursing Facility CPT 99304 99305 99306 99307 99308 99309 99310 Description 1ST NF CARE PR D E/M LW SEVERITY 1ST NF CARE PR D E/M MOD SEVERITY 1ST NF CARE PR D E/M HI SEVERITY SBSQ NF CARE PR D E/M STABLE SBSQ NF CARE PR D E/M MINOR COMPLCTJ SBSQ NF CARE PR D E/M NEW PROBLEM SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM Encounter Domiciliary CPT 99324 99325 99326 99327 99328 99334 99335 99336 99337 Description DOM/R-HOME LW SEVERITY DOM/R-HOME E/M NEW PT MOD SEVERITY DOM/R-HOME E/M NEW PT MOD HI SEVERITY DOM/R-HOME E/M NEW PT HI SEVERITY DOM/R-HOME E/M NEW PT SIGNIFICANT NEW PROBLEM DOM/R-HOME E/M EST PT SELF-LMTD/MINOR DOM/R-HOME E/M EST PT LW MOD SEVERITY DOM/R-HOME E/M EST PT MOD HI SEVERITY DOM/R-HOME E/M EST PT SIGNIFICANT NEW PROBLEM 247 .

52 Bipolar I disorder. most recent episode (or current) mixed. in full remission 296.53 without mention of psychotic behavior Bipolar I disorder.43 mention of psychotic behavior Bipolar I disorder.62 Bipolar I disorder. without 296.40 Bipolar I disorder. most recent episode (or current) manic. single episode in full remission 296. 296. severe.51 Bipolar I disorder. most recent episode (or current) manic.26 Major depressive disorder. most recent episode (or current) mixed. in full remission 296. severe. most recent episode (or current) mixed. in full 296.MENU) Description: Evaluation of length of treatment serves as an important indicator of success in promoting patient compliance with the establishment and maintenance of an effective medication regimen (Retrospective Rule). most recent episode (or current) depressed. 296. in partial or 296.42 Bipolar I disorder. severe. in partial or 296.61 Bipolar I disorder. unspecified 296. moderate Bipolar I disorder. most recent episode (or current) manic. mild 296. severe.5 Bipolar I disorder.50 Bipolar I disorder. most recent episode (or current) depressed.45 unspecified remission 296.55 unspecified remission Bipolar I disorder.41 Bipolar I disorder. in full remission 296. in partial or 296.54 specified as with psychotic behavior Bipolar I disorder. most recent episode (or current) depressed 296.36 Major depressive disorder. unspecified 296. most recent episode (or current) mixed.7 Bipolar I disorder. specified 296. most recent episode (or current) manic. without 296. unspecified 296. most recent episode (or current) manic.56 remission 296.Anti-depressant Medication Mgmt: (a) Effective Acute Phase Treatment and (b) Effective Continuation Phase Treatment (NQF 0105) (Additional Measure . most recent episode (or current) depressed. severe.60 Bipolar I disorder. most recent episode (or current) depressed. most recent episode (or current) depressed. most recent episode (or current) mixed. most recent episode (or current) unspecified 248 .4 Bipolar I disorder. most recent episode (or current) mixed. most recent episode (or current) mixed. Active Diagnosis – depression ICD-9CM Description 296. moderate Bipolar I disorder. most recent episode (or current) manic. specified 296. moderate Bipolar I disorder.44 as with psychotic behavior Bipolar I disorder.64 as with psychotic behavior Bipolar I disorder.66 Bipolar I disorder. most recent episode (or current) depressed. most recent episode (or current) manic 296.46 Bipolar I disorder.63 mention of psychotic behavior Bipolar I disorder. most recent episode (or current) depressed. most recent episode (or current) manic. mild 296. severe. mild 296. recurrent episode.65 unspecified remission 296.

32 Major depressive disorder.23 psychotic behavior Major depressive disorder. recurrent episode. in partial or unspecified remission 296.80 296.22 Major depressive disorder. moderate degree Major depressive disorder.35 remission 298. not elsewhere classified Medication Dispensed – Phenylpiperazine antidepressants RxNorm Description 204453 nefazodone 100 MG Oral Tablet 204454 nefazodone 150 MG Oral Tablet 204455 nefazodone 200 MG Oral Tablet 204456 nefazodone 250 MG Oral Tablet 311923 nefazodone 50 MG Oral Tablet 351128 nefazodone 300 MG Oral Tablet 249 .9 296. single episode.1 Adjustment reaction with prolonged depressive reaction 311 Depressive disorder.90 296.25 Major depressive disorder.296. recurrent episode.34 with psychotic behavior Major depressive disorder. without mention 296. single episode.81 296.89 296. moderate degree Major depressive disorder.24 psychotic behavior 296. recurrent episode. severe degree. mild degree 296.30 Major depressive disorder.8 296. mild degree 296.21 Major depressive disorder. without mention of 296.4 Dysthymic disorder 309.28 Other and unspecified bipolar disorders Bipolar disorder. recurrent episode. specified as with 296.33 of psychotic behavior Major depressive disorder.0 Depressive type psychosis 300. recurrent episode. specified as 296. in partial or unspecified 296. single episode. unspecified Atypical manic disorder Atypical depressive disorder Other and unspecified bipolar disorders Other and unspecified episodic mood disorder Unspecified episodic mood disorder Other specified episodic mood disorder Adjustment disorder with depressed mood Adjustment disorder with mixed anxiety and depressed mood Active Diagnosis – major depression ICD-9CM Description 296.82 296. unspecified degree 296. severe degree. severe degree. severe degree.20 Major depression disorder with single episode of depression 296.0 309.31 Major depressive disorder. single episode. single episode. recurrent episode.99 309.

5 MG Extended Release Capsule 313585 24 HR venlafaxine 75 MG Extended Release Capsule 313586 venlafaxine 75 MG Oral Tablet 314277 venlafaxine 50 MG Oral Tablet 411815 venlafaxine 75 MG Extended Release Capsule 411816 venlafaxine 150 MG Extended Release Capsule 431737 venlafaxine 37.5 MG Extended Release Tablet 431753 venlafaxine 150 MG Extended Release Tablet 431754 venlafaxine 75 MG Extended Release Tablet 596926 duloxetine 20 MG Enteric Coated Capsule 596930 duloxetine 30 MG Enteric Coated Capsule 596934 duloxetine 60 MG Enteric Coated Capsule 616402 duloxetine 40 MG Enteric Coated Capsule 790264 24 HR Desvenlafaxine 100 MG Extended Release Tablet 790288 24 HR Desvenlafaxine 50 MG Extended Release Tablet 801849 venlafaxine 225 MG Extended Release Tablet 803408 Desvenlafaxine 100 MG Oral Tablet 803409 Desvenlafaxine 50 MG Oral Tablet 808744 24 HR venlafaxine 150 MG Extended Release Tablet 808748 24 HR venlafaxine 225 MG Extended Release Tablet 808751 24 HR venlafaxine 37.5 MG Extended Release Tablet 808753 24 HR venlafaxine 75 MG Extended Release Tablet 844817 venlafaxine 37.856364 856369 856373 856377 856381 856382 856383 898697 898702 898704 898707 Trazodone Hydrochloride 150 MG Oral Tablet Trazodone Hydrochloride 300 MG Oral Tablet Trazodone Hydrochloride 100 MG Oral Tablet Trazodone Hydrochloride 50 MG Oral Tablet Trazodone Hydrochloride 10 MG/ML Oral Solution Trazodone Hydrochloride 100 MG Oral Capsule Trazodone Hydrochloride 50 MG Oral Capsule 24 HR Trazodone Hydrochloride 150 MG Extended Release Tablet Trazodone Hydrochloride 150 MG Extended Release Tablet 24 HR Trazodone Hydrochloride 300 MG Extended Release Tablet Trazodone Hydrochloride 300 MG Extended Release Tablet Medication Dispensed – SSNRI antidepressants RxNorm Description 313580 venlafaxine 100 MG Oral Tablet 313581 24 HR venlafaxine 150 MG Extended Release Capsule 313582 venlafaxine 25 MG Oral Tablet 313583 24 HR venlafaxine 37.5 MG Extended Release Capsule 845104 Desvenlafaxine 100 MG Extended Release Tablet 250 .

845106 Desvenlafaxine 50 MG Extended Release Tablet Medication Dispensed – Tricyclic antidepressants RxNorm Description 197363 Amoxapine 100 MG Oral Tablet 197364 Amoxapine 150 MG Oral Tablet 197365 Amoxapine 25 MG Oral Tablet 197366 Amoxapine 50 MG Oral Tablet 197565 Desipramine 10 MG Oral Tablet 197566 Desipramine 100 MG Oral Tablet 197567 Desipramine 150 MG Oral Tablet 197568 Desipramine 25 MG Oral Tablet 197569 Desipramine 50 MG Oral Tablet 197570 Desipramine 75 MG Oral Tablet 197629 Doxepin 10 MG Oral Capsule 197630 Doxepin 100 MG Oral Capsule 197631 Doxepin 150 MG Oral Capsule 197632 Doxepin 75 MG Oral Capsule 198045 Nortriptyline 10 MG Oral Capsule 198046 Nortriptyline 50 MG Oral Capsule 198047 Nortriptyline 75 MG Oral Capsule 199283 Nortriptyline 10 MG Oral Tablet 199406 Nortriptyline 25 MG Oral Tablet 199820 Trimipramine 25 MG Oral Tablet 250033 Trimipramine 10 MG Oral Tablet 309671 Desipramine 25 MG Oral Capsule 309672 Desipramine 50 MG Oral Capsule 310019 Doxepin 10 MG/ML Oral Solution 310020 Doxepin 25 MG Oral Capsule 310021 Doxepin 50 MG/ML Topical Cream 310022 Doxepin 50 MG Oral Capsule 312036 Nortriptyline 2 MG/ML Oral Solution 313496 Trimipramine 100 MG Oral Capsule 313498 Trimipramine 25 MG Oral Capsule 313499 Trimipramine 50 MG Oral Capsule 317136 Nortriptyline 25 MG Oral Capsule 484938 Desipramine 50 MG Enteric Coated Tablet 835564 Imipramine Hydrochloride 25 MG Oral Tablet 835568 Imipramine Hydrochloride 50 MG Oral Tablet 835572 Imipramine pamoate 75 MG Oral Capsule 835577 Imipramine pamoate 150 MG Oral Capsule 251 .

25 MG Disintegrating Tablet 859193 selegiline hydrochloride 5 MG Oral Tablet 865206 24 HR selegiline hydrochloride 0.25 MG/HR Transdermal Patch 252 .5 MG/ML Injectable Solution Clomipramine Hydrochloride 10 MG Oral Capsule Clomipramine Hydrochloride 25 MG Oral Capsule Clomipramine Hydrochloride 50 MG Oral Capsule Clomipramine Hydrochloride 75 MG Oral Capsule Clomipramine Hydrochloride 75 MG Extended Release Tablet Fluphenazine Hydrochloride 0.5 MG / Nortriptyline 10 MG Oral Tablet Fluphenazine Hydrochloride 1.835582 835586 835589 835591 835593 856762 856773 856783 856834 856845 856853 856859 856862 856865 856867 856868 857289 857292 857297 857301 857305 857326 865143 865146 892742 894755 894759 894763 905168 905172 966787 Imipramine Hydrochloride 12.5 MG/ML Injectable Solution Imipramine Hydrochloride 5 MG/ML Oral Solution Imipramine pamoate 125 MG Oral Capsule Imipramine pamoate 100 MG Oral Capsule Imipramine Hydrochloride 10 MG Oral Tablet Amitriptyline Hydrochloride 100 MG Oral Tablet Amitriptyline Hydrochloride 150 MG Oral Tablet Amitriptyline Hydrochloride 10 MG Oral Tablet Amitriptyline Hydrochloride 25 MG Oral Tablet Amitriptyline Hydrochloride 50 MG Oral Tablet Amitriptyline Hydrochloride 75 MG Oral Tablet Amitriptyline Hydrochloride 10 MG/ML Injectable Solution Amitriptyline Hydrochloride 10 MG/ML Oral Solution Amitriptyline Hydrochloride 25 MG Extended Release Capsule Amitriptyline Hydrochloride 5 MG/ML Oral Solution Amitriptyline Hydrochloride 50 MG Extended Release Capsule Clomipramine Hydrochloride 12.5 MG / Nortriptyline 30 MG Oral Tablet Clomipramine Hydrochloride 20 MG Oral Tablet Clomipramine Hydrochloride 40 MG Oral Tablet Clomipramine Hydrochloride 5 MG Oral Tablet Clomipramine Hydrochloride 80 MG Oral Tablet Protriptyline Hydrochloride 10 MG Oral Tablet Protriptyline Hydrochloride 5 MG Oral Tablet Doxepin 3 MG Oral Tablet Medication Dispensed – Monoamine Oxidase Inhibitors RxNorm Description 104837 Isocarboxazid 10 MG Oral Tablet 312347 Phenelzine 15 MG Oral Tablet 313447 Tranylcypromine 10 MG Oral Tablet 859186 selegiline hydrochloride 5 MG Oral Capsule 859190 selegiline hydrochloride 1.

5 MG / Chlordiazepoxide 5 MG Oral Tablet 856792 Amitriptyline Hydrochloride 25 MG / Chlordiazepoxide 10 MG Oral Tablet 856797 Amitriptyline Hydrochloride 25 MG / Perphenazine 2 MG Oral Tablet 856825 Amitriptyline Hydrochloride 25 MG / Perphenazine 4 MG Oral Tablet 856840 Amitriptyline Hydrochloride 50 MG / Perphenazine 4 MG Oral Tablet 856863 Amitriptyline Hydrochloride 12.865210 865214 865218 865220 865222 880383 897069 24 HR selegiline hydrochloride 0.5 MG / Chlordiazepoxide 10 MG Oral Tablet Medication Dispensed – Tetracyclic antidepressants RxNorm Description 104817 Maprotiline 10 MG Oral Tablet 197909 Maprotiline 25 MG Oral Tablet 197910 Maprotiline 50 MG Oral Tablet 197911 Maprotiline 75 MG Oral Tablet 283406 Mirtazapine 15 MG Disintegrating Tablet 283407 Mirtazapine 30 MG Disintegrating Tablet 283485 Mirtazapine 45 MG Disintegrating Tablet 311725 Mirtazapine 15 MG Oral Tablet 311726 Mirtazapine 45 MG Oral Tablet 314111 Mirtazapine 30 MG Oral Tablet 476809 Mirtazapine 7.5 MG Oral Tablet Medication Dispensed – SSRI antidepressants RxNorm Description 151260 Fluoxetine 60 MG Oral Capsule 200371 Citalopram 20 MG Oral Tablet 253 .375 MG/HR Transdermal Patch 24 HR selegiline hydrochloride 0.25 MG Oral Tablet selegiline hydrochloride 10 MG Oral Tablet selegiline hydrochloride 2 MG/ML Oral Solution selegiline hydrochloride 15 MG Oral Tablet selegiline hydrochloride 30 MG Oral Tablet Medication Dispensed – Psychotherapeutic combinations RxNorm Description 403969 Fluoxetine 25 MG / olanzapine 6 MG Oral Capsule 403970 Fluoxetine 25 MG / olanzapine 12 MG Oral Capsule 403971 Fluoxetine 50 MG / olanzapine 12 MG Oral Capsule 403972 Fluoxetine 50 MG / olanzapine 6 MG Oral Capsule 721787 Fluoxetine 25 MG / olanzapine 3 MG Oral Capsule 856706 Amitriptyline Hydrochloride 10 MG / Perphenazine 2 MG Oral Tablet 856720 Amitriptyline Hydrochloride 10 MG / Perphenazine 4 MG Oral Tablet 856769 Amitriptyline Hydrochloride 12.5 MG/HR Transdermal Patch selegiline hydrochloride 1.

248642 251200 283672 309313 309314 310384 310385 312241 312242 312243 312244 312938 312940 312941 313989 313990 313995 314199 349332 351249 351250 351285 389202 541357 562790 562791 562815 645289 645290 645291 730440 730441 730442 794947 803293 826098 826103 861064 902714 902718 903873 254 Fluoxetine 20 MG Oral Tablet Sertraline 200 MG Oral Tablet Citalopram 10 MG Oral Tablet Citalopram 2 MG/ML Oral Solution Citalopram 40 MG Oral Tablet Fluoxetine 10 MG Oral Capsule Fluoxetine 20 MG Oral Capsule Paroxetine 10 MG Oral Tablet Paroxetine 2 MG/ML Oral Suspension Paroxetine 30 MG Oral Tablet Paroxetine 40 MG Oral Tablet Sertraline 100 MG Oral Tablet Sertraline 25 MG Oral Tablet Sertraline 50 MG Oral Tablet Fluoxetine 40 MG Oral Capsule Fluoxetine 10 MG Oral Tablet Fluoxetine 90 MG Enteric Coated Capsule Paroxetine 20 MG Oral Tablet Escitalopram 10 MG Oral Tablet Escitalopram 5 MG Oral Tablet Escitalopram 20 MG Oral Tablet Escitalopram 1 MG/ML Oral Solution Citalopram 40 MG/ML Oral Solution Fluoxetine 40 MG Oral Tablet Paroxetine 12.5 MG Extended Release Tablet Citalopram 10 MG Disintegrating Tablet Citalopram 20 MG Disintegrating Tablet Citalopram 40 MG Disintegrating Tablet Citalopram 10 MG Oral Capsule Citalopram 20 MG Oral Capsule Citalopram 40 MG Oral Capsule Sertraline 150 MG Oral Tablet Fluoxetine 15 MG Oral Tablet Fluoxetine Hydrochloride 8 MG Chewable Tablet Fluoxetine Hydrochloride 64 MG Chewable Tablet Sertraline 20 MG/ML Oral Solution Fluoxetine Hydrochloride 16 MG Chewable Tablet Fluoxetine Hydrochloride 32 MG Chewable Tablet 24 HR Fluvoxamine Maleate 100 MG Extended Release Capsule .5 MG Extended Release Tablet Paroxetine 25 MG Extended Release Tablet Paroxetine 37.

903876 903879 903882 903884 903887 903891 Fluvoxamine Maleate 100 MG Extended Release Capsule 24 HR Fluvoxamine Maleate 150 MG Extended Release Capsule Fluvoxamine Maleate 150 MG Extended Release Capsule Fluvoxamine Maleate 100 MG Oral Tablet Fluvoxamine Maleate 25 MG Oral Tablet Fluvoxamine Maleate 50 MG Oral Tablet Encounter .ED CPT Description 99281 EMER DEPT SELF LIMITED/MINOR 99282 EMER DEPT LOW TO MODERATE SEVERITY 99283 EMER DEPT MODERATE SEVERITY 99284 EMER DEPT HI SEVERITY&URGENT EVAL 99285 EMER DEPT HIGH SEVERITY&THREAT FUNCJ Encounter – outpatient BH CPT Description 90804 IPI-OB-M/S OFFICE 20-30 MIN 90805 IPI-OB-M/S OFFICE 20-30 MIN MEDICAL E/M 90806 IPI-OB-M/S OFFICE 45-50 MIN 90807 IPI-OB-M/S OFFICE 45-50 MIN MEDICAL E/M 90808 IPI-OB-M/S OFFICE 75-80 MIN 90809 IPI-OB-M/S OFFICE 75-80 MIN MEDICAL E/M 90810 INDIV PSYCTX IA 20-30 MIN 90811 INDIV PSYCTX IA 20-30 MIN MEDICAL E/M 90812 INDIV PSYCTX IA 45-50 MIN 90813 INDIV PSYCTX IA 45-50 MIN MEDICAL E/M 90814 INDIV PSYCTX IA 75-80 MIN 90815 INDIV PSYCTX IA 75-80 MIN MEDICAL E/M 98960 EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT 98961 EDUCATION&TRAINING SELF-MGMT NONPHYS 2-4 PTS 98962 EDUCATION&TRAINING SELF-MGMT NONPHYS 5-8 PTS 99078 PHYS EDUCATIONAL SVCS RENDERED PTS GRP SETTING 99201 OFFICE OUTPT NEW 10 MIN 99202 OFFICE OUTPT NEW 20 MINUTES 99203 OFFICE OUTPT NEW 30 MIN 99204 OFFICE OUTPT NEW 45 MIN 99205 OFFICE OUTPT NEW 60 MIN 99211 OFFICE O/P EST 5 MIN 99212 OFFICE OUTPT EST 10 MIN 99213 OFFICE OUTPT EST15 MIN 99214 OFFICE OUTPT EST 25 MIN 255 .

99215 99217 99218 99219 99220 99241 99242 99243 99244 99245 99341 99342 99343 99344 99345 99347 99348 99349 99350 99384 99385 99386 99387 99394 99395 99396 99397 99401 99402 99403 99404 99408 99409 99411 99412 99510 OFFICE OUTPT EST 40 MIN OBS CARE DSCHRG D MGMT 1ST OBS CARE PR D LOW SEVERITY 1ST OBS CARE PR D MODERATE SEVERITY 1ST OBS CARE PR D HIGH SEVERITY OFFICE CONSLTJ 15 MIN OFFICE CONSLTJ 30 MIN OFFICE CONSLTJ 40 MIN OFFICE CONSLTJ 60 MIN OFFICE CONSLTJ 80 MIN HOME VST NEW PT LOW SEVERITY HOME VST NEW PT MOD SEVERITY HOME VST NEW PT MOD TO HI SEVERITY HOME VST NEW PT HI SEVERITY HOME VST NEW PT UNSTABLE/SIGNIFICANT NEW PROBLEM HOME VST EST PT SELF LIMITED/MINOR HOME VST EST PT LOW TO MOD SEVERITY HOME VST EST PT MOD TO HI SEVERITY HOME VST EST PT UNSTABLE/SIGNIFICANT NEW PROBLEM 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 12-17 YR 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 18-39YRS 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 40-64YRS 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 65YRS&> PERIODIC PREVENTIVE MED EST PATIENT AGE 12-17YRS PERIODIC PREVENTIVE MED EST PATIENT AGE 18-39YRS PERIODIC PREVENTIVE MED EST PATIENT AGE 40-64YRS PERIODIC PREVENTIVE MED EST PATIENT AGE 65YRS&> PREV MED CNSL INDIV SPX 15 MIN PREV MED CNSL INDIV SPX 30 MIN PREV MED CNSL INDIV SPX 45 MIN PREV MED CNSL INDIV SPX 60 MIN ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN ALCOHOL/SUBSTANCE SCREEN & INTERVEN >30 MIN PREV MED CNSL GRP SPX 30 MIN PREV MED CNSL GRP SPX 60 MIN HOME VST INDIV FAM/MARRIAGE CNSL Encounter – non-acute inpatient CPT Description 99304 1ST NF CARE PR D E/M LW SEVERITY 99305 1ST NF CARE PR D E/M MOD SEVERITY 256 .

99306 99307 99308 99309 99310 99315 99316 99318 99324 99325 99326 99327 99328 99334 99335 99336 99337 1ST NF CARE PR D E/M HI SEVERITY SBSQ NF CARE PR D E/M STABLE SBSQ NF CARE PR D E/M MINOR COMPLCTJ SBSQ NF CARE PR D E/M NEW PROBLEM SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM NF DSCHRG D MGMT 30 MIN/< NF DSCHRG D MGMT > 30 MIN E/M PT INVG ANNUAL NF ASSMT DOM/R-HOME LW SEVERITY DOM/R-HOME E/M NEW PT MOD SEVERITY DOM/R-HOME E/M NEW PT MOD HI SEVERITY DOM/R-HOME E/M NEW PT HI SEVERITY DOM/R-HOME E/M NEW PT SIGNIFICANT NEW PROBLEM DOM/R-HOME E/M EST PT SELF-LMTD/MINOR DOM/R-HOME E/M EST PT LW MOD SEVERITY DOM/R-HOME E/M EST PT MOD HI SEVERITY DOM/R-HOME E/M EST PT SIGNIFICANT NEW PROBLEM Encounter – acute inpatient CPT Description 99221 1ST HOSP CARE PR D 30 MIN 99222 1ST HOSP CARE PR D 50 MIN 99223 1ST HOSP CARE PR D 70 MIN 99231 SBSQ HOSP CARE PR D 15 MIN 99232 SBSQ HOSP CARE PR D 25 MIN 99233 SBSQ HOSP CARE PR D 35 MIN 99238 HOSP DSCHRG D MGMT 30 MIN/< 99239 HOSP DSCHRG D MGMT > 30 MIN 99251 1ST INPT CONSLTJ 20 MIN 99252 1ST INPT CONSLTJ 40 MIN 99253 1ST INPT CONSLTJ 55 MIN 99254 1ST INPT CONSLTJ 80 MIN 99255 1ST INPT CONSLTJ 110 MIN 99291 CC E/M CRITICALLY ILL/INJURED 1ST 30-74 MIN 257 .

4 Malignant neoplasm of cecum 153.8 Malignant neoplasm of other specified sites of large intestine 153.02 Cyclic neutropenia 288.09 Other neutropenia 89. Active or inactive diagnosis of colon cancer ICD-9 Description 153 Malignant neoplasm of colon 153.7 Malignant neoplasm of liver.3 Malignant neoplasm of sigmoid colon 153.5 Malignant neoplasm of appendix vermiformis 153. or have previously received adjuvant chemotherapy within the 12-month reporting period. specified as secondary Active diagnosis acute renal insufficiency 593.53 Neutropenic splenomegaly Active diagnosis leucopenia 288.9 Malignant neoplasm of colon. unspecified Active diagnosis metastatic sites common to colon cancer 197.7 Malignant neoplasm of splenic flexure 153.MENU) Description: Percentage of patients aged 18 years and older with Stage IIIA through IIIC colon cancer who are referred for adjuvant chemotherapy.1 Malignant neoplasm of transverse colon 153.04 Neutropenia due to infection 288.Oncology Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients (NQF 0385) (Additional Measure .2 Malignant neoplasm of descending colon 153.03 Drug induced neutropenia 288. prescribed adjuvant chemotherapy.9 Unspecified disorder of kidney and ureter Active diagnosis neutropenia 288 Diseases of white blood cells 288.5 Decreased white blood cell count 288.59 Other decreased white blood cell count Procedure result: colon cancer stage III SNOMED 261654001 261656004 261657008 261658003 369921003 258 Description Tumour stage T3a Tumour stage T3bi Tumour stage T3bii Tumour stage T3c T3: Colon/rectum tumour invades through the muscularis propria into the subserosa or the nonperitonealized pericolic or perirectal soft .6 Malignant neoplasm of ascending colon 153.

grade 4 Colon Cancer History V10.05 Personal history of malignant neoplasm of large intestine 259 .grade 2 423053003 ECOG performance status .370046006 tissues T3a.b: Colon/rectum tumour invades <=5 mm beyond the border of the muscularis propria Chemotherapy medication for colon cancer ordered or administered RxNorm Description 105583 Fluorouracil 5 % Topical Cream 105584 Fluorouracil 250 MG Oral Capsule 105691 Leucovorin 7.Enter past medical history SNOMED Description 422894000 ECOG performance status .grade 3 423237006 ECOG performance status .5 MG/ML Injectable Solution 197352 Aminoglutethimide 250 MG Oral Tablet 197709 Fluorouracil 10 MG/ML Topical Cream 197860 Leucovorin 10 MG Oral Tablet 197861 Leucovorin 15 MG Oral Tablet 197862 Leucovorin 25 MG Oral Tablet 197863 Leucovorin 5 MG Oral Tablet 199224 anastrozole 1 MG Oral Tablet 199316 200327 200328 237788 239177 244197 250288 284191 310261 310378 310379 311282 388641 Fluorouracil 25 MG/ML Injectable Solution capecitabine 150 MG Oral Tablet capecitabine 500 MG Oral Tablet Leucovorin 20 MG/ML Injectable Solution Fluorouracil 50 MG/ML Injectable Solution Leucovorin 5 MG/ML Injectable Solution Leucovorin 3 MG/ML Injectable Solution Fluorouracil 5 MG/ML Topical Cream exemestane 25 MG Oral Tablet Fluorouracil 10 MG/ML Topical Solution Fluorouracil 20 MG/ML Topical Solution Leucovorin 10 MG/ML Injectable Solution Leucovorin 25 MG/ML Injectable Solution Poor performance status for ECOG performance .

9 Malignant neoplasm of axillary tail of female breast Malignant neoplasm of other specified sites of female breast Malignant neoplasm of breast (female).enter in past medical history SNO-MED 261650005 261653007 261658003 Description Tumor stage T1c Tumor stage T2c Tumor stage T3c T1c: >1 cm but <= 2 cm in greatest dimension: BREAST: Complete excision less than total mastectomy. Active diagnosis of breast cancer – Enter in Diagnosis in the SOAP note Description ICD9 174 Malignant neoplasm of female breast 174.3 Malignant neoplasm of lower-inner quadrant of female breast 174. modified radical mastectomy.MENU) Description: Percentage of female patients aged 18 years and older with Stage IC through IIIC. unspecified Inactive diagnosis of breast cancer history ICD9 Description V10.3 Secondary malignant neoplasm of brain and spinal cord 198.3 Personal history of malignant neoplasm of breast Active diagnosis of metastatic sites common to breast cancer – Enter in SOAP note ICD9 Description 197 Secondary malignant neoplasm of respiratory and digestive systems 197.1 Malignant neoplasm of central portion of female breast 174.8 174.7 Malignant neoplasm of liver.6 174.past medical history or in procedures SNO-MED Description 416053008 Estrogen receptor positive tumor 416561008 Progesterone receptor positive tumor 417181009 Hormone receptor positive malignant neoplasm of breast 417742002 Hormone receptor positive tumor 260 .5 Secondary malignant neoplasm of bone and bone marrow Procedure-breast cancer Stage IC-IIIC. total mastectomy.2 Malignant neoplasm of upper-inner quadrant of female breast 174. specified as secondary 198.4 Malignant neoplasm of upper-outer quadrant of female breast 174.5 Malignant neoplasm of lower-outer quadrant of female breast 174. radical mastectomy T2: Breast tumor > 2 cm but <= 5 cm in greatest dimension T3: Breast tumor >5 cm in greatest dimension 369899008 369900003 369901004 Breast cancer ER or PR positive. ER or PR positive breast cancer who were prescribed tamoxifen or aromatase inhibitor (AI) during the 12-month reporting period.Oncology Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR Positive Breast Cancer) (NQF 0387) (Additional Measure .

5 MG Oral Tablet 261 .427685000 HER2-positive carcinoma of breast Procedure bilateral oophorectomy – Enter in past medical history or procedures CPT 58720 SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX 58940 OOPHORECTOMY PRTL/TOT UNI/BI 58943 OOPHORECTOMY PRTL/TOT UNI/BI OVARIAN MAL 58951 RESCJ PRIM PRTL MAL W/BSO&OMNTC TAH&LMPHADEC 58952 RESCJ PRIM PRTL MAL W/BSO&OMNTC RAD DEBULKING 58953 BSO W/OMNTC TAH&RAD DSJ DEBULKING 58954 BSO W/OMNTC TAH DEBULKING W/LMPHADEC 58956 BSO TOT OMNTC TAH MAL Procedure performed radiation therapy CPT Codes Description 77427 RADJ TX MGMT 5 TXS 77435 STEREOTACTIC BODY RADIATION MANAGEMENT 77470 SPEC TX PX Procedure performed chemotherapy.Enter in past medical history or procedures CPT Codes Description 96401 CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO 96402 CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO 96405 CHEMOTX ADMN ILESN UP&W/7 < 96406 CHEMOTX ADMN ILESN > 7 96409 CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG 96411 CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG 96413 CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG 96415 CHEMOTHERAPY ADMN IV INFUSION TQ EA HR 96416 CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP 96417 CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR 96420 CHEMOTX ADMN IA PUSH TQ 96422 CHEMO IA INFUSION UP TO 1 HR 96423 CHEMOTHERAPY ADMN INTRAARTERIAL INFUSION EA HR 96425 CHEMOTX ADMN IA NFS > 8 HR PRTBLE IMPLTBL PMP 96440 CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS 96445 CHEMOTX ADMN PRTL CAVITY REQ&W/PRITONEOCNTS 96450 CHEMOTX ADMN CNS REQ&W/SPI PNXR 96521 RFL/MAIN PORTABLE PMP 96522 RFL/MAIN IMPLTABLE PMP/RSVR F/DRUG DLVR SYSIC 96523 IRRIGATION IMPLTED VAD F/DRUG DLVR SYSS 96542 CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1+ AGENTS 96549 UNLIS CHEMOTX PX Medication ordered or active of tamoxifen or aromatase inhibitor RX Codes Description 198240 Tamoxifen 10 MG Oral Tablet 199224 anastrozole 1 MG Oral Tablet 200064 letrozole 2.

6 MG Drug Implant 348163 histrelin 0.375 ML Leuprolide Acetate 120 MG/ML Prefilled Syringe 752889 0.88 MG/ML Injectable Suspension 905053 Triptorelin 11.8 MG Drug Implant 310592 Goserelin 3.25 MG/ML Prefilled Syringe 763359 1 ML Leuprolide 15 MG/ML Prefilled Syringe 727600 1 ML Leuprolide 3.15 MG/ACTUAT Nasal Spray 247495 Buserelin 1 MG/ML Injectable Solution 314008 Goserelin 10.3 MG/ML Injectable Suspension 642361 Triptorelin 2.2 MG/ACTUAT Nasal Spray 199821 Triptorelin 1.1 MG/ACTUAT Nasal Spray 108754 Buserelin 0.5 ML Leuprolide 20 MG/ML Prefilled Syringe 727935 1.25 ML Leuprolide Acetate 30 MG/ML Prefilled Syringe 752884 0.5 ML Leuprolide 7.5 ML Leuprolide 15 MG/ML Prefilled Syringe 763348 1.5 ML Leuprolide Acetate 60 MG/ML Prefilled Syringe 763392 1 ML Leuprolide 11.63 MG/ML Injectable Suspension 262 .5 MG/ML Injectable Solution 348161 histrelin 1 MG/ML Injectable Solution 597333 histrelin 50 MG Drug Implant 204864 Leuprolide 15 MG/ML Injectable Solution 259291 Leuprolide 20 MG/ML Injectable Suspension 204418 Leuprolide 3.62 MG/ML Injectable Suspension 905062 Triptorelin 5.5 MG/ML Prefilled Syringe 727938 1.1 MG/ML Injectable Suspension 353530 Triptorelin 5.250423 310261 313195 389230 Tamoxifen 40 MG Oral Tablet exemestane 25 MG Oral Tablet Tamoxifen 20 MG Oral Tablet Tamoxifen 2 MG/ML Oral Solution Active medication of gonadotropin-releasing hormone analogue RxNorm Description 752899 0.75 MG/ML Prefilled Syringe 763346 1 ML Leuprolide 7.2 MG/ML Injectable Solution 348162 histrelin 0.5 MG/ML Injectable Suspension 583425 Leuprolide Acetate 120 MG/ML Injectable Suspension 853483 Nafarelin 0.5 MG/ML Prefilled Syringe 105629 Buserelin 0.75 MG/ML Injectable Suspension 311283 Leuprolide 5 MG/ML Injectable Solution 284986 Leuprolide 65 MG Drug Implant 197866 Leuprolide 7.

with a diagnosis of prostate cancer at low risk of recurrence receiving interstitial prostate brachytherapy.1 Pain in thoracic spine 724. OR external beam radiotherapy to the prostate.5 Backache.MENU) Description: Percentage of patients.9 Other and unspecified disorders of bone and cartilage 786.Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients (NQF 0389) (Additional Measure .44 Screening for malignant neoplasms of prostate V84.79 Other disorders of coccyx 733.3 Neoplasm related pain (acute) (chronic) 724. OR cryotherapy who did not have a bone scan performed at any time since diagnosis of prostate cancer.03 Genetic susceptibility to malignant neoplasm of prostate Procedure performed of Prostate Cancer Treatment CPT Description 55810 PRST8ECT PRNL RAD 55812 PRST8ECT PRNL RAD LYMPH NODE BX 55815 PRST8ECT PRNL RAD BI PEL LMPHADEC 55840 PRST8ECT RETROPUBIC RAD +-NRV SPARING 55842 PRST8ECT RETROPUBIC RAD LYMPH NODE BX 55845 PRST8ECT RETROPUBIC RAD W/BI PEL LMPHADEC 55866 LAPS PRST8ECT RETROPUBIC RAD W/NRV SPARING 55873 CRYOSURG ABLATION PROSTATE US & MONITORING 77427 RADJ TX MGMT 5 TXS 77776 NTRSTL RADJ SRC APPL SMPL 77777 NTRSTL RADJ SRC APPL INTRM 77778 NTRSTL RADJ SRC APPL CPLX 77787 REMOTE AFTLD RADIONUCLIDE BRACHYTX > 12 CHANNEL 263 . unspecified 724.59 Other chest pain 789 Other symptoms involving abdomen and pelvis V76. OR radical prostatectomy.6 Disorders of sacrum 724. regardless of age.5 Chest pain 786. Active diagnosis of prostate cancer ICD-9 Description 185 Malignant neoplasm of prostate Active diagnosis of pain related to prostate cancer ICD-9 Description 338.

TOTAL:MFR:PT:SER/PLAS:QN: Prostate specific Ag/Prostate volume calculated from height.total in Serum or Plasma PROSTATE SPECIFIC AG.Procedure result of AJCC Cancer Stage Low Risk Recurrence Prostate Cancer SNOMED Description 261650005 Tumor stage T1c 261651009 Tumor stage T2a Procedure performed of Salvage Therapy CPT 55860 55862 55865 55875 55876 Description PRST8 SPEC AG CPLXED DIR MEAS EXPOS PRST8 INSJ RADACT NODE BX EXPOS PRST8 INSJ RADACT BI PEL LMPHADEC TPRNL PLMT NDL/CATHS INTO PRST8 RADJ INSJ PLACE INTSTITL DEV RADIATN TX PERQ PROSTATE 1+ Diagnostic study performed of bone scan CPT Description 78300 B1&/JT IMG LMTD AREA 78305 B1&/JT IMG MLT AREAS 78306 B1&/JT IMG WHBDY 78315 B1&/JT IMG 3 PHASE STD 78320 B1&/JT IMG TOMOG SPECT 78350 B1 DNS STD 1+ SITS 1 PHTN ABSRPTM 78351 B1 DNS STD 1+ SITS DUAL PHTN ABSRPTM 1+ SITS Laboratory test result for Prostate Apecific Antigen Test result <= 10 mg/dL CPT Description 84152 PRST8 SPEC AG CPLXED DIR MEAS 84153 PRST8 SPEC AG TOT 84154 PRST8 SPEC AG FR LOINC 10508-0 10886-0 12841-3 14120-0 15323-9 15324-7 15325-4 19195-7 19197-3 19198-1 19199-9 264 Description Prostate specific Ag [Presence] in Tissue by Immune stain Prostate Specific Ag Free [Mass/volume] in Serum or Plasma Prostate Specific Ag Free/Prostate specific Ag. width & length Prostate specific Ag/Prostate volume calculated from planimetry Prostate specific Ag/Prostate volume calculated Prostate specific Ag [Units/volume] in Serum or Plasma Prostate specific Ag [Moles/volume] in Serum or Plasma Prostate specific Ag [Units/volume] in Semen Prostate specific Ag [Mass/volume] in Semen .FREE/PROSTATE SPECIFIC AG.

protein bound [Mass/volume] in Serum or Plasma Prostate specific Ag [Mass/volume] in Urine Prostate specific Ag [Mass/volume] in Serum or Plasma by Detection limit = 0.01 ng/mL Lab test result of gleason score <= 6 LOINC Description 35266-6 Gleason score in Specimen Qualitative 265 .19200-5 19201-3 19203-9 19204-7 19205-4 19206-2 2857-1 33667-7 34611-4 35741-8 Prostate specific Ag [Moles/volume] in Semen Prostate Specific Ag Free [Units/volume] in Serum or Plasma Prostate Specific Ag Free [Moles/volume] in Serum or Plasma Prostate Specific Ag Free [Units/volume] in Semen Prostate Specific Ag Free [Mass/volume] in Semen Prostate Specific Ag Free [Moles/volume] in Semen Prostate specific Ag [Mass/volume] in Serum or Plasma Prostate specific Ag.

Type One [juvenile].Diabetes: HbA1c Control (<8%) (NQF 0575) (Additional Measure . Not Stated As Uncontrolled. not stated as uncontrolled.12 Diabetes Mellitus With Ketoacidosis. Type Two or unspecified type. Not Stated As Uncontrolled. Type Two or unspecified type. even 266 . even if the patient requires insulin 250. 250. Type one [juvenile type].02 Diabetes Mellitus Without Mention Of Complication.11 Diabetes Mellitus With Ketoacidosis. Fifth digit 2 is for use with type two patients. Fifth digit 0 is for use with type two patients.13 Diabetes Mellitus With Ketoacidosis.0%. Type Two or unspecified type. Fifth digit 0 is for use with type two patients.4 Diabetes With Renal Manifestations 250. Not Stated As Uncontrolled 250.20 Diabetes Mellitus With Hyperosmolar Coma. Not Stated As Uncontrolled. Type One [juvenile type] Not Stated As Uncontrolled 250. Fifth digit 0 is for use with type two patients. Uncontrolled 250.MENU) Description: The percentage of patients 18-75 years of age with diabetes (type 1 or type 2) who had HbA1c < 8. Type Two or unspecified type.10 Diabetes Mellitus With Ketoacidosis. uncontrolled. even if the patient requires insulin 250. even if the patient requires insulin 250. Type Two or unspecified type. Not Stated As Uncontrolled 250. Fifth digit 0 is for use with type two patients. even if the patient requires insulin. ICD-9 Description 250 Diabetes Mellitus 250. even if the patient requires insulin 250. Active diagnosis: Diabetes <= 2 years before the end of the measurement period. even if the patient requires insulin 250. Type One [juvenile type].00 Diabetes Mellitus Without Mention Of Complication. Type One [juvenile]. even if the patient requires insulin 250. Not Stated As Uncontrolled.32 Diabetes Mellitus With Other Coma. Type One [juvenile type].0 Diabetes Mellitus Without Mention Of Complication 250.23 Diabetes Mellitus With Hyperosmolar Coma. Uncontrolled.03 Diabetes Mellitus Without Mention Of Complication. Uncontrolled 250. Type One [juvenile type]. Type Two or unspecified type. uncontrolled 250. Uncontrolled. type two or unspecified type. Fifth digit 2 is for use with type two patients.30 Diabetes Mellitus With Other Coma. not stated as uncontrolled. Fifth digit 0 is for use with type two patients. Type two or unspecified type.21 Diabetes Mellitus With Hyperosmolar Coma. Type Two or unspecified type.31 Diabetes Mellitus With Other Coma.40 Diabetes Mellitus With Renal Manifestations.01 Diabetes Mellitus Without Mention Of Complication.22 Diabetes Mellitus With Hyperosmolar Coma. Uncontrolled. 250. Type one [juvenile type]. Fifth digit 2 is for use with type two patients.33 Diabetes Mellitus With Other Coma. even if the patient requires insulin 250. Fifth digit 2 is for use with type two patients. Uncontrolled 250.

Type Two or unspecified type. Fifth-digit 2 is for use with type two patients. Type Two or unspecified type.50 250. Not Stated As Uncontrolled. Uncontrolled Diabetes With Other Specified Manifestations Diabetes Mellitus With Other Specified Manifestations. even if the patient requires insulin Diabetes Mellitus With Ophthalmic Manifestations. Uncontrolled.72 250.61 250. Fifth-digit 0 is for use with type two patients. Fifth-digit 2 is for use with type two patients.250. Fifth-digit 2 is for use with type two patients. Type Two or unspecified type. Fifth-digit 0 is for use with type two patients.62 250. Uncontrolled Diabetes Mellitus With Neurological Manifestations.63 250. Not Stated As Uncontrolled Diabetes Mellitus With Peripheral Circulatory Disorders.7 250. Uncontrolled Diabetes Mellitus With Ophthalmic Manifestations. Type One [juvenile type]. Uncontrolled.41 250. Type One [juvenile type]. Type One [juvenile type].42 250.43 250.51 250. Uncontrolled. Type One [juvenile type]. Type Two or unspecified type.80 if the patient requires insulin Diabetes Mellitus With Renal Manifestations. even if the patient requires insulin Diabetes Mellitus With Other Specified Manifestations. even if the patient requires insulin Diabetes Mellitus With Neurological Manifestations. Fifth-digit 0 is for use with type two patients. Type Two or unspecified type. Type Two or unspecified type.71 250. even if the patient requires insulin 250. Fifth-digit 2 is for use with type two patients. Fifth-digit 0 is for use with type two patients. Not Stated As Uncontrolled Diabetes Mellitus With Ophthalmic Manifestations. Fifth digit 2 is for use with type two patients. Type One [juvenile type]. Type Two or unspecified type.70 250.53 250.73 250. Type One [juvenile type] Not Stated As Uncontrolled Diabetes Mellitus With Neurological Manifestations. Type One [juvenile type]. Uncontrolled.82 267 .52 250. Type Two or unspecified type. even if the patient requires insulin Diabetes Mellitus With Neurological Manifestations. even if the patient requires insulin Diabetes Mellitus With Ophthalmic Manifestations. Uncontrolled. even if the patient requires insulin Diabetes Mellitus With Peripheral Circulatory Disorders. Not Stated As Uncontrolled. Type One [juvenile type] Uncontrolled Diabetes With Peripheral Circulatory Disorders Diabetes Mellitus With Peripheral Circulatory Disorders. Type Two or unspecified type.8 250. Not Stated As Uncontrolled. even if the patient requires insulin Diabetes Mellitus With Peripheral Circulatory Disorders.60 250. Not Stated As Uncontrolled. Not Stated As Uncontrolled Diabetes Mellitus With Other Specified Manifestations. Not Stated As Uncontrolled Diabetes Mellitus With Renal Manifestations. Type One [juvenile type]. even if the patient requires insulin Diabetes Mellitus With Renal Manifestations.81 250.

03 362.9 250. Or The Puerperium.2 362. Not Stated As Uncontrolled Diabetes Mellitus With Unspecified Complication. Uncontrolled Diabetes With Unspecified Complication Diabetes Mellitus With Unspecified Complication.01 The most recent lab test for HbA1c with results of less than 8.250. Childbirth.0 362.02 362. Childbirth. Type Two or unspecified type. even if the patient requires insulin Diabetes Mellitus With Unspecified Complication.0 648. Type One [juvenile type]. Complicating Pregnancy.05 362.93 357. With Delivery 250. Fifth-digit 2 is for use with type two patients.91 250.04 362.0% • Patients will be excluded if: • They have an active diagnosis of polycystic ovaries 256. Fifth-digit 0 is for use with type two patients. Uncontrolled Polyneuropathy In Diabetes Diabetic Retinopathy Background Diabetic Retinopathy Proliferative Diabetic Retinopathy Nonproliferative diabetic retinopathy NOS Mild nonproliferative diabetic retinopathy Moderate nonproliferative diabetic retinopathy Severe nonproliferative diabetic retinopathy Diabetic macular edema Diabetic Cataract Diabetes Mellitus Complicating Pregnancy.00 648.01 362.83 250. Not Stated As Uncontrolled.41 648. Or The Puerperium Diabetes Mellitus Of Mother.4 Polycystic Ovaries 268 .92 250. Type One [juvenile type]. even if the patient requires insulin Diabetes Mellitus With Unspecified Complication. Type One [juvenile type]. Type Two or unspecified type.90 Diabetes Mellitus With Other Specified Manifestations.06 362. Unspecified As To Episode Of Care Diabetes Mellitus Of Mother. Uncontrolled.07 366.

8 Secondary diabetes mellitus with other specified manifestations 249.83 Abnormal Glucose Tolerance Of Mother.61 Secondary diabetes mellitus with neurological manifestations. Or The Puerperium 648.81 Abnormal Glucose Tolerance Of Mother.6. uncontrolled 249. not stated as uncontrolled. uncontrolled 249.2 Secondary diabetes mellitus with hyperosmolarity 249.50 Secondary diabetes mellitus with ophthalmic manifestations. not stated as uncontrolled.80 Secondary diabetes mellitus with other specified manifestations. Complicating Pregnancy.71 Secondary diabetes mellitus with peripheral circulatory disorders. With Delivery.20 Secondary diabetes mellitus with hyperosmolarity. uncontrolled 249.60 Secondary diabetes mellitus with neurological manifestations. or unspecified 249. Childbirth. or unspecified 249.1 Secondary diabetes mellitus without mention of complication 249. With Mention Of Postpartum Complication 648. not stated as 269 .10 Secondary diabetes mellitus with ketoacidosis. Complicating Pregnancy.30 Secondary diabetes mellitus with other coma.80 Abnormal Glucose Tolerance Of Mother.84 Abnormal Glucose Tolerance Of Mother. Childbirth. or unspecified 249.31 Secondary diabetes mellitus with other coma.7 Secondary diabetes mellitus with peripheral circulatory disorders 249.Active diagnosis of gestational diabetes ICD-9 Description 648.0 Secondary diabetes mellitus without mention of complication 249.82 Abnormal Glucose Tolerance Of Mother. not stated as uncontrolled. or unspecified 249.3 Secondary diabetes mellitus with other coma 249.41 Secondary diabetes mellitus with renal manifestations. uncontrolled 249. not stated as uncontrolled or unspecified 249. not stated as uncontrolled. uncontrolled 249.70 Secondary diabetes mellitus with peripheral circulatory disorders. Secondary diabetes mellitus with neurological manifestations 249. Unspecified As To Episode Of Care 648.5 Secondary diabetes mellitus with ophthalmic manifestations 249.00 Secondary diabetes mellitus without mention of complication. or unspecified 249. or unspecified 249. Antepartum 648. uncontrolled 249. uncontrolled 249.4 Secondary diabetes mellitus with renal manifestations 249. uncontrolled 249. or unspecified 249. Postpartum Diagnosis Active of Steroid induced diabetes ICD-9 Description 249 Secondary Diabetes Mellitus 249.40 Secondary diabetes mellitus with renal manifestations. not stated as uncontrolled. Or The Puerperium.21 Secondary diabetes mellitus with hyperosmolarity. not stated as uncontrolled.8 Abnormal Glucose Tolerance Of Mother. not stated as uncontrolled. With Delivery 648.11 Secondary diabetes mellitus with ketoacidosis.51 Secondary diabetes mellitus with ophthalmic manifestations.01 Secondary diabetes mellitus without mention of complication.

81 249. not stated as uncontrolled.91 251.5 ML pramlintide acetate 1 MG/ML Prefilled Syringe 861787 Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet 861790 Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Antidiabetic Agents 744863 exenatide 0.6 MG/ML Injectable Solution 861042 2.5 MG / Metformin hydrochloride 250 MG Oral Tablet 861736 Glipizide 2.9 249.90 249.7 ML pramlintide acetate 1 MG/ML Prefilled Syringe 861044 1. or unspecified Secondary diabetes mellitus with other specified manifestations. Active RxNORM Description Alph-glucosides 199149 Acarbose 50 MG Oral Tablet 199150 Acarbose 100 MG Oral Tablet 200132 Acarbose 25 MG Oral Tablet 205329 miglitol 25 MG Oral Tablet 205330 miglitol 50 MG Oral Tablet 205331 miglitol 100 MG Oral Tablet 401938 Miglustat 100 MG Oral Capsule Amylin analogs 200256 repaglinide 1 MG Oral Tablet 200257 repaglinide 0. uncontrolled Other Specified Disorders Of Pancreatic Internal Secretion Poisoning By Adrenal Cortical Steroids Medications Ordered.0 uncontrolled. uncontrolled Secondary diabetes mellitus with unspecified complication Secondary diabetes mellitus with unspecified complication.25 MG/ML Injectable Solution 847910 pioglitazone 15 MG Oral Tablet 847915 60 ACTUAT exenatide 0.5 MG / Metformin hydrochloride 500 MG Oral Tablet 861740 Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet 270 .5 MG Oral Tablet 200258 repaglinide 2 MG Oral Tablet 311919 nateglinide 120 MG Oral Tablet 314142 nateglinide 60 MG Oral Tablet 389139 nateglinide 180 MG Oral Tablet 861035 pramlintide acetate 1 MG/ML Injectable Solution 861039 pramlintide acetate 0. Dispensed.8 962. or unspecified Secondary diabetes mellitus with unspecified complication.249.005 MG/ACTUAT Prefilled Syringe Antidiabetic Combination 602544 glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet 602549 glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet 602550 glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet 647237 glimepiride 2 MG / pioglitazone 30 MG Oral Tablet 647239 glimepiride 4 MG / pioglitazone 30 MG Oral Tablet 706895 glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet 706896 glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet 861731 Glipizide 2.

5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Biguanides sitagliptin 100 MG Oral Tablet sitagliptin 25 MG Oral Tablet sitagliptin 50 MG Oral Tablet 24 HR Metformin hydrochloride 500 MG Extended Release Tablet Metformin hydrochloride 500 MG Extended Release Tablet 24 HR Metformin hydrochloride 750 MG Extended Release Tablet Metformin hydrochloride 750 MG Extended Release Tablet 24 HR Metformin hydrochloride 1000 MG Extended Release Tablet Metformin hydrochloride 1000 MG Extended Release Tablet Metformin hydrochloride 1000 MG Oral Tablet Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 850 MG Oral Tablet Metformin hydrochloride 625 MG Oral Tablet Metformin hydrochloride 100 MG/ML Oral Solution Glipizide 2.861743 861748 861753 861760 861763 861769 861783 861787 861790 861795 861806 861816 861819 861822 665033 665038 665042 860975 860978 860981 860984 860996 860999 861004 861007 861010 861021 861025 861731 861736 861740 861743 861748 861753 861760 Glyburide 1.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet 271 .5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.

Human 100 UNT/ML Injectable Solution Insulin Glargine 100 UNT/ML Injectable Solution Insulin. Prompt Zinc. Aspart. Human 50 UNT/ML Injectable Suspension Insulin. Pork 40 UNT/ML Injectable Solution Insulin. Beef-Pork 40 UNT/ML Injectable Suspension Insulin. Prompt Zinc. Beef-Pork 100 UNT/ML Injectable Suspension Insulin. Beef-Pork 40 UNT/ML Injectable Suspension Insulin. Pork 30 UNT/ML / NPH Insulin. Regular. Beef 100 UNT/ML Injectable Solution Insulin. Human 30 UNT/ML Injectable Suspension Insulin. Human 100 UNT/ML Injectable Suspension Insulin Lispro 100 UNT/ML Injectable Solution insulin. Aspart. Pork 500 UNT/ML Injectable Solution Insulin. Pork 100 UNT/ML Injectable Solution Insulin. protamine zinc. Human 75 UNT/ML Injectable Suspension Insulin Lispro 50 UNT/ML / Insulin. Pork 70 UNT/ML 205314 237527 242120 242916 242917 259111 260265 283394 311040 311041 311053 311054 311055 311056 311057 311058 311059 311060 311061 314038 317800 351297 358349 272 . Human 70 UNT/ML / Insulin. Regular. Prompt Zinc.861763 861769 861783 861787 861790 861795 861806 861816 861819 861822 Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet Metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Insulin Insulin. Zinc. Aspart Protamine. Regular. Pork 100 UNT/ML Injectable Suspension Insulin. Protamine Zinc. Regular. Pork 100 UNT/ML Injectable Suspension Insulin Lispro 25 UNT/ML / Insulin. Regular. Beef-Pork 100 UNT/ML Injectable Solution Insulin. Regular. Beef 100 UNT/ML Injectable Suspension Insulin. Beef-Pork 40 UNT/ML Inhalant Solution Insulin. Protamine Lispro. Regular. Protamine Zinc. beef 100 UNT/ML Injectable Suspension Insulin. Zinc. Protamine Zinc. Protamine Lispro. Beef-Pork 100 UNT/ML Injectable Suspension Insulin. Prompt Zinc. Pork 100 UNT/ML Injectable Suspension Insulin.

Aspart. Human 50 UNT/ML / Insulin. Glulisine. Human 75 UNT/ML Prefilled Syringe 3 ML Insulin. Pork 40 UNT/ML Injectable Solution 90 ACTUAT insulin human. Human 100 UNT/ML Injectable Solution Insulin. Protamine Lispro. Human 100 UNT/ML Prefilled Syringe 1.25 MG Oral Tablet 273 . Glulisine. Human 70 UNT/ML / Insulin. rDNA origin 3 MG/ACTUAT Dry Powder Inhaler insulin human. Zinc. rDNA origin 1 MG/ACTUAT Dry Powder Inhaler 90 ACTUAT insulin human. rDNA origin 3 MG/ACTUAT Inhalant Powder Insulin. Human 100 UNT/ML Prefilled Syringe 3 ML Insulin. Human 50 UNT/ML Injectable Suspension 3 ML Insulin. rDNA origin 1 MG/ACTUAT Inhalant Powder insulin human. Human 30 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 100 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 50 UNT/ML / Insulin. Human 50 UNT/ML Prefilled Syringe 3 ML Insulin Glargine 100 UNT/ML Prefilled Syringe 3 ML insulin detemir 100 UNT/ML Prefilled Syringe 3 ML Insulin Lispro 25 UNT/ML / Insulin.Injectable Suspension 484322 485210 544614 763002 763007 763013 763014 833159 847191 847207 847211 847230 847239 847252 847259 847263 847416 200256 200257 200258 311919 314142 389139 105374 153842 197306 197307 197495 197496 197737 insulin detemir 100 UNT/ML Injectable Solution Insulin.5 MG Oral Tablet repaglinide 2 MG Oral Tablet nateglinide 120 MG Oral Tablet nateglinide 60 MG Oral Tablet nateglinide 180 MG Oral Tablet Sulfonylureas gliquidone 30 MG Oral Tablet glimepiride 3 MG Oral Tablet Acetohexamide 250 MG Oral Tablet Acetohexamide 500 MG Oral Tablet Chlorpropamide 100 MG Oral Tablet Chlorpropamide 250 MG Oral Tablet Glyburide 1. Protamine Lispro. Aspart Protamine.5 ML Insulin Lispro 100 UNT/ML Prefilled Syringe Meglitinides repaglinide 1 MG Oral Table repaglinide 0. Aspart Protamine. Aspart. Aspart.

198291 198292 198293 198294 199245 199246 199247 199825 199984 199985 200065 252960 310488 310489 310490 310534 310536 310537 310539 312440 312441 312859 312860 312861 313418 313419 314000 314006 315107 315239 317573 379804 389137 602544 Tolazamide 100 MG Oral Tablet Tolazamide 250 MG Oral Tablet Tolazamide 500 MG Oral Tablet Tolbutamide 500 MG Oral Tablet glimepiride 1 MG Oral Tablet glimepiride 2 MG Oral Tablet glimepiride 4 MG Oral Tablet Gliclazide 80 MG Oral Tablet troglitazone 200 MG Oral Tablet troglitazone 400 MG Oral Tablet troglitazone 300 MG Oral Tablet Glyburide 4.5 MG Oral Tablet 24 HR Glipizide 5 MG Extended Release Tablet 24 HR Glipizide 10 MG Extended Release Tablet Tolbutamide 50 MG/ML Injectable Solution pioglitazone 15 MG Oral Tablet Glipizide 2.5 MG Extended Release Tablet Glipizide 5 MG Oral Tablet Glyburide 2.5 MG Oral Tablet Glyburide 3 MG Oral Tablet Glyburide 5 MG Oral Tablet Glyburide 6 MG Oral Tablet pioglitazone 30 MG Oral Tablet pioglitazone 45 MG Oral Tablet rosiglitazone 2 MG Oral Tablet rosiglitazone 4 MG Oral Tablet rosiglitazone 8 MG Oral Tablet Tolazamide 250 MG Oral Capsule Tolbutamide 250 MG Oral Tablet Glyburide 1.5 MG Oral Tablet Glipizide 10 MG Oral Tablet 24 HR Glipizide 2.5 MG Oral Tablet Gliclazide 30 MG Extended Release Tablet glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet 274 .

5 MG / Metformin hydrochloride 250 MG Oral Tablet Glipizide 2.602549 602550 647237 647239 706895 706896 757710 757712 844809 844824 844827 861731 861736 861740 861743 861748 861753 861760 861763 861783 861806 861816 861822 glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet glimepiride 2 MG / pioglitazone 30 MG Oral Tablet glimepiride 4 MG / pioglitazone 30 MG Oral Tablet glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet vildagliptin 100 MG Oral Tablet vildagliptin 50 MG Oral Tablet Glipizide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet Metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet Metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet Thiazolidinediones 312440 312441 312859 312860 312861 pioglitazone 30 MG Oral Tablet pioglitazone 45 MG Oral Tablet rosiglitazone 2 MG Oral Tablet rosiglitazone 4 MG Oral Tablet rosiglitazone 8 MG Oral Tablet 275 .5 MG Extended Release Tablet Glipizide 5 MG Extended Release Tablet Glipizide 10 MG Extended Release Tablet Glipizide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet Glipizide 5 MG / Metformin hydrochloride 500 MG Oral Tablet Glyburide 1.25 MG / Metformin hydrochloride 250 MG Oral Tablet Glyburide 2.

317573 pioglitazone 15 MG Oral Tablet Encounter Codes Accepted for appointment outside of Physician using MU: CPT Encounte CPT Encounter ED CPT Encounter CPT Encounter r Acute Non-Acute Outpatient Inpatient Inpatient Opthamologi cal services 99221 1ST HOSP CARE PR D 30 MIN 99222 1ST HOSP CARE PR D 50 MIN 99281 EMER DEPT SELF LIMITED/MINO R 99304 1ST NF CARE PR D E/M LW SEVERITY 92002 OPH MEDICAL XM&EVAL INTRM NEW PT OPH MEDICAL XM&EVAL COMPRE NEW PT 1+ VST OPH MEDICAL XM&EVAL INTRM EST PT OPH MEDICAL XM&EVAL COMPRE EST PT 1+ VST 99282 EMER DEPT LOW TO MODERATE SEVERITY 99305 1ST NF CARE PR D E/M MOD SEVERITY 92004 99223 1ST HOSP CARE PR D 70 MIN 99231 SBSQ HOSP CARE PR D 15 MIN 99283 EMER DEPT MODERATE SEVERITY 99306 1ST NF CARE PR D E/M HI SEVERITY 92012 99284 EMER DEPT HI SEVERITY&UR GENT EVAL 99307 SBSQ NF CARE PR D E/M STABLE 92014 99232 SBSQ HOSP CARE PR D 25 MIN 99233 SBSQ HOSP CARE PR D 35 MIN 99238 HOSP DSCHRG 276 99285 EMER DEPT HIGH SEVERITY&TH REAT FUNCJ 99308 SBSQ NF CARE PR D E/M MINOR COMPLCTJ 99309 SBSQ NF CARE PR D E/M NEW PROBLEM 99310 SBSQ NF CARE PR D .

D MGMT 30 MIN/< E/M UNSTABLE/ NEW PROBLEM 99315 NF DSCHRG D MGMT 30 MIN/< 99239 HOSP DSCHRG D MGMT > 30 MIN 99251 1ST 99252 INPT CONSLT J 20 MIN 1ST INPT CONSLT J 40 MIN 99253 1ST INPT CONSLT J 55 MIN 99254 1ST INPT CONSLT J 80 MIN 99255 1ST INPT CONSLT J 110 MIN 99316 NF DSCHRG D MGMT > 30 MIN 99318 E/M PT INVG ANNUAL NF ASSMT DOM/RHOME LW SEVERITY 99324 99325 DOM/RHOME E/M NEW PT MOD SEVERITY DOM/RHOME E/M NEW PT MOD HI SEVERITY DOM/RHOME E/M NEW PT HI SEVERITY DOM/RHOME E/M NEW PT SIGNIFICAN 99326 99327 99328 277 .

T NEW PROBLEM 99334 DOM/RHOME E/M EST PT SELFLMTD/MINO R DOM/RHOME E/M EST PT LW MOD SEVERITY DOM/RHOME E/M EST PT MOD HI SEVERITY DOM/RHOME E/M EST PT SIGNIFICAN T NEW PROBLEM 99335 99336 99337 278 .