C.M.R. 10, 144, ch. 101, ch. III, 144-101-III-45, app 144-101-III-45-B
The following shall apply to non-emergent use of the emergency department (see Sec. 45.03-1(D)(1)(c) and 45.03-1(D)(2)(b))
ICD-10 codes will be used to identify non-emergent use of the emergency department for services delivered beginning October 1, 2015.
ICD-10 Code | ICD-10 Code Description |
J02.0 | Streptococcal pharyngitis |
J03.00 | Acute streptococcal tonsillitis, unspecified |
J03.01 | Acute recurrent streptococcal tonsillitis |
B97.10 | Unspecified enterovirus as the cause of diseases classified elsewhere |
B97.89 | Other viral agents as the cause of diseases classified elsewhere |
F41.9 | Anxiety disorder, unspecified |
F41.1 | Generalized anxiety disorder |
H10.30 | Unspecified acute conjunctivitis, unspecified eye |
H10.31 | Unspecified acute conjunctivitis, right eye |
H10.32 | Unspecified acute conjunctivitis, left eye |
H10.33 | Unspecified acute conjunctivitis, bilateral |
H10.9 | Unspecified conjunctivitis |
H60.00 | Abscess of external ear, unspecified ear |
H60.01 | Abscess of right external ear |
H60.02 | Abscess of left external ear |
H60.03 | Abscess of external ear, bilateral |
H60.10 | Cellulitis of external ear, unspecified ear |
H60.11 | Cellulitis of right external ear |
H60.12 | Cellulitis of left external ear |
H60.13 | Cellulitis of external ear, bilateral |
H60.311 | Diffuse otitis externa, right ear |
H60.312 | Diffuse otitis externa, left ear |
H60.313 | Diffuse otitis externa, bilateral |
H60.319 | Diffuse otitis externa, unspecified ear |
H60.321 | Hemorrhagic otitis externa, right ear |
H60.322 | Hemorrhagic otitis externa, left ear |
H60.323 | Hemorrhagic otitis externa, bilateral |
H60.329 | Hemorrhagic otitis externa, unspecified ear |
H60.391 | Other infective otitis externa, right ear |
H60.392 | Other infective otitis externa, left ear |
H60.393 | Other infective otitis externa, bilateral |
H60.399 | Other infective otitis externa, unspecified ear |
H65.00 | Acute serous otitis media, unspecified ear |
H65.01 | Acute serous otitis media, right ear |
H65.02 | Acute serous otitis media, left ear |
H65.03 | Acute serous otitis media, bilateral |
H65.04 | Acute serous otitis media recurrent, right ear |
H65.05 | Acute serous otitis media recurrent, left ear |
H65.06 | Acute serous otitis media, recurrent, bilateral |
H65.07 | Acute serous otitis media, recurrent, unspecified ear |
H65.90 | Unspecified nonsuppurative otitis media, unspecified ear |
H65.91 | Unspecified nonsuppurative otitis media, right ear |
H65.92 | Unspecified nonsuppurative otitis media, left ear |
H65.93 | Unspecified nonsuppurative otitis media, bilateral |
H66.001 | Acute suppurative otitis media without spontaneous rupture of the ear drum, right ear |
H66.002 | Acute suppurative otitis media without spontaneous rupture of the ear drum, left ear |
H66.003 | Acute suppurative otitis media without spontaneous rupture of the ear drum, bilateral |
H66.004 | Acute suppurative otitis media without spontaneous rupture of the ear drum, recurrent, right ear |
H66.005 | Acute suppurative otitis media without spontaneous rupture of the ear drum, recurrent, left ear |
H66.006 | Acute suppurative otitis media without spontaneous rupture of the ear drum, recurrent, bilateral |
H66.007 | Acute suppurative otitis media without spontaneous rupture of the ear drum, recurrent, unspecified ear |
H66.009 | Acute suppurative otitis media without spontaneous rupture of the ear drum, unspecified ear |
H66.90 | Otitis media, unspecified, unspecified ear |
H66.91 | Otitis media, unspecified, right ear |
H66.92 | Otitis media, unspecified, left ear |
H66.93 | Otitis media, unspecified, bilateral |
J01.90 | Acute sinusitis, unspecified |
J01.91 | Acute recurrent sinusitis, unspecified |
J02.8 | Acute pharyngitis due to other specified organisms |
J02.9 | Acute pharyngitis, unspecified |
J06.9 | Acute upper respiratory infection, unspecified |
J20.0 | Acute bronchitis due to Mycoplasma pneumoniae |
J20.1 | Acute bronchitis due to Hemophilus influenzae |
J20.2 | Acute bronchitis due to streptococcus |
J20.3 | Acute bronchitis due to coxsackievirus |
J20.4 | Acute bronchitis due to parainfluenza virus |
J20.5 | Acute bronchitis due to respiratory syncytial virus |
J20.6 | Acute bronchitis due to rhinovirus |
J20.7 | Acute bronchitis due to echovirus |
J20.8 | Acute bronchitis due to other specified organisms |
J20.9 | Acute bronchitis, unspecified |
J32.9 | Chronic sinusitis, unspecified |
J40 | Bronchitis, not specified as acute or chronic |
J45.20 | Mild intermittent asthma, uncomplicated |
J45.30 | Mild persistent asthma, uncomplicated |
J45.40 | Moderate persistent asthma, uncomplicated |
J45.50 | Severe persistent asthma, uncomplicated |
J45.21 | Mild intermittent asthma w/ (acute) exacerbation |
J45.31 | Mild persistent asthma w/ (acute) exacerbation |
J45.41 | Moderate persist asthma w/ (acute) exacerbation |
J45.51 | Severe persist asthma w/ (acute) exacerbation |
J45.20 | Mild intermittent asthma, uncomplicated |
J45.30 | Mild persistent asthma, uncomplicated |
J45.40 | Moderate persistent asthma, uncomplicated |
J45.50 | Severe persistent asthma, uncomplicated |
J45.21 | Mild intermittent asthma w/ (acute) exacerbation |
J45.31 | Mild persistent asthma w/ (acute) exacerbations |
J45.41 | Moderate persist asthma w/ (acute) exacerbation |
J45.51 | Severe persist asthma w/ (acute) exacerbation |
J44.9 | Chronic obstructive pulmonary disease, unspecified |
J44.1 | Chronic obstructive pulmonary disease w/ (acute) exacerbation |
J45.990 | Exercise induced bronchospasm |
J45.991 | Cough variant asthma |
J45.909 | Unspecified asthma, uncomplicated |
J45.998 | Other asthma |
J45.901 | Unspecified asthma with (acute) exacerbation |
L22 | Diaper dermatitis |
L20.0 | Besnier's prurigo |
L20.81 | Atopic neurodermatitis |
L20.82 | Flexural eczema |
L20.84 | Intrinsic (allergic) eczema |
L20.89 | Other atopic dermatitis |
L20.9 | Atopic dermatitis, unspecified |
L23.7 | Allergic contact dermatitis due to plants, except food |
L24.7 | Irritant contact dermatitis due to plants, except food |
L25.5 | Unspecified contact dermatitis due to plants, except food |
L23.9 | Allergic contact dermatitis, unspecified cause |
L24.9 | Irritant contact dermatitis, unspecified cause |
L25.9 | Unspecified contact dermatitis, unspecified cause |
L30.0 | Nummular dermatitis |
L30.2 | Cutaneous autosensitization |
L30.8 | Other specified dermatitis |
L30.9 | Dermatitis, unspecified |
M25.512 | Pain in left shoulder |
M25.519 | Pain in unspecified shoulder |
M25.521 | Pain in right elbow |
M25.522 | Pain in left elbow |
M25.529 | Pain in unspecified elbow |
M25.531 | Pain in right wrist |
M25.532 | Pain in left wrist |
M25.539 | Pain in unspecified wrist |
M79.643 | Pain in unspecified hand |
M79.646 | Pain in unspecified finger(s) |
M25.551 | Pain in right hip |
M25.552 | Pain in left hip |
M25.559 | Pain in unspecified hip |
M25.561 | Pain in right knee |
M25.562 | Pain in left knee |
M25.569 | Pain in unspecified knee |
M25.571 | Pain in right ankle and joints of right foot |
M25.572 | Pain in left ankle and joints of left foot |
M25.579 | Pain in unspecified ankle and joints of unspecified foot |
M54.5 | Low back pain |
M54.89 | Other dorsalgia |
M54.9 | Dorsalgia, unspecified |
M60.80 | Other myositis, unspecified site |
M60.811 | Other myositis, right shoulder |
M60.812 | Other myositis, left shoulder |
M60.819 | Other myositis, unspecified shoulder |
M60.821 | Other myositis, right upper arm |
M60.822 | Other myositis, left upper arm |
M60.829 | Other myositis, unspecified upper arm |
M60.831 | Other myositis, right forearm |
M60.832 | Other myositis, left forearm |
M60.839 | Other myositis, unspecified forearm |
M60.841 | Other myositis, right hand |
M60.842 | Other myositis, left hand |
M60.849 | Other myositis, unspecified hand |
M60.851 | Other myositis, right thigh |
M60.852 | Other myositis, left thigh |
M60.859 | Other myositis, unspecified thigh |
M60.861 | Other myositis, right lower leg |
M60.862 | Other myositis, left lower leg |
M60.869 | Other myositis, unspecified lower leg |
M60.871 | Other myositis, right ankle and foot |
M60.872 | Other myositis, left ankle and foot |
M60.879 | Other myositis, unspecified ankle and foot |
M60.88 | Other myositis, other site |
M60.89 | Other myositis, multiple sites |
M60.9 | Myositis, unspecified |
M79.1 | Myalgia |
M79.7 | Fibromyalgia |
M79.601 | Pain in right arm |
M79.602 | Pain in left arm |
M79.603 | Pain in arm, unspecified |
M79.604 | Pain in right leg |
M79.605 | Pain in left leg |
M79.606 | Pain in leg, unspecified |
M79.609 | Pain in unspecified limb |
M79.621 | Pain in right upper arm |
M79.622 | Pain in left upper arm |
M79.629 | Pain in unspecified upper arm |
M79.631 | Pain in right forearm |
M79.632 | Pain in left forearm |
M79.639 | Pain in unspecified forearm |
M79.641 | Pain in right hand |
M79.642 | Pain in left hand |
M79.643 | Pain in unspecified hand |
M79.644 | Pain in right finger(s) |
M79.645 | Pain in left finger(s) |
M79.646 | Pain in unspecified finger(s) |
M79.651 | Pain in right thigh |
M79.652 | Pain in left thigh |
M79.659 | Pain in unspecified thigh |
M79.661 | Pain in right lower leg |
M79.662 | Pain in left lower leg |
M79.669 | Pain in unspecified lower leg |
M79.671 | Pain in right foot |
M79.672 | Pain in left foot |
M79.673 | Pain in unspecified foot |
M79.674 | Pain in right toe(s) |
M79.675 | Pain in left toe(s) |
M79.676 | Pain in unspecified toe(s) |
G93.3 | Postviral fatigue syndrome |
R53.0 | Neoplastic (malignant) related fatigue |
R53.1 | Weakness |
R53.81 | Other malaise |
R58.83 | Other fatigue |
R21 | Rash and other nonspecific skin eruption |
G44.1 | Vascular headache, not elsewhere classified |
R51 | Headache |
R05 | Cough |
* The Department shall submit to CMS and anticipates approval for a State Plan Amendment related to these provisions.
C.M.R. 10, 144, ch. 101, ch. III, 144-101-III-45, app 144-101-III-45-B