bluecare/tenncareselect effective: medical emergency … · 2009. 10. 7. · e8405 accident to...

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BlueCare/TennCareSelect Medical Emergency Diagnosis Codes - Alpha Sorted Effective: BlueCare West 11/01/08 BlueCare East 01/01/09 TennCareSelect 09/01/09 Diag# Diag Desc 4414 Abdominal aneurysm without mention of rupture 4413 Abdominal aneurysm, ruptured 78936 Abdominal or pelvic swelling, mass, or lump, epigastric 78937 Abdominal or pelvic swelling, mass, or lump, generalized 78934 Abdominal or pelvic swelling, mass, or lump, left lower quadrant 78932 Abdominal or pelvic swelling, mass, or lump, left upper quadrant 78939 Abdominal or pelvic swelling, mass, or lump, other specified site 78935 Abdominal or pelvic swelling, mass, or lump, periumbilic 78933 Abdominal or pelvic swelling, mass, or lump, right lower quadrant 78931 Abdominal or pelvic swelling, mass, or lump, right upper quardant 78930 Abdominal or pelvic swelling, mass, or lump, unspecified site 78906 Abdominal pain, epigastric 78907 Abdominal pain, generalized 78904 Abdominal pain, left lower quadrant 78902 Abdominal pain, left upper quadrant 78909 Abdominal pain, other specified site 78905 Abdominal pain, periumbilic 78903 Abdominal pain, right lower quadrant 78901 Abdominal pain, right upper quadrant 78900 Abdominal pain, unspecified site 63301 Abdominal pregnancy with intrauterine pregnancy 63300 Abdominal pregnancy without intrauterine pregnancy 78946 Abdominal rigidity, epigastric 78947 Abdominal rigidity, generalized 78944 Abdominal rigidity, left lower quadrant 78942 Abdominal rigidity, left upper quadrant 78949 Abdominal rigidity, other specified site 78945 Abdominal rigidity, periumbilic 78943 Abdominal rigidity, right lower quadrant 78941 Abdominal rigidity, right upper quadrant 78940 Abdominal rigidity, unspecified site 78966 Abdominal tenderness, epigastric 78967 Abdominal tenderness, generalized

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Page 1: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

Diag# Diag Desc4414 Abdominal aneurysm without mention of rupture 4413 Abdominal aneurysm, ruptured 78936 Abdominal or pelvic swelling, mass, or lump, epigastric 78937 Abdominal or pelvic swelling, mass, or lump, generalized 78934 Abdominal or pelvic swelling, mass, or lump, left lower quadrant 78932 Abdominal or pelvic swelling, mass, or lump, left upper quadrant 78939 Abdominal or pelvic swelling, mass, or lump, other specified site 78935 Abdominal or pelvic swelling, mass, or lump, periumbilic 78933 Abdominal or pelvic swelling, mass, or lump, right lower quadrant 78931 Abdominal or pelvic swelling, mass, or lump, right upper quardant 78930 Abdominal or pelvic swelling, mass, or lump, unspecified site 78906 Abdominal pain, epigastric 78907 Abdominal pain, generalized 78904 Abdominal pain, left lower quadrant 78902 Abdominal pain, left upper quadrant 78909 Abdominal pain, other specified site 78905 Abdominal pain, periumbilic 78903 Abdominal pain, right lower quadrant 78901 Abdominal pain, right upper quadrant 78900 Abdominal pain, unspecified site 63301 Abdominal pregnancy with intrauterine pregnancy 63300 Abdominal pregnancy without intrauterine pregnancy 78946 Abdominal rigidity, epigastric 78947 Abdominal rigidity, generalized 78944 Abdominal rigidity, left lower quadrant 78942 Abdominal rigidity, left upper quadrant 78949 Abdominal rigidity, other specified site 78945 Abdominal rigidity, periumbilic 78943 Abdominal rigidity, right lower quadrant 78941 Abdominal rigidity, right upper quadrant 78940 Abdominal rigidity, unspecified site 78966 Abdominal tenderness, epigastric 78967 Abdominal tenderness, generalized

Page 2: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

78964 Abdominal tenderness, left lower quadrant 78962 Abdominal tenderness, left upper quadrant 78969 Abdominal tenderness, other specified site 78965 Abdominal tenderness, periumbilic 78963 Abdominal tenderness, right lower quadrant 78961 Abdominal tenderness, right upper quadrant 78960 Abdominal tenderness, unspecified site 79091 Abnormal arterial blood gases 7867 Abnormal chest sounds 79092 Abnormal coagulation profile 7810 Abnormal involuntary movements 76381 Abnormality in fetal heart rate or rhythm before the onset of labor 76382 Abnormality in fetal heart rate or rhythm during labor 76383 Abnormality in fetal heart rate or rhythm, unspecified as to time of onset 65973 Abnormality in fetal heart rate/rhythm, antepartum condition or complication 65971 Abnormality in fetal heart rate/rhythm, delivered 65970 Abnormality in fetal heart rate/rhythm, unspecified episode of care 7812 Abnormality of gait 9996 ABO incompatibility reaction, not elsewhere classified 9131 Abrasion or friction burn of elbow, forearm & wrist, infected 9130 Abrasion or friction burn of elbow, forearm & wrist, without mention of infection 9101 Abrasion or friction burn of face, neck & scalp except eye, infected 9100 Abrasion or friction burn of face, neck & scalp except eye, without mention of infection 9151 Abrasion or friction burn of fingers, infected 9150 Abrasion or friction burn of fingers, without mention of infection 9171 Abrasion or friction burn of foot & toe(s), infected 9141 Abrasion or friction burn of hand(s), except finger(s) alone, infected 9140 Abrasion or friction burn of hand(s), except finger(s) alone, without mention of infection 9161 Abrasion or friction burn of hip, thigh, leg & ankle, infected 9160 Abrasion or friction burn of hip, thigh, leg & ankle, without mention of infection 9191 Abrasion or friction burn of other, multiple & unspecified sites, infected 9121 Abrasion or friction burn of shoulder & upper arm, infected 9120 Abrasion or friction burn of shoulder & upper arm, without mention of infection 9111 Abrasion or friction burn of trunk, infected

Page 3: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

9110 Abrasion or friction burn of trunk, without mention of infection 566 Abscess of anal & rectal regions 5695 Abscess of intestine 5720 Abscess of liver 5130 Abscess of lung 5131 Abscess of mediastinum 2541 Abscess of thymus 31383 Academic underachievement disorder of childhood or adolescence E9224 Accident caused by air gun E9231 Accident caused by blasting materials E9241 Accident caused by caustic and corrosive substances E9021 Accident caused by changes in air pressure in aircraft E9251 Accident caused by electric power generating plants, distribution stations, or transmission lines E9211 Accident caused by explosion of gas cylinder E9218 Accident caused by explosion of other specified pressure vessel E9219 Accident caused by explosion of unspecified pressure vessel E9232 Accident caused by explosive gases E9225 Accident caused by firearm & air gun missile, paintball gun E8901 Accident caused by fumes from combustion of polyvinylchloride & similar material in private dwelling conflagration E8911 Accident caused by fumes from combustion of polyvinylchloride &similar material in fire in other & unspecified buildingE9242 Accident caused by hot (boiling) water E9222 Accident caused by hunting rifle E8931 Accident caused by ignition of clothing from controlled fire in other building or structure E8932 Accident caused by ignition of clothing from controlled fire not in building or structure E8938 Accident caused by ignition of clothing from other specified sources E8939 Accident caused by ignition of clothing from unspecified source E9252 Accident caused by industrial wiring, appliances, and electrical machinery E9223 Accident caused by military firearms E9258 Accident caused by other electric current E9238 Accident caused by other explosive materials E8981 Accident caused by other fire and flames E8902 Accident caused by other smoke & fumes from conflagration in private dwelling E8912 Accident caused by other smoke and fumes from conflagration in other & unspecified building or structure E9228 Accident caused by other specified firearm missile

Page 4: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E9248 Accident caused by other substance E9221 Accident caused by shotgun (automatic) E9259 Accident caused by unspecified electric current E9239 Accident caused by unspecified explosive material E9229 Accident caused by unspecified firearm missile E9249 Accident caused by unspecified hot substances, caustic or corrosive material or steam E9022 Accident due to diving caused by changes in air pressure E9011 Accident due to excessive cold of man-made origin E9018 Accident due to excessive cold of other specified origin E9019 Accident due to excessive cold of unspecified origin E9001 Accident due to excessive heat of man made origin E9009 Accident due to excessive heat of unspecified origin E9028 Accident due to other specified causes of changes in air pressure E9029 Accident due to unspecified cause of changes in air pressure E8284 Accident involving animal being ridden involving occupant of streetcar E8288 Accident involving animal being ridden involving other specified person E8280 Accident involving animal being ridden involving pedestrian E8289 Accident involving animal being ridden involving unspecified person E8282 Accident involving animal being ridden rider of animal E8458 Accident involving spacecraft & ground crew, airline employee E8450 Accident involving spacecraft & occupant of spacecraft E8459 Accident involving spacecraft & other person E8497 Accident occurring in a residential institution E8492 Accident occurring at a mine or quarry E8494 Accident occurring at a place for recreation or sport E8496 Accident occurring at a public building E8493 Accident occurring at an industrial place or premises E8490 Accident occurring at home E8499 Accident occurring in an unspecified place E8498 Accident occurring in other specified places E8491 Accident occurring on a farm E8495 Accident occurring on a street or highway E8403 Accident to powered aircraft at takeoff or landing & other occupant of commercial aircraft; surface to surface transportE8404 Accident to powered aircraft at takeoff or landing involving ccupant of commercial aircraft in surface to air transport

Page 5: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8402 Accident to powered aircraft at takeoff or landing involving crew of commercial aircraft; surface to surface transport E8408 Accident to powered aircraft at takeoff or landing involving ground crew, airline employee E8401 Accident to powered aircraft at takeoff or landing involving occupant of any military aircraft E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft E8400 Accident to powered aircraft at takeoff or landing involving occupant of spacecraft E8406 Accident to powered aircraft at takeoff or landing involving occupant of unpowered aircraft except parachutist E8409 Accident to powered aircraft at takeoff or landing involving other person E8407 Accident to powered aircraft at takeoff or landing involving parachutist; military or other E8413 Accident to powered aircraft, other & unspecified & other occupant of commercial aircraft; surface to surface transport E8412 Accident to powered aircraft, other & unspecified involving crew of commercial aircraft; surface to surface transport E8418 Accident to powered aircraft, other & unspecified involving ground crew, airline employee E8411 Accident to powered aircraft, other & unspecified involving occupant of any military aircraft E8414 Accident to powered aircraft, other & unspecified involving occupant of commercial aircraft in surface to air transport E8415 Accident to powered aircraft, other & unspecified involving occupant of other powered aircraft E8410 Accident to powered aircraft, other & unspecified involving occupant of spacecraft E8416 Accident to powered aircraft, other & unspecified involving occupant of unpowered aircraft except parachutist E8419 Accident to powered aircraft, other & unspecified involving other person E8417 Accident to powered aircraft, other & unspecified involving parachutist; military or other E8428 Accident to unpowered aircraft involving ground crew, airline employee E8426 Accident to unpowered aircraft involving occupant of unpowered aircraft, except parachutist E8429 Accident to unpowered aircraft involving other person E8427 Accident to unpowered aircraft involving parachutist; military or other E8316 Accident to watercraft causing other injury to dockers, stevedores E8312 Accident to watercraft causing other injury to occupant of other watercraft; crew E8313 Accident to watercraft causing other injury to occupant of other watercraft; non-crew E8311 Accident to watercraft causing other injury to occupant of small boat, powered E8310 Accident to watercraft causing other injury to occupant of small boat, unpowered E8318 Accident to watercraft causing other injury to other specified person E8315 Accident to watercraft causing other injury to swimmer E8319 Accident to watercraft causing other injury to unspecified person E8314 Accident to watercraft causing other injury to water skier E8306 Accident to watercraft causing submersion involving dockers stevedores E8302 Accident to watercraft causing submersion involving occupant of other watercraft, crew E8303 Accident to watercraft causing submersion involving occupant of other watercraft; other than crew

Page 6: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8301 Accident to watercraft causing submersion involving occupant of small boat, powered E8300 Accident to watercraft causing submersion involving occupant of small boat, unpowered E8308 Accident to watercraft causing submersion involving other specified person E8305 Accident to watercraft causing submersion involving swimmer E8309 Accident to watercraft causing submersion involving unspecified person E8304 Accident to watercraft causing submersion involving water skier E8913 Accidental burning caused by conflagration in other & unspecified building or structure E8903 Accidental burning caused by conflagration of private dwelling E8707 Accidental cut, puncture, perforations or hemorrhage during administration of enema E8705 Accidental cut, puncture, perforations or hemorrhage during aspiration of fluid or tissue, puncture & cartherization E8704 Accidental cut, puncture, perforations or hemorrhage during endoscopic examination E8706 Accidental cut, puncture, perforations or hemorrhage during heart catheterization E8701 Accidental cut, puncture, perforations or hemorrhage during infusion or transfusion E8703 Accidental cut, puncture, perforations or hemorrhage during injection or vaccination E8702 Accidental cut, puncture, perforations or hemorrhage during kidney dialysis or other perfusion E8708 Accidental cut, puncture, perforations or hemorrhage during other specified medical care E8700 Accidental cut, puncture, perforations or hemorrhage during surgical operation E8709 Accidental cut, puncture, perforations or hemorrhage during unspecified medical care E8832 Accidental fall into storm drain or manhole E8831 Accidental fall into well E8619 Accidental poisoning by unspecified cleansing & polishing agents, disinfectants, paints & varnishes E8522 Accidental poisoning by a bromine compounds E8531 Accidental poisoning by a butyrophenone-based tranquilizers E8520 Accidental poisoning by a chloral hydrate group E8521 Accidental poisoning by a paraldehyde E8530 Accidental poisoning by a phenothiazine-based tranquilizer E8641 Accidental poisoning by acids, not elsewhere specified E8587 Accidental poisoning by agents affecting skin & mucous membranes, opthamological E8586 Accidental poisoning by agents primarily acting on smooth & skeletal muscles & respiratory system E8582 Accidental poisoning by agents primarily affecting blood constituents E8583 Accidental poisoning by agents primarily affecting cardiovascular systems E8584 Accidental poisoning by agents primarily affecting gastrointestinal systems E8630 Accidental poisoning by agriculture & horticultural insecticides of organiochlorine compounds E8600 Accidental poisoning by alcoholic beverages, not elsewhere specified

Page 7: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8540 Accidental poisoning by an antidepressant E8504 Accidental poisoning by an aromatic analgesics, not elsewhere classified E8509 Accidental poisoning by an unspecified analgesic or antipyretic E8529 Accidental poisoning by an unspecified sedative or hypnotic E8539 Accidental poisoning by an unspecified tranquilizer E856 Accidental poisoning by antibiotics E8550 Accidental poisoning by anticonvulsant & anti-Parkinsonism drugs E8662 Accidental poisoning by antimony, its compounds, or fumes E8506 Accidental poisoning by antirheumatics [antiphlogistics] E8663 Accidental poisoning by arsenic, its compounds, or fumes E851 Accidental poisoning by barbiturates E8653 Accidental poisoning by berries & seeds E8632 Accidental poisoning by carbamates E8683 Accidental poisoning by carbon monoxide from incomplete combustion of domestic fuel E8688 Accidental poisoning by carbon monoxide from other sources E8642 Accidental poisoning by caustic alkalis, not elsewhere specified E8543 Accidental poisoning by central nervous system stimulants E8640 Accidental poisoning by corrosive aromatics, not elsewhere specified E8667 Accidental poisoning by cosmetics E8614 Accidental poisoning by disinfectants E8692 Accidental poisoning by freon E8638 Accidental poisoning by fumigants E8636 Accidental poisoning by fungicides E8604 Accidental poisoning by fusel oil, not elsewhere specified E867 Accidental poisoning by gas distributed by pipeline E8666 Accidental poisoning by glues & adhesives E8524 Accidental poisoning by glutethmide group E8635 Accidental poisoning by herbicides E8500 Accidental poisoning by heroin E8580 Accidental poisoning by hormones & synthetic substitutes E8631 Accidental poisoning by insecticides of organophosphorus compounds E8603 Accidental poisoning by isopropyl alcohol, not elsewhere specified E8693 Accidental poisoning by lacrimogenic gas, tear gas E8615 Accidental poisoning by lead paint

Page 8: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8660 Accidental poisoning by lead, its compounds, or fumes E8680 Accidental poisoning by liquefied petroleum gas distributed in mobile containers E8552 Accidental poisoning by local anesthetics E8622 Accidental poisoning by lubricating oils E8650 Accidental poisoning by meat E8661 Accidental poisoning by mercury, its components, or fumes E8501 Accidental poisoning by methadone E8523 Accidental poisoning by methaqualone compounds E8602 Accidental poisoning by methyl alcohol, not elsewhere specified E8525 Accidental poisoning by mixed sedatives, not elsewhere classified E8633 Accidental poisoning by mixtures of insecticides E8682 Accidental poisoning by motor vehicle exhaust gas E8655 Accidental poisoning by mushrooms & other fungi E8690 Accidental poisoning by nitrogen oxides E8639 Accidental poisoning by other & unspecified agricultural & horticultural chemical E8601 Accidental poisoning by other & unspecified ethyl alcohol & its products, not elsewhere specified E8634 Accidental poisoning by other & unspecified insecticides E8681 Accidental poisoning by other & unspecified utility gas E857 Accidental poisoning by other anti-infectives E8551 Accidental poisoning by other central nervous system depressants E8613 Accidental poisoning by other cleaning & polishing agents E8652 Accidental poisoning by other fish E8664 Accidental poisoning by other metals, their compounds, or fumes E8507 Accidental poisoning by other non-narcotic analgesics E8502 Accidental poisoning by other opiates & related narcotics E8616 Accidental poisoning by other paints & varnishes E8548 Accidental poisoning by other psychotropic agents E8608 Accidental poisoning by other specified alcohols, not elsewhere specified E8508 Accidental poisoning by other specified analgesics & antipyretics E8643 Accidental poisoning by other specified corrosives & caustics, not elsewhere specified E8588 Accidental poisoning by other specified drugs E8558 Accidental poisoning by other specified drugs acting on central & autonomic nervous systems E8658 Accidental poisoning by other specified foods E8659 Accidental poisoning by other specified foods

Page 9: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8698 Accidental poisoning by other specified gases & vapors E8654 Accidental poisoning by other specified plants E8528 Accidental poisoning by other specified sedatives & hypnotics E8668 Accidental poisoning by other specified solid or liquid substances E8624 Accidental poisoning by other specified solvents E8538 Accidental poisoning by other specified tranquilizers E8554 Accidental poisoning by parasympatholytics & spasmolytics E8553 Accidental poisoning by parasympathomimetics [cholinergics] E8621 Accidental poisoning by petroleum fuels & cleaners E8623 Accidental poisoning by petroleum solids E8620 Accidental poisoning by petroleum solvents E8665 Accidental poisoning by plant food & fertilizer E8612 Accidental poisoning by polishes E8581 Accidental poisoning by primarily systemic agents E8541 Accidental poisoning by psychodysleptics [hallucinogens] E8542 Accidental poisoning by psychostimulants E8505 Accidental poisoning by pyrazole derivatives E8637 Accidental poisoning by rodenticides E8503 Accidental poisoning by salicylates E8694 Accidental poisoning by second-hand tobacco smoke E8651 Accidental poisoning by shellfish E8611 Accidental poisoning by soap products E8691 Accidental poisoning by sulfur dioxide E8556 Accidental poisoning by sympathomimetics (adrenergics) E8555 Accidental poisoning by sympathomimetics [adrenergics] E8610 Accidental poisoning by synthetic detergents & shampoos E8609 Accidental poisoning by unspecified alcohol, not elsewhere specified E8689 Accidental poisoning by unspecified carbon monoxide E8644 Accidental poisoning by unspecified corrosives & caustics E8589 Accidental poisoning by unspecified drugs E8559 Accidental poisoning by unspecified drugs acting on the central & autonomic nervous systems E8699 Accidental poisoning by unspecified gases & vapors E8669 Accidental poisoning by unspecified solid or liquid substances E8629 Accidental poisoning by unspecified solvent

Page 10: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8585 Accidental poisoning by water, mineral & uric acid metabolism drugs 9982 Accidental puncture or laceration during a procedure, not elsewhere classified E9133 Accidental suffocation by falling earth or other substance E9138 Accidental suffocation by other specified means E9131 Accidental suffocation by plastic bag E9139 Accidental suffocation by unspecified means E9132 Accidental suffocation due to lack of air (in closed place) E9197 Accidents caused by earth moving, scraping, or excavating machines E9205 Accidents caused by hypodermic needle E9203 Accidents caused by knives, swords, and daggers E9192 Accidents caused by lifting machines and appliances E9193 Accidents caused by metalworking machines E9191 Accidents caused by mining and earth-drilling machinery E9204 Accidents caused by other hand tools and implements E9201 Accidents caused by other powered hand tools E9208 Accidents caused by other specified cutting & piercing instruments or objects E9198 Accidents caused by other specified machinery E9209 Accidents caused by other unspecified cutting & piercing instruments or objects E9202 Accidents caused by powered households appliances and implements E9195 Accidents caused by prime movers, except electrical motors E9196 Accidents caused by transmission machinery E9199 Accidents caused by unspecified machinery E9194 Accidents caused by woodworking and forming machines E9043 Accidents due to exposure to weather conditions, not elsewhere classifiable E9041 Accidents due to lack of food E9042 Accidents due to lack of water E9049 Accidents due to privation, unqualified E847 Accidents involving cable cars not running on rails E848 Accidents involving other vehicles, not elsewhere classifiable E846 Accidents involving powered vehicles used solely within buildings & premises of industrial & commercial establishments 7916 Acetonuria 9403 Acid chemical burn of cornea & conjunctival sac 2830 Acquired hemolytic anemias, autoimmune hemolytic anemias 2832 Acquired hemolytic anemias, hemoglobinuria due to hemolysis from external causes

Page 11: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

4210 Acute & subacute bacterial endocarditis 41181 Acute & subacute forms of ischemic heart disease, coronary occlusion wo myocardial infarction 4211 Acute & subacute infective endocarditis in diseases classified elsewhere 570 Acute & subacute necrosis of liver 34121 Acute (transverse) myelitis in conditions classified elsewhere 34120 Acute (transverse) myelitis NOS 5711 Acute alcoholic hepatitis 38105 Acute allergic mucoid otitis media 38106 Acute allergic sanguinous otitis media 38104 Acute allergic serous otitis media 0060 Acute amebic dysentery without mention of abscess 36522 Acute angle closure glaucoma 5400 Acute appendicitis with generalized peritonitis 5401 Acute appendicitis with peritoneal abscess 5409 Acute appendicitis without mention of peritonitis 37205 Acute atopic conjunctivitis 46619 Acute bronchiolitis due to other infectious organisms 46611 Acute bronchiolitis due to respiratory syncytial virus (RSV) 4660 Acute bronchitis 51911 Acute bronchospasm 5173 Acute chest syndrome 37200 Acute conjunctivitis, unspecified 5950 Acute cystitis 53221 Acute duodenal ulcer with hemorrhage & perforation, with obstruction 53220 Acute duodenal ulcer with hemorrhage & perforation, without mention of obstruction 53201 Acute duodenal ulcer with hemorrhage, with obstruction 53200 Acute duodenal ulcer with hemorrhage, without mention of obstruction 53211 Acute duodenal ulcer with perforation, with obstruction 53210 Acute duodenal ulcer with perforation, without mention of obstruction 53231 Acute duodenal ulcer without mention of hemorrhage or perforation, with obstruction 53230 Acute duodenal ulcer without mention of hemorrhage, perforation, or obstruction 4219 Acute endocarditis, unspecified 46431 Acute epiglottitis with obstruction 46430 Acute epiglottitis without mention of obstruction

Page 12: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

4612 Acute ethmoidal sinusitis 38151 Acute eustachian salpingitis 37202 Acute follicular conjunctivitis 4611 Acute frontal sinusitis 53121 Acute gastric ulcer with hemorrhage & perforation, with obstruction 53120 Acute gastric ulcer with hemorrhage & perforation, without mention of obstruction 53101 Acute gastric ulcer with hemorrhage, with obstruction 53100 Acute gastric ulcer with hemorrhage, without mention of obstruction 53111 Acute gastric ulcer with perforation, with obstruction 53110 Acute gastric ulcer with perforation, without mention of obstruction 53131 Acute gastric ulcer without mention of hemorrhage or perforation, with obstruction 53130 Acute gastric ulcer wo mention of hemorrhage or perforation, wo mention of obstruction 53501 Acute gastritis with hemorrhage 53500 Acute gastritis without mention of hemorrhage 53401 Acute gastrojejunal ulcer with hemorrhage & obstruction 53420 Acute gastrojejunal ulcer with hemorrhage & perforation, without mention of obstruction 53421 Acute gastrojejunal ulcer with hemorrhage, perforation & obstruction 53400 Acute gastrojejunal ulcer with hemorrhage, without mention of obstruction 53411 Acute gastrojejunal ulcer with perforation & obstruction 53410 Acute gastrojejunal ulcer with perforation, without mention of obstruction 53431 Acute gastrojejunal ulcer without mention of hemorrhage or perforation, with obstruction 53430 Acute gastrojejunal ulcer without mention of hemorrhage, perforation or obstruction 58081 Acute glomerulonephritis in diseases classified elsewhere 5800 Acute glomerulonephritis with lesion of proliferative glomerulonephritis 5804 Acute glomerulonephritis with Lesion of rapidly progressive glomerulonephritis 58089 Acute glomerulonephritis with other specified pathological lesion in kidney 5809 Acute glomerulonephritis with unspecified pathological lesion in kidney 42091 Acute idiopathic pericarditis 37601 Acute inflammation of orbit, orbital cellulitis 37603 Acute inflammation of orbit, orbital osteomyelitis 37602 Acute inflammation of orbit, orbital periostitis 37604 Acute inflammation of orbit, tenonitis 37600 Acute inflammation of orbit, unspecified 6150 Acute inflammatory diseases of uterus, except cervix

Page 13: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

5847 Acute kidney failure with lesion of medullary [papillary] necrosis 5846 Acute kidney failure with lesion of renal cortical necrosis 5845 Acute kidney failure with lesion of tubular necrosis 5848 Acute kidney failure with other specified pathological lesion in kidney 5849 Acute kidney failure, unspecified 4644 Acute laryngitis & tracheitis, croup 46401 Acute laryngitis w obstruction 46400 Acute laryngitis wo mention of obstruction 46421 Acute laryngotracheitis with obstruction 46420 Acute laryngotracheitis without mention of obstruction 20801 Acute leukemia of unspecified cell type, in remission 20800 Acute leukemia of unspecified cell type, without mention of remission 20401 Acute lymphoid leukemia, in remission 20400 Acute lymphoid leukemia, without mention of remission 4610 Acute maxillary sinusitis 20601 Acute monocytic leukemia, in remission 20600 Acute monocytic leukemia, without mention of remission 38102 Acute mucoid otitis media 20501 Acute myeloid leukemia, in remission 20500 Acute myeloid leukemia, without mention of remission 41000 Acute myocardial infarction of anterolateral wall, episode of care unspecified 41001 Acute myocardial infarction of anterolateral wall, initial episode of care 41002 Acute myocardial infarction of anterolateral wall, subsequent episode of care 41020 Acute myocardial infarction of inferolateral wall, episode of care unspecified 41021 Acute myocardial infarction of inferolateral wall, initial episode of care 41022 Acute myocardial infarction of inferolateral wall, subsequent episode of care 41030 Acute myocardial infarction of inferoposterior wall, episode of care unspecified 41031 Acute myocardial infarction of inferoposterior wall, initial episode of care 41032 Acute myocardial infarction of inferoposterior wall, subsequent episode of care 41010 Acute myocardial infarction of other anterior wall, episode of care unspecified 41011 Acute myocardial infarction of other anterior wall, initial episode of care 41012 Acute myocardial infarction of other anterior wall, subsequent episode of care 41040 Acute myocardial infarction of other inferior wall, episode of care unspecified 41041 Acute myocardial infarction of other inferior wall, initial episode of care

Page 14: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

41042 Acute myocardial infarction of other inferior wall, subsequent episode of care 41050 Acute myocardial infarction of other lateral wall, episode of care unspecified 41051 Acute myocardial infarction of other lateral wall, initial episode of care 41052 Acute myocardial infarction of other lateral wall, subsequent episode of care 41080 Acute myocardial infarction of other specified sites, episode of care unspecified 41081 Acute myocardial infarction of other specified sites, initial episode of care 41082 Acute myocardial infarction of other specified sites, subsequent episode of care 41060 Acute myocardial infarction of true posterior wall, episode of care unspecified 41061 Acute myocardial infarction of true posterior wall, initial episode of care 41062 Acute myocardial infarction of true posterior wall, subsequent episode of care 41090 Acute myocardial infarction of unspecified site, episode of care unspecified 41091 Acute myocardial infarction of unspecified site, initial episode of care 41092 Acute myocardial infarction of unspecified site, subsequent episode of care 41070 Acute myocardial infarction, subendocardial infarction, episode of care unspecified 41071 Acute myocardial infarction, subendocardial infarction, initial episode of care 41072 Acute myocardial infarction, subendocardial infarction, subsequent episode of care 4220 Acute myocarditis in diseases classified elsewhere 42291 Acute myocarditis, idiopathic myocarditis 42292 Acute myocarditis, septic myocarditis 42293 Acute myocarditis, toxic myocarditis 42290 Acute myocarditis, unspecified 04521 Acute nonparalytic poliomyelitis, poliovirus type I 04522 Acute nonparalytic poliomyelitis, poliovirus type II 04523 Acute nonparalytic poliomyelitis, poliovirus type III 04520 Acute nonparalytic poliomyelitis, unspecified type poliovirus 38100 Acute nonsuppurative otitis media, unspecified 07051 Acute or unspecified hepatitis C wo mention of hepatic coma 6145 Acute or unspecified pelvic peritonitis, female 73007 Acute osteomyelitis of ankle & foot 73003 Acute osteomyelitis of forearm 73004 Acute osteomyelitis of hand 73006 Acute osteomyelitis of lower leg 73009 Acute osteomyelitis of multiple sites 73008 Acute osteomyelitis of other specified sites

Page 15: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

73005 Acute osteomyelitis of pelvic region & thigh 73001 Acute osteomyelitis of shoulder region 73002 Acute osteomyelitis of upper arm 73000 Acute osteomyelitis, site unspecified 33811 Acute pain due to trauma 5770 Acute pancreatitis 04501 Acute paralytic poliomyelitis specified as bulbar, poliovirus type I 04502 Acute paralytic poliomyelitis specified as bulbar, poliovirus type II 04503 Acute paralytic poliomyelitis specified as bulbar, poliovirus type III 04500 Acute paralytic poliomyelitis specified as bulbar, unspecified type of poliovirus 6143 Acute parametritis & pelvic cellulitis 2983 Acute paranoid reaction 53301 Acute peptic ulcer of unspecified site with hemorrhage & obstruction 53320 Acute peptic ulcer of unspecified site with hemorrhage & perforation, without mention of obstruction 53321 Acute peptic ulcer of unspecified site with hemorrhage, perforation & obstruction 53300 Acute peptic ulcer of unspecified site with hemorrhage, without mention of obstruction 53311 Acute peptic ulcer of unspecified site with perforation & obstruction 53310 Acute peptic ulcer of unspecified site with perforation, without mention of obstruction 53331 Acute peptic ulcer of unspecified site without mention of hemorrhage & perforation, with obstruction 53330 Acute peptic ulcer of unspecified site without mention of hemorrhage, perforation or obstruction 4200 Acute pericarditis in diseases classified elsewhere 42090 Acute pericarditis, unspecified 04511 Acute poliomyelitis w other paralysis, poliovirus type I 04512 Acute poliomyelitis w other paralysis, poliovirus type II 04513 Acute poliomyelitis w other paralysis, poliovirus type III 04510 Acute poliomyelitis w other paralysis, unspecified type of poliovirus 04591 Acute poliomyelitis, unspecified, poliovirus type I 04592 Acute poliomyelitis, unspecified, poliovirus type II 04593 Acute poliomyelitis, unspecified, poliovirus type III 33812 Acute post-thoracotomy pain 5061 Acute pulmonary edema due to fumes & vapors 4150 Acute pulmonary heart disease, acute cor pulmonale 41511 Acute pulmonary heart disease, iatrogenic pulmonary embolism & infarction 41519 Acute pulmonary heart disease, other pulmonary embolism & infarction

Page 16: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

5080 Acute pulmonary manifestations due to radiation 9987 Acute reaction to foreign substance accidentally left during a procedure, not elsewhere classified 3081 Acute reaction to stress predominant disturbance of consciousness 3080 Acute reaction to stress, predominant disturbance of emotions 3082 Acute reaction to stress, predominant psychomotor disturbance 3911 Acute rheumatic endocarditis 3919 Acute rheumatic heart disease, unspecified 3912 Acute rheumatic myocarditis 3910 Acute rheumatic pericarditis 6140 Acute salpingitis & oophoritis 38103 Acute sanguinous otitis media 29542 Acute schizophrenic episode, chronic 29545 Acute schizophrenic episode, in remission 29541 Acute schizophrenic episode, subchronic 29543 Acute schizophrenic episode, subchronic w acute exacerbation 29540 Acute schizophrenic episode, unspecified 38101 Acute serous otitis media 4619 Acute sinusitis, unspecified 4613 Acute sphenoidal sinusitis 38202 Acute suppurative otitis media in diseases classified elsewhere 38201 Acute suppurative otitis media with spontaneous rupture of eardrum 38200 Acute suppurative otitis media without spontaneous rupture of eardrum 09181 Acute syphilitic meningitis, secondary 2450 Acute thyroiditis 463 Acute tonsillitis 46411 Acute tracheitis with obstruction 46410 Acute tracheitis without mention of obstruction 5570 Acute vascular insufficiency of intestine 45340 Acute venous embolism & thrombosis of deep vessels of lower extremity; Unspecified deep vessels of lower extremity 45342 Acute venous embolism and thrombosis of deep vessels of lower extremity; Distal lower extremity 45341 Acute venous embolism and thrombosis of deep vessels of lower extremity; Proximal lower extremity 4538 Acute venous embolism and thrombosis of other specified veins 436 Acute, but ill-defined, cerebrovascular disease 30924 Adjustment disorder with anxiety

Page 17: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

3090 Adjustment disorder with depressed mood 30922 Adjustment reaction w emancipation disorder of adolescence & early adult life 3094 Adjustment reaction w mixed disturbance of emotions & conduct 30928 Adjustment reaction w mixed emotional features 30982 Adjustment reaction w physical symptoms 3093 Adjustment reaction w predominant disturbance of conduct 30921 Adjustment reaction w separation anxiety disorder 30923 Adjustment reaction w specific academic or work inhibition 30983 Adjustment reaction w withdrawal 30981 Adjustment reactions, prolonged posttraumatic stress disorder 7725 Adrenal hemorrhage of fetus or newborn 99582 Adult emotional and psychological abuse 99580 Adult maltreatment, unspecified 99584 Adult neglect (nutritional) 99581 Adult physical abuse 99583 Adult sexual abuse 30113 Affective personality disorder, cyclothymic disorder 30110 Affective personality disorder, unspecified 0865 African trypanosomiasis, unspecified 9991 Air embolism as a complication of medical care, not elsewhere classified 9580 Air embolism as an early complication of trauma 30301 Alcohol dependence syndrome, acute alcoholic intoxication, continuous 30302 Alcohol dependence syndrome, acute alcoholic intoxication, episodic 30303 Alcohol dependence syndrome, acute alcoholic intoxication, in remission 30300 Alcohol dependence syndrome, acute alcoholic intoxication, unspecified 30391 Alcohol dependence syndrome, other & unspecified alcohol dependence, continuous 30392 Alcohol dependence syndrome, other & unspecified alcohol dependence, episodic 30393 Alcohol dependence syndrome, other & unspecified alcohol dependence, in remission 30390 Alcohol dependence syndrome, unspecified alcohol dependence 2911 Alcohol induced persisting amnestic disorder 2912 Alcohol induced persisting dementia 2915 Alcohol induced psychotic disorder with delusions 2913 Alcohol induced psychotic disorder with hallucinations 29182 Alcohol induced sleep disorders

Page 18: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

29181 Alcohol withdrawal 2910 Alcohol withdrawal delirium 4255 Alcoholic cardiomyopathy 53531 Alcoholic gastritis with hemorrhage 53530 Alcoholic gastritis without mention of hemorrhage 9402 Alkaline chemical burn of cornea & conjunctival sac 5583 Allergic gastroenteritis & colitis 2870 Allergic purpura 9953 Allergy, unspecified, not elsewhere classified 78097 Altered mental status 2940 Amnestic disorder in conditions classified elsewhere 99562 Anaphylactic shock due to crustaceans 99568 Anaphylactic shock due to eggs 99565 Anaphylactic shock due to fish 99566 Anaphylactic shock due to food additives 99563 Anaphylactic shock due to fruits & vegetables 99567 Anaphylactic shock due to milk products 99569 Anaphylactic shock due to other specified food 99561 Anaphylactic shock due to peanuts 9994 Anaphylactic shock due to serum, not elsewhere classified 99564 Anaphylactic shock due to tree nuts & seeds 99560 Anaphylactic shock due to unspecified food 2859 Anemia, unspecified 0930 Aneurysm of aorta, specified as syphilitic 4423 Aneurysm of artery of lower extremity 44281 Aneurysm of artery of the neck 4420 Aneurysm of artery of upper extremity 41411 Aneurysm of coronary vessels 41410 Aneurysm of heart (wall) 4422 Aneurysm of iliac artery 44289 Aneurysm of other specified site 44284 Aneurysm of other visceral artery 4421 Aneurysm of renal artery 44283 Aneurysm of splenic artery

Page 19: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

44282 Aneurysm of the subclavian artery 4429 Aneurysm of unspecified site 4130 Angina pectoris, angina decubitus 4131 Angina pectoris, prinzmetal angina 56985 Angiodysplasia of intestine with hemorrhage 53783 Angiodysplasia of stomach & duodenum with hemorrhage 9951 Angioneurotic edema, not elsewhere classified E8273 Animal drawn vehicle accident involving occupant of animal-drawn vehicle E8274 Animal drawn vehicle accident involving occupant of streetcar E8278 Animal drawn vehicle accident involving other unspecified person E8270 Animal drawn vehicle accident involving pedestrian E8272 Animal drawn vehicle accident involving rider of animal E8279 Animal drawn vehicle accident involving unspecified person 7830 Anorexia 64133 Antepartum hemorrhage associated with coagulation defects, antepartum complication 64130 Antepartum hemorrhage associated with coagulation defects, unspecified as to episode of care 64131 Antepartum hemorrhage associated with coagulation defects, with delivery 83651 Anterior closed dislocation of tibia, proximal end 33520 Anterior horn cell disease, motor neuron disease, amyotrophic lateral sclerosis 33522 Anterior horn cell disease, motor neuron disease, progressive bulbar palsy 33521 Anterior horn cell disease, motor neuron disease, progressive muscular atrophy 33523 Anterior horn cell disease, motor neuron disease, pseudobulbar palsy 0322 Anterior nasal diphtheria 83661 Anterior open dislocation of tibia, proximal end 0223 Anthrax septicemia 0229 Anthrax, unspecified 3017 Antisocial personality disorder 29384 Anxiety disorder in conditions classified elsewhere 94811 Any degree burn involving 10-19 percent of body surface with third degree burn of 10 - 19% 94810 Any degree burn involving 10-19 percent of body surface with third degree burn of less than 10 percent or unspecified 94821 Any degree burn involving 20 - 29 percent of body surface with third degree burn of 10-19% 94822 Any degree burn involving 20 - 29 percent of body surface with third degree burn of 20-29% 94820 Any degree burn involving 20 - 29 percent of body surface with third degree burn of less than 10 percent or unspecified 94831 Any degree burn involving 30 - 39 percent of body surface with third degree burn of 10-19 percent

Page 20: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

94833 Any degree burn involving 30 - 39 percent of body surface with third degree burn of 30-39% 94830 Any degree burn involving 30 - 39 percent of body surface with third degree burn of less than 10 percent or unspecified 94832 Any degree burn involving 30-39 percent of body surface with third degree burn of 20-29% 94841 Any degree burn involving 40-49 percent of body surface with third degree burn of 10-19% 94842 Any degree burn involving 40-49 percent of body surface with third degree burn of 20-29% 94843 Any degree burn involving 40-49 percent of body surface with third degree burn of 30-39% 94844 Any degree burn involving 40-49 percent of body surface with third degree burn of 40-49% 94840 Any degree burn involving 40-49 percent of body surface with third degree burn of less than 10 percent or unspecified 94851 Any degree burn involving 50-59 percent of body surface with third degree burn of 10-19% 94852 Any degree burn involving 50-59 percent of body surface with third degree burn of 20-29% 94853 Any degree burn involving 50-59 percent of body surface with third degree burn of 30-39% 94854 Any degree burn involving 50-59 percent of body surface with third degree burn of 40-49% 94855 Any degree burn involving 50-59 percent of body surface with third degree burn of 50-59% 94850 Any degree burn involving 50-59 percent of body surface with third degree burn of less than 10 percent or unspecified 94861 Any degree burn involving 60-69 percent of body surface with third degree burn of 10-19% 94862 Any degree burn involving 60-69 percent of body surface with third degree burn of 20-29% 94863 Any degree burn involving 60-69 percent of body surface with third degree burn of 30-39% 94864 Any degree burn involving 60-69 percent of body surface with third degree burn of 40-49% 94865 Any degree burn involving 60-69 percent of body surface with third degree burn of 50-59% 94866 Any degree burn involving 60-69 percent of body surface with third degree burn of 60-69% 94860 Any degree burn involving 60-69 percent of body surface with third degree burn of less than 10 percent or unspecified 94871 Any degree burn involving 70-79 percent of body surface with third degree burn of 10-19% 94872 Any degree burn involving 70-79 percent of body surface with third degree burn of 20-29% 94873 Any degree burn involving 70-79 percent of body surface with third degree burn of 30-39% 94874 Any degree burn involving 70-79 percent of body surface with third degree burn of 40-49% 94875 Any degree burn involving 70-79 percent of body surface with third degree burn of 50-59% 94876 Any degree burn involving 70-79 percent of body surface with third degree burn of 60-69% 94877 Any degree burn involving 70-79 percent of body surface with third degree burn of 70-79% 94870 Any degree burn involving 70-79 percent of body surface with third degree burn of less than 10 percent or unspecified 94881 Any degree burn involving 80-89 percent of body surface with third degree burn of 10-19% 94882 Any degree burn involving 80-89 percent of body surface with third degree burn of 20-29% 94883 Any degree burn involving 80-89 percent of body surface with third degree burn of 30-39% 94884 Any degree burn involving 80-89 percent of body surface with third degree burn of 40-49% 94885 Any degree burn involving 80-89 percent of body surface with third degree burn of 50-59%

Page 21: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

94886 Any degree burn involving 80-89 percent of body surface with third degree burn of 60-69% 94887 Any degree burn involving 80-89 percent of body surface with third degree burn of 70-79% 94888 Any degree burn involving 80-89 percent of body surface with third degree burn of 80-89% 94880 Any degree burn involving 80-89 percent of body surface with third degree burn of less than 10 percent or unspecified 94890 Any degree burn involving 90 percent or more of body surface with third degree burn of less than 10 % or unspecified 94891 Any degree burn involving 90% or more of body surface with third degree burn of 10-19% 94892 Any degree burn involving 90% or more of body surface with third degree burn of 20-29% 94893 Any degree burn involving 90% or more of body surface with third degree burn of 30-39% 94894 Any degree burn involving 90% or more of body surface with third degree burn of 40-49% 94895 Any degree burn involving 90% or more of body surface with third degree burn of 50-59% 94896 Any degree burn involving 90% or more of body surface with third degree burn of 60-69% 94897 Any degree burn involving 90% or more of body surface with third degree burn of 70-79% 94898 Any degree burn involving 90% or more of body surface with third degree burn of 80-89% 94899 Any degree burn involving 90% or more of body surface with third degree burn of 90% or more of body surface 94800 Any degree burn involving less than 10 percent of body surface, with third degree burn of less than 10 % or unspecified 4419 Aortic aneurysm of unspecified site without mention of rupture 4415 Aortic aneurysm of unspecified site, ruptured 44102 Aortic aneurysm, dissection of aorta, abdominal 44101 Aortic aneurysm, dissection of aorta, thoracic 44103 Aortic aneurysm, dissection of aorta, thoracoabdominal 44100 Aortic aneurysm, dissection of aorta, unspecified site 7843 Aphasia 541 Appendicitis, unqualified 0787 Arenaviral hemorrhagic fever 4440 Arterial embolism & thrombosis of abdominal aorta 44481 Arterial embolism & thrombosis of arteries of the extremities of iliac artery 44489 Arterial embolism & thrombosis of arteries of the extremities of other artery 4449 Arterial embolism & thrombosis of arteries of the extremities of unspecified artery 44422 Arterial embolism & thrombosis of arteries of the lower extremities 44421 Arterial embolism & thrombosis of arteries of the upper extremities 4441 Arterial embolism & thrombosis of thoracic aorta 4476 Arteritis, unspecified 05671 Arthritis due to rubella 7133 Arthropathy associated with dermatological disorders

Page 22: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

7131 Arthropathy associated with gastrointestinal conditions other than infections 71177 Arthropathy associated with helminthiasis, ankle & foot 71173 Arthropathy associated with helminthiasis, forearm 71174 Arthropathy associated with helminthiasis, hands 71176 Arthropathy associated with helminthiasis, lower leg 71179 Arthropathy associated with helminthiasis, multiple sites 71178 Arthropathy associated with helminthiasis, other specified sites 71175 Arthropathy associated with helminthiasis, pelvic region & thigh 71171 Arthropathy associated with helminthiasis, shoulder region 71170 Arthropathy associated with helminthiasis, site unspecified 71172 Arthropathy associated with helminthiasis, upper arm 7132 Arthropathy associated with hematological disorders 7136 Arthropathy associated with hypersensitivity reaction 71167 Arthropathy associated with mycoses, ankle & foot 71163 Arthropathy associated with mycoses, forearm 71164 Arthropathy associated with mycoses, hand 71166 Arthropathy associated with mycoses, lower leg 71169 Arthropathy associated with mycoses, multiple sites 71168 Arthropathy associated with mycoses, other specified sites 71165 Arthropathy associated with mycoses, pelvic region & thigh 71161 Arthropathy associated with mycoses, shoulder region 71160 Arthropathy associated with mycoses, site unspecified 71162 Arthropathy associated with mycoses, upper arm 7135 Arthropathy associated with neurological disorders 71147 Arthropathy associated with other bacterial diseases, ankle & foot 71143 Arthropathy associated with other bacterial diseases, forearm 71144 Arthropathy associated with other bacterial diseases, hand 71146 Arthropathy associated with other bacterial diseases, lower leg 71149 Arthropathy associated with other bacterial diseases, multiple sites 71148 Arthropathy associated with other bacterial diseases, other specified sites 71145 Arthropathy associated with other bacterial diseases, pelvic region & thigh 71141 Arthropathy associated with other bacterial diseases, shoulder region 71140 Arthropathy associated with other bacterial diseases, site unspecified 71142 Arthropathy associated with other bacterial diseases, upper arm

Page 23: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

7138 Arthropathy associated with other conditions classifiable elsewhere 7130 Arthropathy associated with other endocrine & metabolic disorders 71187 Arthropathy associated with other infectious & parasitic diseases, ankle & foot 71183 Arthropathy associated with other infectious & parasitic diseases, forearm 71184 Arthropathy associated with other infectious & parasitic diseases, hand 71186 Arthropathy associated with other infectious & parasitic diseases, lower leg 71189 Arthropathy associated with other infectious & parasitic diseases, multiple sites 71188 Arthropathy associated with other infectious & parasitic diseases, other specified sites 71185 Arthropathy associated with other infectious & parasitic diseases, pelvic region & thigh 71181 Arthropathy associated with other infectious & parasitic diseases, shoulder region 71180 Arthropathy associated with other infectious & parasitic diseases, site unspecified 71182 Arthropathy associated with other infectious & parasitic diseases, upper arm 71157 Arthropathy associated with other viral diseases, ankle & foot 71153 Arthropathy associated with other viral diseases, forearm 71154 Arthropathy associated with other viral diseases, hand 71156 Arthropathy associated with other viral diseases, lower leg 71159 Arthropathy associated with other viral diseases, multiple sites 71158 Arthropathy associated with other viral diseases, other specified sites 71155 Arthropathy associated with other viral diseases, pelvic region & thigh 71151 Arthropathy associated with other viral diseases, shoulder region 71150 Arthropathy associated with other viral diseases, site unspecified 71152 Arthropathy associated with other viral diseases, upper arm 71113 Arthropathy associated with Reiter's disease & nonspecific urethritis, forearm 71114 Arthropathy associated with Reiter's disease & nonspecific urethritis, hand 71116 Arthropathy associated with Reiter's disease & nonspecific urethritis, lower leg 71115 Arthropathy associated with Reiter's disease & nonspecific urethritis, pelvic region & thigh 71111 Arthropathy associated with Reiter's disease & nonspecific urethritis, shoulder region 71110 Arthropathy associated with Reiter's disease & nonspecific urethritis, site unspecified 71112 Arthropathy associated with Reiter's disease & nonspecific urethritis, upper arm 7134 Arthropathy associated with respiratory disorders 0650 Arthropod-borne Crimean hemorrhagic fever (CHF Congo virus) 0659 Arthropod-borne hemorrhagic fever, unspecified 0652 Arthropod-borne Kyasanur forest disease 0651 Arthropod-borne Omsk hemorrhagic fever

Page 24: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

0653 Arthropod-borne other tick-borne hemorrhagic fever 0669 Arthropod-borne viral disease, unspecified 79901 Asphyxia 9947 Asphyxiation & strangulation 49390 Asthma, unspecified 49391 Asthma, unspecified type, with status asthmaticus 49392 Asthma, unspecified, with (acute) exacerbation 44502 Atheroembolism toe syndrome 44581 Atheroembolism, kidney 44501 Atheroembolism, of upper extermities 44589 Atheroembolism, other site 53511 Atrophic gastritis with hemorrhage 53510 Atrophic gastritis without mention of hemorrhage 31401 Attention deficit disorder of childhood w hyperactivity 31400 Attention deficit disorder of childhood wo mention of hyperactivity 29682 Atypical depressive disorder 29681 Atypical manic disorder 29900 Autistic disorder, current or active state 29901 Autistic disorder, residual state 8713 Avulsion of eye 92231 Back contusion 7907 Bacteremia 77183 Bacteremia of newborn 04111 Bacterial inf in conditions classified elsewhere & of unspec site; Methicillin suscep staph aureus (Revised 10/2008) 04183 Bacterial infection condition classified elsewhere & of unspecified site clostridium perfringens 0413 Bacterial infection in conditions classified elsewhere & of unspecified site; Klebsiella pneumoniae 04186 Bacterial infection in conditions classified elsewhere and of unspecified site; Helicobacter pylori [H. pylori] 0419 Bacterial infection, unspecified, in conditions classified elsewhere of unspecified site 04182 Bacterial infections in conditions classified elsewhere & of unspecified site, bacillus fragilis 04181 Bacterial infections in conditions classified elsewhere & of unspecified site, mycoplasma 04184 Bacterial infections in conditions classified elsewhere & of unspecified site, other anaerobes 48281 Bacterial pneumonia due to Anaerobes 48282 Bacterial pneumonia due to Escherichia coli, E. coli 4822 Bacterial pneumonia due to Hemophilus influenzae (H. influenzae)

Page 25: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

4820 Bacterial pneumonia due to Klebsiella pneumoniae 48284 Bacterial pneumonia due to Legionnaires' disease 48283 Bacterial pneumonia due to other gram-negative bacteria 48249 Bacterial pneumonia due to other Staphylococcus 48239 Bacterial pneumonia due to other Streptococcus 4821 Bacterial pneumonia due to Pseudomonas 48240 Bacterial pneumonia due to Staphylococcus, unspecified 48231 Bacterial pneumonia due to Streptococcus, group A 48232 Bacterial pneumonia due to Streptococcus, group B 48230 Bacterial pneumonia due to Streptococcus, unspecified 4829 Bacterial pneumonia, unspecified 9930 Barotrauma, otitic 9931 Barotrauma, sinus 53085 Barrett's esophagus 40311 Benign hypertensive kidney disease with chronic kidney disease 40310 Benign hypertensive kidney disease without chronic kidney disease 60021 Benign localized hyperplasia of prostate with urinary obstruction 55102 Bilateral femoral hernia with gangrene 55202 Bilateral femoral hernia with obstruction 55002 Bilateral inguinal hernia, with gangrene 55012 Bilateral inguinal hernia, with obstruction, without mention of gangrene 29680 Bipolar disorder, unspecified 29655 Bipolar I disorder, most recent episode (or current) depressed, in partial or unspecified remission 29656 Bipolar I disorder, most recent episode (or current) depressed, in remission 29651 Bipolar I disorder, most recent episode (or current) depressed, mild 29652 Bipolar I disorder, most recent episode (or current) depressed, moderate 29654 Bipolar I disorder, most recent episode (or current) depressed, severe, specified as w psychotic behavior 29653 Bipolar I disorder, most recent episode (or current) depressed, severe, wo mention of psychotic behavior 29650 Bipolar I disorder, most recent episode (or current) depressed, unspecified 29646 Bipolar I disorder, most recent episode (or current) manic, in full remission 29645 Bipolar I disorder, most recent episode (or current) manic, in partial or unspecified remission 29641 Bipolar I disorder, most recent episode (or current) manic, mild 29642 Bipolar I disorder, most recent episode (or current) manic, moderate 29644 Bipolar I disorder, most recent episode (or current) manic, severe, specified as w psychotic behavior

Page 26: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

29643 Bipolar I disorder, most recent episode (or current) manic, severe, wo mention of psychotic behavior 29640 Bipolar I disorder, most recent episode (or current) manic, unspecified 29666 Bipolar I disorder, most recent episode (or current) mixed, in full remission 29665 Bipolar I disorder, most recent episode (or current) mixed, in partial or unspecified remission 29661 Bipolar I disorder, most recent episode (or current) mixed, mild 29662 Bipolar I disorder, most recent episode (or current) mixed, moderate 29664 Bipolar I disorder, most recent episode (or current) mixed, severe, specified as w psychotic behavior 29663 Bipolar I disorder, most recent episode (or current) mixed, severe, wo mention of psychotic behavior 29660 Bipolar I disorder, most recent episode (or current) mixed, unspecified 2967 Bipolar I disorder, most recent episode (or current) unspecified 29606 Bipolar I disorder, single manic episode; in full remission 29605 Bipolar I disorder, single manic episode; in partial or unspecified remission 29601 Bipolar I disorder, single manic episode; mild 29602 Bipolar I disorder, single manic episode; moderate 29603 Bipolar I disorder, single manic episode; severe wo mention of psychotic behavior 29604 Bipolar I disorder, single manic episode; severe, specified as w psychotic behavior 29600 Bipolar I disorder, single manic episode; unspecified 9210 Black eye, not otherwise specified 0848 Blackwater fever 5960 Bladder neck obstruction 9133 Blister of elbow, forearm & wrist, infected 9132 Blister of elbow, forearm & wrist, without mention of infection 9103 Blister of face, neck & scalp except eye, infected 9102 Blister of face, neck & scalp except eye, without mention of infection 9153 Blister of fingers, infected 9173 Blister of foot & toe(s), infected 9143 Blister of hand(s), except finger(s) alone, infected 9142 Blister of hand(s), except finger(s) alone, without mention of infection 9163 Blister of hip, thigh, leg & ankle, infected 9193 Blister of other, multiple & unspecified sites, infected 9123 Blister of shoulder & upper arm, infected 9122 Blister of shoulder & upper arm, without mention of infection 9113 Blister of trunk, infected 94223 Blisters with epidermal loss due to second degree burn of abdominal wall

Page 27: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

94523 Blisters with epidermal loss due to second degree burn of ankle 94224 Blisters with epidermal loss due to second degree burn of any part of back 94121 Blisters with epidermal loss due to second degree burn of any part of ear 94126 Blisters with epidermal loss due to second degree burn of any part of scalp 94526 Blisters with epidermal loss due to second degree burn of any part of thigh 94324 Blisters with epidermal loss due to second degree burn of axilla 94426 Blisters with epidermal loss due to second degree burn of back of hand 94221 Blisters with epidermal loss due to second degree burn of breast 94222 Blisters with epidermal loss due to second degree burn of chest wall, excluding breast & nipple 94124 Blisters with epidermal loss due to second degree burn of chin 94322 Blisters with epidermal loss due to second degree burn of elbow 94122 Blisters with epidermal loss due to second degree burn of eye, with other parts of face, head & neck 94522 Blisters with epidermal loss due to second degree burn of foot 94321 Blisters with epidermal loss due to second degree burn of forearm 94127 Blisters with epidermal loss due to second degree burn of forehead & cheek 94225 Blisters with epidermal loss due to second degree burn of genitalia 94525 Blisters with epidermal loss due to second degree burn of knee 94123 Blisters with epidermal loss due to second degree burn of lip(s) 94524 Blisters with epidermal loss due to second degree burn of lower leg 94529 Blisters with epidermal loss due to second degree burn of multiple sites of lower limb(s) 94428 Blisters with epidermal loss due to second degree burn of multiple sites of wrist(s) & hand(s) 94129 Blisters with epidermal loss due to second degree burn of multiple sites, except eye, of face, head & neck 9462 Blisters with epidermal loss due to second degree burn of multiple specified sites 94128 Blisters with epidermal loss due to second degree burn of neck 94125 Blisters with epidermal loss due to second degree burn of nose (septum) 94229 Blisters with epidermal loss due to second degree burn of other & multiple sites of trunk 94425 Blisters with epidermal loss due to second degree burn of palm of hand 94326 Blisters with epidermal loss due to second degree burn of scapular region 94325 Blisters with epidermal loss due to second degree burn of shoulder 94421 Blisters with epidermal loss due to second degree burn of single digit other than thumb 94422 Blisters with epidermal loss due to second degree burn of thumb 94521 Blisters with epidermal loss due to second degree burn of toe(s) 94424 Blisters with epidermal loss due to second degree burn of two or more digits of hand including thumb 94423 Blisters with epidermal loss due to second degree burn of two or more digits of hand, not including thumb

Page 28: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

94120 Blisters with epidermal loss due to second degree burn of unspecified site of face & head 94420 Blisters with epidermal loss due to second degree burn of unspecified site of hand 94520 Blisters with epidermal loss due to second degree burn of unspecified site of lower limb (leg) 94220 Blisters with epidermal loss due to second degree burn of unspecified site of trunk 94320 Blisters with epidermal loss due to second degree burn of unspecified site of upper limb 94323 Blisters with epidermal loss due to second degree burn of upper arm 94329 Blisters with epidermal loss due to second degree burn of upper limb, except wrist & hand 94427 Blisters with epidermal loss due to second degree burn of wrist 9492 Blisters with epidermal loss due to second degree burn, unspecified site 0051 Botulism food poisoning 6206 Broad ligament laceration syndrome 4941 Bronchiectasis with acute exacerbation 490 Bronchitis, not specified as acute or chronic 485 Bronchopneumonia, organism unspecified 0200 Bubonic plague 9472 Burn of esophagus 9473 Burn of gastrointestinal tract 9471 Burn of larynx, trachea & lung 9470 Burn of mouth & pharynx 9478 Burn of other specified sites of internal organs 94101 Burn of unspecified degree of any part of ear 94106 Burn of unspecified degree of any part of scalp 94104 Burn of unspecified degree of chin 94102 Burn of unspecified degree of eye, with other parts of face, head & neck 94107 Burn of unspecified degree of forehead & cheek 94103 Burn of unspecified degree of lip(s) 94109 Burn of unspecified degree of multiple sites, except with eye, of face, head & neck 94108 Burn of unspecified degree of neck 94105 Burn of unspecified degree of nose, septum 94100 Burn of unspecified degree of unspecified site of face & head 9479 Burn of unspecified site of internal organs 9474 Burn of vagina & uterus 9405 Burn with resulting rupture & destruction of eyeball 92232 Buttock contusion

Page 29: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

95202 C1 - C4 level cervical cord injury with anterior spinal cord syndrome without spinal bone injury 95203 C1 - C4 level cervical cord injury with central spinal cord syndrome without spinal bone injury 95201 C1 - C4 level cervical cord injury with complete lesion of spinal cord without spinal bone injury 95204 C1 - C4 level cervical cord injury with other specified spinal cord injury without spinal bone injury 95200 C1 - C4 level cervical cord injury with unspecified spinal cord injury without spinal bone injury 95207 C5-C7 level cervical cord injury with anterior spinal cord syndrome without spinal bone injury 95208 C5-C7 level cervical cord injury with central spinal cord syndrome without spinal bone injury 95206 C5-C7 level cervical cord injury with complete lesion of spinal cord without spinal bone injury 95209 C5-C7 level cervical cord injury with other specified spinal cord injury without spinal bone injury 95205 C5-C7 level cervical cord injury with unspecified spinal cord injury without spinal bone injury 9933 Caisson disease 5942 Calculus in urethra 57431 Calculus of bile duct with acute cholecystitis, with obstruction 57430 Calculus of bile duct with acute cholecystitis, without mention of obstruction 57441 Calculus of bile duct with other cholecystitis, with obstruction 57440 Calculus of bile duct with other cholecystitis, without mention of obstruction 57451 Calculus of bile duct without mention of cholecystitis, with obstruction 57450 Calculus of bile duct without mention of cholecystitis, without mention of obstruction 57481 Calculus of gallbladder & bile duct with acute & chronic cholecystis with obstruction 57480 Calculus of gallbladder & bile duct with acute & chronic cholecystis without obstruction 57461 Calculus of gallbladder & bile duct with acute cholecystis with obstruction 57460 Calculus of gallbladder & bile duct with acute cholecystis without obstruction 57471 Calculus of gallbladder & bile duct with other cholecystis with obstruction 57470 Calculus of gallbladder & bile duct with other cholecystis without obstruction 57491 Calculus of gallbladder & bile duct without cholecystis w obstruction 57490 Calculus of gallbladder & bile duct without cholecystis without obstruction 57401 Calculus of gallbladder with acute cholecystitis, with obstruction 57400 Calculus of gallbladder with acute cholecystitis, without mention of obstruction 57411 Calculus of gallbladder with other cholecystitis, with obstruction 57410 Calculus of gallbladder with other cholecystitis, without mention of obstruction 57420 Calculus of gallbladder without mention of cholecystitis or obstruction 57421 Calculus of gallbladder without mention of cholecystitis, with obstruction 5920 Calculus of kidney 5949 Calculus of lower urinary tract, unspecified

Page 30: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

5921 Calculus of ureter 11283 Candidal meningitis 86512 Capsular tears to spleen without major disruption of parenchyma, with open wound into cavity 86502 Capsular tears to spleen, without major disruption of parenchyma, without mention of open wound into cavity 77985 Cardiac arrest of newborn 9971 Cardiac complications, not elsewhere classified 4279 Cardiac dysrhythmia, unspecified 42731 Cardiac dysrhythmias, atrial fibrillation 42732 Cardiac dysrhythmias, atrial flutter 4275 Cardiac dysrhythmias, cardiac arrest 42769 Cardiac dysrhythmias, other premature beats 4270 Cardiac dysrhythmias, paroxysmal supraventricular tachycardia 4272 Cardiac dysrhythmias, paroxysmal tachycardia, unspecified 4271 Cardiac dysrhythmias, paroxysmal ventricular tachycardia 42760 Cardiac dysrhythmias, premature beats, unspecified 42781 Cardiac dysrhythmias, sinoatrial node dysfunction 42761 Cardiac dysrhythmias, supraventricular premature beats 42741 Cardiac dysrhythmias, ventricular fibrillation 42742 Cardiac dysrhythmias, ventricular flutter 78551 Cardiogenic shock 4258 Cardiomyopathy in other diseases classified elsewhere 4253 Cardiomyopathy, endocardial fibroelastosis 4250 Cardiomyopathy, endomyocardial fibrosis 3062 Cardiovascular malfunction arising from mental factors 99882 Cataract fragments in eye following cataract surgery, not elsewhere classified 0783 Cat-scratch disease 9524 Cauda equina spinal cord injury without spinal bone injury 68101 Cellulitis & abscess of finger, felon 6819 Cellulitis & abscess of unspecified digit 47871 Cellulitis & perichondritis of larynx 6825 Cellulitis and abscess of buttock 6820 Cellulitis and abscess of face 6827 Cellulitis and abscess of foot, except toes 6824 Cellulitis and abscess of hand, except fingers & thumb

Page 31: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

6826 Cellulitis and abscess of leg, except foot 6821 Cellulitis and abscess of neck 6822 Cellulitis and abscess of trunk 6829 Cellulitis and abscess of unspecified sites 6823 Cellulitis and abscess of upper arm & forearm 47821 Cellulitis of pharynx or nasopharynx 0201 Cellulocutaneous plague 85152 Cerebellar or brain stem contusion with open intracranial wound, brief loss of consciousness 85159 Cerebellar or brain stem contusion with open intracranial wound, concussion, unspecified 85156 Cerebellar or brain stem contusion with open intracranial wound, loss of consciousness of unspecified duration 85153 Cerebellar or brain stem contusion with open intracranial wound, moderate loss of consciousness 85151 Cerebellar or brain stem contusion with open intracranial wound, no loss of consciousness 85154 Cerebellar or brain stem contusion with open intracranial wound, prolonged loss of consciousness w return 85155 Cerebellar or brain stem contusion with open intracranial wound, prolonged loss of consciousness without return 85150 Cerebellar or brain stem contusion with open intracranial wound, state of consciousness unspecified 85149 Cerebellar or brain stem contusion wo of open intracranial wound, with concussion, unspecified 85142 Cerebellar or brain stem contusion wo open intracranial wound, brief loss of consciousness 85146 Cerebellar or brain stem contusion wo open intracranial wound, loss of consciousness of unspecified duration 85143 Cerebellar or brain stem contusion wo open intracranial wound, moderate loss of consciousness 85141 Cerebellar or brain stem contusion wo open intracranial wound, no loss of consciousness 85144 Cerebellar or brain stem contusion wo open intracranial wound, prolonged loss of consciousness with return 85145 Cerebellar or brain stem contusion wo open intracranial wound, prolonged loss of consciousness without return 85140 Cerebellar or brain stem contusion wo open intracranial wound, state of consciousness unspecified 85172 Cerebellar or brain stem laceration with open intracranial wound, brief loss of consciousness 85176 Cerebellar or brain stem laceration with open intracranial wound, loss of consciousness of unspecified duration 85173 Cerebellar or brain stem laceration with open intracranial wound, moderate loss of consciousness 85171 Cerebellar or brain stem laceration with open intracranial wound, no loss of consciousness 85174 Cerebellar or brain stem laceration with open intracranial wound, prolonged loss of consciousness with return 85175 Cerebellar or brain stem laceration with open intracranial wound, prolonged loss of consciousness without return 85170 Cerebellar or brain stem laceration with open intracranial wound, state of consciousness unspecified 85179 Cerebellar or brain stem laceration with open intracranial wound, with concussion, unspecified 85162 Cerebellar or brain stem laceration without open intracranial wound, brief loss of consciousness 85166 Cerebellar or brain stem laceration without open intracranial wound, loss of consciousness of unspecified duration 85163 Cerebellar or brain stem laceration without open intracranial wound, moderate loss of consciousness

Page 32: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

85161 Cerebellar or brain stem laceration without open intracranial wound, no loss of consciousness 85164 Cerebellar or brain stem laceration without open intracranial wound, prolonged loss of consciousness with return 85165 Cerebellar or brain stem laceration without open intracranial wound, prolonged loss of consciousness without return 85160 Cerebellar or brain stem laceration without open intracranial wound, state of consciousness unspecified 85169 Cerebellar or brain stem laceration without open intracranial wound, with concussion, unspecified 43491 Cerebral artery occlusion, unspecified, with cerebral infarction 43490 Cerebral artery occlusion, unspecified, without mention of cerebral infarction 3302 Cerebral degeneration in generalized lipidoses 3303 Cerebral degeneration of childhood in other diseases classified elsewhere 3301 Cerebral degenerations usually manifest in childhood, cerebral lipidoses 7792 Cerebral depression, coma, & other abnormal cerebral signs (originating in perinatal period) 4373 Cerebrovascular disease, cerebral aneurysm, nonruptured 4372 Cerebrovascular disease, hypertensive encephalopathy 4377 Cerebrovascular disease, transient global amnesia 67403 Cerebrovascular disorders in the puerperium, antepartum condition or complication 67401 Cerebrovascular disorders in the puerperium, delivered 67402 Cerebrovascular disorders in the puerperium, delivered with postpartum complication 67404 Cerebrovascular disorders in the puerperium, postpartum condition or complication 67400 Cerebrovascular disorders in the puerperium, unspecified episode of care 7231 Cervicalgia 9400 Chemical burn of eyelids & periocular area 0527 Chickenpox w other specified complications 0528 Chickenpox w unspecified complication 0520 Chickenpox, postvaricella encephalitis 0521 Chickenpox, varicella (hemorrhagic) pneumonitis 0529 Chickenpox, varicella wo mention of complication 9915 Chilblains 99550 Child abuse, unspecified 99551 Child emotional and psychological abuse 99552 Child neglect (nutritional) E9674 Child or adult abuse perpetrated by child E9676 Child or adult abuse perpetrated by grandparent E9672 Child or adult abuse perpetrated by mother, stepmother, or girlfriend E9678 Child or adult abuse perpetrated by non-related caregiver

Page 33: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E9677 Child or adult abuse perpetrated by other relative E9671 Child or adult abuse perpetrated by other specified person E9675 Child or adult abuse perpetrated by sibling E9673 Child or adult abuse perpetrated by spouse or partner 99554 Child physical abuse 99553 Child sexual abuse 29910 Childhood disintegrative disorder, current or active state 29911 Childhood disintegrative disorder, residual state 56781 Choleperitonitis 0010 Cholera due to Vibrio cholerae 0011 Cholera due to Vibrio cholerae el tor 0019 Cholera, unspecified 71217 Chondrocalcinosis due to dicalcium phosphate crystals, ankle & foot 71227 Chondrocalcinosis due to dicalcium phosphate crystals, ankle & foot 71213 Chondrocalcinosis due to dicalcium phosphate crystals, forearm 71223 Chondrocalcinosis due to dicalcium phosphate crystals, forearm 71214 Chondrocalcinosis due to dicalcium phosphate crystals, hand 71224 Chondrocalcinosis due to dicalcium phosphate crystals, hand 71216 Chondrocalcinosis due to dicalcium phosphate crystals, lower leg 71226 Chondrocalcinosis due to dicalcium phosphate crystals, lower leg 71219 Chondrocalcinosis due to dicalcium phosphate crystals, multiple sites 71229 Chondrocalcinosis due to dicalcium phosphate crystals, multiple sites 71218 Chondrocalcinosis due to dicalcium phosphate crystals, other specified sites 71228 Chondrocalcinosis due to dicalcium phosphate crystals, other specified sites 71215 Chondrocalcinosis due to dicalcium phosphate crystals, pelvic region & thigh 71225 Chondrocalcinosis due to dicalcium phosphate crystals, pelvic region & thigh 71211 Chondrocalcinosis due to dicalcium phosphate crystals, shoulder region 71221 Chondrocalcinosis due to dicalcium phosphate crystals, shoulder region 71210 Chondrocalcinosis due to dicalcium phosphate crystals, unspecified site 71220 Chondrocalcinosis due to dicalcium phosphate crystals, unspecified site 71212 Chondrocalcinosis due to dicalcium phosphate crystals, upper arm 71222 Chondrocalcinosis due to dicalcium phosphate crystals, upper arm 71237 Chondrocalcinosis, crystal unspecified, ankle & foot 71233 Chondrocalcinosis, crystal unspecified, forearm

Page 34: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

71234 Chondrocalcinosis, crystal unspecified, hand 71236 Chondrocalcinosis, crystal unspecified, lower leg 71239 Chondrocalcinosis, crystal unspecified, multiple sites 71238 Chondrocalcinosis, crystal unspecified, other specified sites 71235 Chondrocalcinosis, crystal unspecified, pelvic region & thigh 71231 Chondrocalcinosis, crystal unspecified, shoulder region 71230 Chondrocalcinosis, crystal unspecified, unspecified site 71232 Chondrocalcinosis, crystal unspecified, upper arm 49122 Chronic bronchitis, with acute bronchitis 30112 Chronic depressive personality disorder 53271 Chronic duodenal ulcer without mention of hemorrhage or perforation, with obstruction 53270 Chronic duodenal ulcer without mention of hemorrhage, perforation or obstruction 30151 Chronic factitious illness w physical symptoms 53171 Chronic gastric ulcer without mention of hemorrhage or perforation, with obstruction 53170 Chronic gastric ulcer without mention of hemorrhage, perforation, or obstruction 53471 Chronic gastrojejunal ulcer without mention of hemorrhage or perforation, with obstruction 53470 Chronic gastrojejunal ulcer without mention of hemorrhage, perforation, or obstruction 07044 Chronic hepatitis C w hepatic coma 30111 Chronic hypomanic personality disorder 4149 Chronic ischemic heart disease, unspecified 3222 Chronic meningitis 49321 Chronic obstructive asthma with status asthmaticus 49320 Chronic obstructive asthma, unspecified 49322 Chronic obstructive asthma, with (acute) exacerbation 53260 Chronic or unspecified duodenal ulcer w hemorrhage & perforation, wo mention of obstruction 53261 Chronic or unspecified duodenal ulcer with hemorrhage, perforation & obstruction 53241 Chronic or unspecified duodenal ulcer with hemorrhage, with obstruction 53240 Chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction 53251 Chronic or unspecified duodenal ulcer with perforation & obstruction 53250 Chronic or unspecified duodenal ulcer with perforation, without mention of obstruction 53160 Chronic or unspecified gastric ulcer w hemorrhage & perforation, wo mention of obstruction 53161 Chronic or unspecified gastric ulcer with hemorrhage & perforation, with obstruction 53141 Chronic or unspecified gastric ulcer with hemorrhage, with obstruction 53140 Chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction

Page 35: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

53151 Chronic or unspecified gastric ulcer with perforation, with obstruction 53150 Chronic or unspecified gastric ulcer with perforation, without mention of obstruction 53441 Chronic or unspecified gastrojejunal ulcer with hemorrhage & obstruction 53460 Chronic or unspecified gastrojejunal ulcer with hemorrhage & perforation, without mention of obstruction 53461 Chronic or unspecified gastrojejunal ulcer with hemorrhage, perforation & obstruction 53440 Chronic or unspecified gastrojejunal ulcer with hemorrhage, without mention of obstruction 53451 Chronic or unspecified gastrojejunal ulcer with perforation & obstruction 53450 Chronic or unspecified gastrojejunal ulcer with perforation, without mention of obstruction 53341 Chronic or unspecified peptic ulcer of unspecified site with hemorrhage & obstruction 53360 Chronic or unspecified peptic ulcer of unspecified site with hemorrhage & perforation, without mention of obstruction 53361 Chronic or unspecified peptic ulcer of unspecified site with hemorrhage, perforation & obstruction 53340 Chronic or unspecified peptic ulcer of unspecified site with hemorrhage, without mention of obstruction 53351 Chronic or unspecified peptic ulcer of unspecified site with perforation & obstruction 53350 Chronic or unspecified peptic ulcer of unspecified site with perforation, without mention of obstruction 53371 Chronic peptic ulcer of unspecified site without mention of hemorrhage or perforation, with obstruction 53370 Chronic peptic ulcer of unspecified site without mention of hemorrhage, perforation, or obstruction 7707 Chronic respiratory disease arising in the perinatal period 70706 Chronic ulcer of skin; pressure ulcer; ankle (Revised 10/2008) 70705 Chronic ulcer of skin; pressure ulcer; buttock (Revised 10/2008) 70701 Chronic ulcer of skin; pressure ulcer; elbow (Revised 10/2008) 70707 Chronic ulcer of skin; pressure ulcer; heel (Revised 10/2008) 70704 Chronic ulcer of skin; pressure ulcer; hip (Revised 10/2008) 70703 Chronic ulcer of skin; pressure ulcer; lower back (Revised 10/2008) 70709 Chronic ulcer of skin; pressure ulcer; other site (Revised 10/2008) 70700 Chronic ulcer of skin; pressure ulcer; unspecified site (Revised 10/2008) 70702 Chronic ulcer of skin; pressure ulcer; upper back (Revised 10/2008) 5571 Chronic vascular insufficiency of intestine 07022 Chronic viral hepatitis B w hepatic coma, wo hepatitis delta 30745 Circadian rhythm sleep disorder of nonorganic origin 80146 Close fracture base of skull w intracranial injury other & unspecified nature loss of consciousness unspecified duration80026 Close fracture vault of skull w subarachnoid subdural & extradural hemorrhage loss of consciousness unspecified duration83201 Closed anterior dislocation of elbow 83101 Closed anterior dislocation of humerus 83900 Closed dislocation cervical vertebra, unspecified

Page 36: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

83104 Closed dislocation of acromioclavicular joint 8370 Closed dislocation of ankle 83304 Closed dislocation of carpometacarpal joint 83941 Closed dislocation of coccyx vertebra 83200 Closed dislocation of elbow, unspecified site 83905 Closed dislocation of fifth cervical vertebra 83400 Closed dislocation of finger, unspecified part 83901 Closed dislocation of first cervical vertebra 83800 Closed dislocation of foot, unspecified part 83904 Closed dislocation of fourth cervical vertebra 83500 Closed dislocation of hip, unspecified site 83806 Closed dislocation of interphalangeal joint of foot 83402 Closed dislocation of interphalangeal joint, hand 8300 Closed dislocation of jaw 83650 Closed dislocation of knee, unspecified part 83920 Closed dislocation of lumbar vertebra 83305 Closed dislocation of metacarpal bone, proximal end 83401 Closed dislocation of metacarpophalangeal joint 83804 Closed dislocation of metatarsal bone, joint unspecified 83805 Closed dislocation of metatarsophalangeal joint 83303 Closed dislocation of midcarpal joint 83802 Closed dislocation of midtarsal joint 83908 Closed dislocation of multiple cervical vertebrae 83809 Closed dislocation of other part of foot 83309 Closed dislocation of other part of wrist 83209 Closed dislocation of other site of elbow 83109 Closed dislocation of other site of shoulder 83949 Closed dislocation of other vertebra 8363 Closed dislocation of patella 83302 Closed dislocation of radiocarpal joint 83301 Closed dislocation of radioulnar (joint), distal 83942 Closed dislocation of sacrum, sacroilliac joing 83902 Closed dislocation of second cervical vertebra 83907 Closed dislocation of seventh cervical vertebra

Page 37: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

83100 Closed dislocation of shoulder, unspecified site 83906 Closed dislocation of sixth cervical vertebra 83961 Closed dislocation of sternum, sternoclavicular joint 83801 Closed dislocation of tarsal bone, joint unspecified 83803 Closed dislocation of tarsometatarsal joint 83903 Closed dislocation of third cervical vertebra 83921 Closed dislocation of thoracic vertebra 8398 Closed dislocation of vertebra of multiple & ill-defined sites 83969 Closed dislocation of vertebra of other location 83940 Closed dislocation of vertebra, unspecified site 83300 Closed dislocation of wrist, unspecified part 80144 Closed fracture base of skull w intracranial injury of other & unspecified nature prolong loss of consciousness w return80140 Closed fracture base of skull w intracranial injury of other & unspecified nature, unspecified state of consciousness 80145 Closed fracture base of skull w intracranial injury other & unspecified nature, prolong loss of consciousness wo return 80136 Closed fracture base of skull w other & unspecified intracranial hemorrhage, loss of consciousness unspecified duration 80124 Closed fracture base of skull w subarachnoid, subdural, & extradural hemorrhage, prolong loss of consciousness w return80125 Closed fracture base of skull w subarachnoid, subdural, & extradural hemorrhage, prolong loss of consciousness wo return80112 Closed fracture base of skull with cerebral laceration & contusion, brief loss of consciousness 80116 Closed fracture base of skull with cerebral laceration & contusion, loss of consciousness of unspecified duration 80113 Closed fracture base of skull with cerebral laceration & contusion, moderate loss of consciousnes 80114 Closed fracture base of skull with cerebral laceration & contusion, prolong loss of conciousness with return 80115 Closed fracture base of skull with cerebral laceration & contusion, prolong loss of consciousness without return 80110 Closed fracture base of skull with cerebral laceration & contusion, unspecified state of consciousness 80119 Closed fracture base of skull with cerebral laceration & contusion, with concussion, unspecified 80142 Closed fracture base of skull with intracranial injury of other & unspecified nature, brief loss of consciousness 80143 Closed fracture base of skull with intracranial injury of other & unspecified nature, moderate loss of consciousness 80141 Closed fracture base of skull with intracranial injury of other & unspecified nature, no loss of consciousness 80149 Closed fracture base of skull with intracranial injury of other & unspecified nature, with concussion, unspecified 80132 Closed fracture base of skull with other & unspecified intracranial hemorrhage, brief loss of consciousness 80133 Closed fracture base of skull with other & unspecified intracranial hemorrhage, moderate loss of consciousness 80131 Closed fracture base of skull with other & unspecified intracranial hemorrhage, no loss of consciousness 80134 Closed fracture base of skull with other & unspecified intracranial hemorrhage, prolong loss of consciousness w return 80135 Closed fracture base of skull with other & unspecified intracranial hemorrhage, prolong loss of consciousness wo return 80130 Closed fracture base of skull with other & unspecified intracranial hemorrhage, state of consciousness unspecified

Page 38: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80139 Closed fracture base of skull with other & unspecified intracranial hemorrhage, with concussion, unspecified 80122 Closed fracture base of skull with subarachnoid, subdural, & extradural hemorrhage, brief loss of consciousness 80123 Closed fracture base of skull with subarachnoid, subdural, & extradural hemorrhage, moderate loss of consciousness 80121 Closed fracture base of skull with subarachnoid, subdural, & extradural hemorrhage, no loss of consciousness 80120 Closed fracture base of skull with subarachnoid, subdural, & extradural hemorrhage, unspecified state of consciousness 80129 Closed fracture base of skull with subarachnoid, subdural, & extradural hemorrhage, with concussion, unspecified 80102 Closed fracture base of skull without mention of intracranial injury, brief loss of consciousness 80106 Closed fracture base of skull without mention of intracranial injury, loss of consciousness of unspecified duration 80103 Closed fracture base of skull without mention of intracranial injury, moderate loss of consciousness 80101 Closed fracture base of skull without mention of intracranial injury, no loss of consciousness 80104 Closed fracture base of skull without mention of intracranial injury, prolong loss of conciousness with return 80105 Closed fracture base of skull without mention of intracranial injury, prolong loss of conciousness without return 80100 Closed fracture base of skull without mention of intracranial injury, unspecified state of consciousness 80109 Closed fracture base of skull without mention of intracranial injury, with concussion, unspecified 80126 Closed fracture base skull w subarachnoid subdural & extradural hemorrhage loss of consciousness unspecified duratation 8080 Closed fracture of acetabulum 81003 Closed fracture of acromial end of clavicle 81101 Closed fracture of acromial process of scapula 80227 Closed fracture of alveolar border of body of mandible 81202 Closed fracture of anatomical neck of humerus 80225 Closed fracture of angle of jaw 82521 Closed fracture of astragalus 82003 Closed fracture of base of neck of femur 81502 Closed fracture of base of other metacarpal bone(s) 80111 Closed fracture of base of skull with cerebral laceration & contusion, no loss of consciousness 81501 Closed fracture of base of thumb (first) metacarpal 8244 Closed fracture of bimalleolar 8090 Closed fracture of bones of trunk 80603 Closed fracture of C1 - C4 level cervical vertebra with central spinal cord syndrome 80602 Closed fracture of C1 - C4 level cervical vertebrae with anterior spinal cord syndrome 80601 Closed fracture of C1 - C4 level cervical vertebrae with complete lesion of spinal cord 80604 Closed fracture of C1 - C4 level cervical vertebrae with other specified spinal cord injury 80600 Closed fracture of C1 - C4 level cervical vertebrae with unspecified spinal cord injury 80608 Closed fracture of C5 - C7 level cervical vertebrae with central spinal cord syndrome

Page 39: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80606 Closed fracture of C5 - C7 level cervical vertebrae with complete lesion of spinal cord 80609 Closed fracture of C5 - C7 level cervical vertebrae with other specified spinal cord injury 80605 Closed fracture of C5 - C7 level cervical vertebrae with unspecified spinal cord injury 80607 Closed fracture of C5 - C7 level cervical vertibrae with anterior spinal cord syndrome 8250 Closed fracture of calcaneus 81407 Closed fracture of capitate bone (os magnum) of wrist 81400 Closed fracture of carpal bone, unspecified 80500 Closed fracture of cervical vertebra wo mention of spinal cord injury, unspecified level 81000 Closed fracture of clavicle, unspecified part 80221 Closed fracture of condylar process of mandible 81102 Closed fracture of coracoid process of scapula 80223 Closed fracture of coronoid process of mandible 81302 Closed fracture of coronoid process of ulna 82523 Closed fracture of cuboid bone 82524 Closed fracture of cuneiform bone of foot 81343 Closed fracture of distal end of ulna 81602 Closed fracture of distal phalanx or phalanges of hand 8052 Closed fracture of dorsal (thoracic) vertebra without mention of spinal cord injury 80708 Closed fracture of eight or more ribs 82001 Closed fracture of epiphysis of neck of femur 82121 Closed fracture of femoral condyle 80505 Closed fracture of fifth cervical vertebra wo mention of spinal cord injury 80501 Closed fracture of first cervical vertebra wo mention of spinal cord injury 80705 Closed fracture of five ribs 80704 Closed fracture of four ribs 80504 Closed fracture of fourth cervical vertebra wo mention of spinal cord injury 81103 Closed fracture of glenoid cavity & neck of scapula 81203 Closed fracture of greater tuberosity of humerus 81408 Closed fracture of hamate (unciform) bone of wrist 81305 Closed fracture of head of radius 80841 Closed fracture of ilium 82021 Closed fracture of intertrochanteric section of neck of femur 80842 Closed fracture of ischium 8075 Closed fracture of larynx & trachea

Page 40: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

81242 Closed fracture of lateral condyle of humerus 8242 Closed fracture of lateral malleolus 82122 Closed fracture of lower eiphysis of femur 82120 Closed fracture of lower end of femur, unspecified part 81340 Closed fracture of lower end of forearm, unspecified 81344 Closed fracture of lower end of radius with ulna 8054 Closed fracture of lumbar vertebra without mention of spinal cord injury 8064 Closed fracture of lumbar with spinal cord injury 81402 Closed fracture of lunate (semilunar) bone of wrist 8024 Closed fracture of malar & maxillary bones 80220 Closed fracture of mandible unspecified site 81243 Closed fracture of medial condyle of humerus 8240 Closed fracture of medial malleolus 81500 Closed fracture of metacarpal bone(s), site unspecified 82525 Closed fracture of metatarsal bone(s) 82002 Closed fracture of midcervical section of femur 81601 Closed fracture of middle or proximal phalanx or phalanges of hand 80508 Closed fracture of multiple cervical vertebra wo mention of spinal cord injury 80709 Closed fracture of multiple ribs, unspecified 80229 Closed fracture of multiple sites of mandible 81509 Closed fracture of multiple sites of metacarpus 81603 Closed fracture of multiple sites of phalanx or phalanges of hand 8020 Closed fracture of nasal bones 81401 Closed fracture of navicular (scaphoid) bone of wrist 81504 Closed fracture of neck of metacarpal bone(s) 81306 Closed fracture of neck of radius 81301 Closed fracture of olecranon process of ulna 8260 Closed fracture of one or more phalanges of foot 80701 Closed fracture of one rib 8026 Closed fracture of orbital floor (blow-out) 80228 Closed fracture of other & unspecified part of body of mandible 81409 Closed fracture of other bone of wrist 8028 Closed fracture of other facial bones 81109 Closed fracture of other part of scapula

Page 41: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80849 Closed fracture of other specified part of pelvis 8220 Closed fracture of patella 81600 Closed fracture of phalanx or phalanges of hand, unspecified 81404 Closed fracture of pisiform bone of wrist 8082 Closed fracture of pubis 81308 Closed fracture of radius with ulna, upper end 80700 Closed fracture of rib(s), unspecified 80661 Closed fracture of sacrum & coccyx with complete cauda equina lesion 80662 Closed fracture of sacrum & coccyx with other cauda equina injury 80669 Closed fracture of sacrum & coccyx with other spinal cord injury 80660 Closed fracture of sacrum & coccyx with unspecified spinal cord injury 8056 Closed fracture of sacrum & coccyx without mention of spinal cord injury 81100 Closed fracture of scapula, unspecified part 80502 Closed fracture of second cervical vertebra wo mention of spinal cord injury 80707 Closed fracture of seven ribs 80507 Closed fracture of seventh cervical vertebra wo mention of spinal cord injury 81002 Closed fracture of shaft of clavicle 82101 Closed fracture of shaft of femur 82321 Closed fracture of shaft of fibula 82322 Closed fracture of shaft of fibula with tibia 81221 Closed fracture of shaft of humerus 81503 Closed fracture of shaft of metacarpal bone(s) 81321 Closed fracture of shaft of radius 81320 Closed fracture of shaft of radius or ulna, unspecified 81323 Closed fracture of shaft of radius with ulna 82320 Closed fracture of shaft of tibia 81322 Closed fracture of shaft of ulna 80706 Closed fracture of six ribs 80506 Closed fracture of sixth cervical vertebra wo mention of spinal cord injury 80432 Closed fracture of skull or face w other bone, unspecified intracranial hemorrhage, brief loss of consciousness 80433 Closed fracture of skull or face w other bone, unspecified intracranial hemorrhage, moderate loss of consciousness 80431 Closed fracture of skull or face w other bone, unspecified intracranial hemorrhage, no loss of consciousness 80434 Closed fracture of skull or face w other bone, unspecified intracranial hemorrhage, prolong loss consciousness w return 80435 Closed fracture of skull or face w other bone, unspecified intracranial hemorrhage, prolong loss consciousness wo return

Page 42: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80430 Closed fracture of skull or face w other bone, unspecified intracranial hemorrhage, state of consciousness unspecified 80436 Closed fracture of skull or face w other bone, unspecified intracranial hemorrhage, unconsciousness unspecified duration80439 Closed fracture of skull or face w other bone, unspecified intracranial hemorrhage, with concussion, unspecified 80442 Closed fracture of skull or face w other bones, unspecified intracranial injury, breif loss of consciousness 80443 Closed fracture of skull or face w other bones, unspecified intracranial injury, moderate loss of conciousness 80441 Closed fracture of skull or face w other bones, unspecified intracranial injury, no loss of consciousness 80444 Closed fracture of skull or face w other bones, unspecified intracranial injury, prolong loss of consciousness w return 80445 Closed fracture of skull or face w other bones, unspecified intracranial injury, prolong loss of consciousness wo return80440 Closed fracture of skull or face w other bones, unspecified intracranial injury, unspecified state of consciousness 80449 Closed fracture of skull or face w other bones, unspecified intracranial injury, with concussion unspecified 81001 Closed fracture of sternal end of clavicle 8072 Closed fracture of sternum 80222 Closed fracture of subcondylar process of mandible 82022 Closed fracture of subtrochanteric section of neck of femur 82123 Closed fracture of supracondylar of Femur 81201 Closed fracture of surgical neck of humerus 80226 Closed fracture of symphysis of body of mandible 80622 Closed fracture of T1 - T6 level dorsal vertebrae with anterior cord syndrome 80623 Closed fracture of T1 - T6 level dorsal vertebrae with central spinal cord syndrome 80621 Closed fracture of T1 - T6 level dorsal vertebrae with complete lesion of cord 80624 Closed fracture of T1 - T6 level dorsal vertebrae with other specified spinal cord injury 80620 Closed fracture of T1 - T6 level dorsal vertebrae with unspecified spinal cord injury 80627 Closed fracture of T7 - T12 level dorsal vertebrae with anterior spinal cord syndrome 80628 Closed fracture of T7 - T12 level dorsal vertebrae with central spinal cord syndrome 80626 Closed fracture of T7 - T12 level dorsal vertebrae with complete lesion of spinal cord 80629 Closed fracture of T7 - T12 level dorsal vertebrae with other specified spinal cord injury 80625 Closed fracture of T7 - T12 level dorsal vertebrae with unspecified spinal cord injury 80503 Closed fracture of third cervical vertebra wo mention of spinal cord injury 80703 Closed fracture of three ribs 81405 Closed fracture of trapezium bone (larger multangular) of wrist 81406 Closed fracture of trapezoid bone (smaller multangular) of wrist 8246 Closed fracture of trimalleolar 81403 Closed fracture of triquetral (cuneiform) bone of wrist 80702 Closed fracture of two ribs

Page 43: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

8290 Closed fracture of unspecified bone 82520 Closed fracture of unspecified bone(s) of foot (except toes) 81244 Closed fracture of unspecified condyle(s) of humerus 82000 Closed fracture of unspecified intracapsular section of neck of femur 8248 Closed fracture of unspecified part of ankle 82100 Closed fracture of unspecified part of femur 82381 Closed fracture of unspecified part of fibula 82382 Closed fracture of unspecified part of fibula with tibia 81380 Closed fracture of unspecified part of forearm 81220 Closed fracture of unspecified part of humerus 81240 Closed fracture of unspecified part of lower end of humerus 8208 Closed fracture of unspecified part of neck of femur 81381 Closed fracture of unspecified part of radius 81383 Closed fracture of unspecified part of radius with ulna 80224 Closed fracture of unspecified part of ramus of mandible 82380 Closed fracture of unspecified part of tibia 81382 Closed fracture of unspecified part of ulna 8058 Closed fracture of unspecified part of vertebral column without mention of spinal cord injury 82020 Closed fracture of unspecified trochanteric section of neck of femur 8068 Closed fracture of unspecified vertebra with spinal cord injury 82301 Closed fracture of upper end of fibula 82302 Closed fracture of upper end of fibula with tibia 81300 Closed fracture of upper end of forearm, unspecified 81200 Closed fracture of upper end of humerus, unspecified part 82300 Closed fracture of upper end of tibia 80012 Closed fracture of vault of skull with cerebral laceration & contusion, brief loss of consciousness 80016 Closed fracture of vault of skull with cerebral laceration & contusion, loss of consciousness of unspecified duration 80013 Closed fracture of vault of skull with cerebral laceration & contusion, moderate loss of consciousness 80011 Closed fracture of vault of skull with cerebral laceration & contusion, no loss of consciousness 80014 Closed fracture of vault of skull with cerebral laceration & contusion, prolonged loss of conciousness w return 80015 Closed fracture of vault of skull with cerebral laceration & contusion, prolonged loss of conciousness wo return 80010 Closed fracture of vault of skull with cerebral laceration & contusion, state of consciousness unspecified 80019 Closed fracture of vault of skull with cerebral laceration & contusion, with concussion, unspecified 80029 Closed fracture of vault of skull with subarachnoid, subdural & extradural hemorrhage, with concussion, unspecified

Page 44: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80022 Closed fracture of vault of skull with subarachnoid, subdural & extradural hemorrhage, brief loss of consciouness 80023 Closed fracture of vault of skull with subarachnoid, subdural & extradural hemorrhage, moderate loss of consciousness 80021 Closed fracture of vault of skull with subarachnoid, subdural & extradural hemorrhage, no loss of consciousness 80020 Closed fracture of vault of skull with subarachnoid, subdural & extradural hemorrhage, unspecified state of conciousness80006 Closed fracture of vault of skull without mention of intracranial injury, loss of consciousness of unspecified duration 80005 Closed fracture of vault of skull without mention of intracranial injury, prolonged loss of conciousness wo return 80000 Closed fracture of vault of skull without mention of intracranial injury, unspecified state of consciousness 80002 Closed fracture of vault of skull without mention of intracranial injury, with brief loss of consciousness 80009 Closed fracture of vault of skull without mention of intracranial injury, with concussion, unspecified 80003 Closed fracture of vault of skull without mention of intracranial injury, with moderate loss of consciousness 80001 Closed fracture of vault of skull without mention of intracranial injury, with no loss of consciousness 80004 Closed fracture of vault of skull wo mention of intracranial injury, prolonged loss of conciousness & return 80446 Closed fracture skull or face w other bones, unspecified intracranial injury, loss of consciousness unspecified duration80426 Closed fracture skull or face, subarachnoid, subdural & extradural hemorrhage loss of consciousness unspecified duration80421 Closed fracture skull or face, subarachnoid, subdural & extradural hemorrhage no loss of consciousness 80420 Closed fracture skull or face, subarachnoid, subdural & extradural hemorrhage state of consciousness unspecified 80422 Closed fracture skull or face, subarachnoid, subdural & extradural hemorrhage, brief loss of consciousness 80423 Closed fracture skull or face, subarachnoid, subdural & extradural hemorrhage, moderate loss of consciousness 80424 Closed fracture skull or face, subarachnoid, subdural & extradural hemorrhage, pronlong loss of consciousness w return 80425 Closed fracture skull or face, subarachnoid, subdural & extradural hemorrhage, pronlong loss of consciousness wo return 80429 Closed fracture skull or face, subarachnoid, subdural & extradural hemorrhage, with concussion, unspecified 80042 Closed fracture vault of skull w intercranial injury of other & unspecified nature, brief loss of consciousness 80043 Closed fracture vault of skull w intercranial injury of other & unspecified nature, moderate loss of consciousness 80041 Closed fracture vault of skull w intercranial injury of other & unspecified nature, no loss of consciousnes 80040 Closed fracture vault of skull w intercranial injury of other & unspecified nature, unspecified state of consciousness 80044 Closed fracture vault of skull w intercranial injury other & unspecified nature prolonged loss of consciousness w return80046 Closed fracture vault of skull w intercranial injury other & unspecified nature, loss consciousness unspecified duration80045 Closed fracture vault of skull w intercranial injury other & unspecified nature, prolong loss of consciousness wo return80049 Closed fracture vault of skull w intracranial injury of other & unspecified nature, with concussion, unspecified 80036 Closed fracture vault of skull w other & unspecified intracranial hemorrhage, loss of consciousness unspecfied duration 80034 Closed fracture vault of skull w other & unspecified intracranial hemorrhage, prolonged loss of consciousness w return 80035 Closed fracture vault of skull w other & unspecified intracranial hemorrhage, prolonged loss of consciousness wo return 80024 Closed fracture vault of skull w subarachnoid, subdural & extradural hemorrhage, prolong loss of consciousness w return 80025 Closed fracture vault of skull w subarachnoid, subdural & extradural hemorrhage, prolong loss of consciousness wo return

Page 45: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80032 Closed fracture vault of skull with other & unspecified intracranial hemorrhage, brief loss of consciousness 80039 Closed fracture vault of skull with other & unspecified intracranial hemorrhage, concussion, unspecified 80033 Closed fracture vault of skull with other & unspecified intracranial hemorrhage, moderate loss of consciousness 80031 Closed fracture vault of skull with other & unspecified intracranial hemorrhage, no loss of consciousness 80030 Closed fracture vault of skull with other & unspecified intracranial hemorrhage, unspecified loss of consciousness 80412 Closed fractures of skull or face w other bones, w cerebral laceration & contusion, brief loss of consciousness 80413 Closed fractures of skull or face w other bones, w cerebral laceration & contusion, moderate loss of consciousness 80411 Closed fractures of skull or face w other bones, w cerebral laceration & contusion, no loss of consciousness 80410 Closed fractures of skull or face w other bones, w cerebral laceration & contusion, state of consciousness unspecified 80419 Closed fractures of skull or face w other bones, w cerebral laceration & contusion, with concussion, unspecified 80406 Closed fractures of skull or face w other bones, wo intracranial injury, loss of consciousness unspecified duration 80404 Closed fractures of skull or face w other bones, wo intracranial injury, prolong loss of consciousness w return 80405 Closed fractures of skull or face w other bones, wo intracranial injury, prolong loss of consciousness wo return 80409 Closed fractures of skull or face w other bones, wo intracranial injury, with concussion, unspecified 80400 Closed fractures of skull or face w other bones, wo mention of intracranial injury state of consciousness unspecified 80402 Closed fractures of skull or face w other bones, wo mention of intracranial injury, brief loss of consciousness 80403 Closed fractures of skull or face w other bones, wo mention of intracranial injury, moderate loss of consciousness 80401 Closed fractures of skull or face w other bones, wo mention of intracranial injury, no loss of consciousness 80416 Closed fractures skull or face w other bones, cerebral laceration & contusion loss of consciousness unspecified duration80414 Closed fractures skull or face w other bones, cerebral laceration & contusion, prolonged loss of consciousness w return 80415 Closed fractures skull or face w other bones, w cerebral laceration & contusion, prolong loss of consciousness wo return83103 Closed inferior dislocation of humerus 83204 Closed lateral dislocation of elbow 83203 Closed medial dislocation of elbow 81303 Closed Monteggia's fracture 83502 Closed obturator dislocation of hip 83202 Closed posterior dislocation of elbow 83501 Closed posterior dislocation of hip 83102 Closed posterior dislocation of humerus 80312 Closed skull fracture with cerebral laceration & contusion, brief loss of consciousness 80316 Closed skull fracture with cerebral laceration & contusion, loss of consciousness of unspecified duration 80313 Closed skull fracture with cerebral laceration & contusion, moderate loss of consciousness 80311 Closed skull fracture with cerebral laceration & contusion, no loss of consciousness 80314 Closed skull fracture with cerebral laceration & contusion, prolong loss of consciousness with return to conscious state

Page 46: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80315 Closed skull fracture with cerebral laceration & contusion, prolong loss of consciousness wo return to conscious state 80310 Closed skull fracture with cerebral laceration & contusion, state of consciousness unspecified 80319 Closed skull fracture with cerebral laceration & contusion, with concussion, unspecified 80342 Closed skull fracture with intracranial injury of other & unspecified nature, brief loss of consciousness 80346 Closed skull fracture with intracranial injury of other & unspecified nature, loss of consciousness unspecified duration80343 Closed skull fracture with intracranial injury of other & unspecified nature, moderate loss of consciousness 80341 Closed skull fracture with intracranial injury of other & unspecified nature, no loss of consciousness 80344 Closed skull fracture with intracranial injury of other & unspecified nature, prolong loss of consciousness with return 80345 Closed skull fracture with intracranial injury of other & unspecified nature, prolong loss of consciousness wo return 80340 Closed skull fracture with intracranial injury of other & unspecified nature, state of consciousness unspecified 80349 Closed skull fracture with intracranial injury of other & unspecified nature, with concussion, unspecified 80332 Closed skull fracture with other & unspecified intracranial hemorrhage, brief loss of consciousness 80336 Closed skull fracture with other & unspecified intracranial hemorrhage, loss of consciousness of unspecified duration 80333 Closed skull fracture with other & unspecified intracranial hemorrhage, moderate loss of consciousness 80331 Closed skull fracture with other & unspecified intracranial hemorrhage, no loss of consciousness 80334 Closed skull fracture with other & unspecified intracranial hemorrhage, prolong loss of consciousness with return 80335 Closed skull fracture with other & unspecified intracranial hemorrhage, prolong loss of consciousness without return 80330 Closed skull fracture with other & unspecified intracranial hemorrhage, state of consciousness unspecified 80339 Closed skull fracture with other & unspecified intracranial hemorrhage, with concussion, unspecified 80322 Closed skull fracture with subarachnoid, subdural & extradural hemorrhage, brief loss of consciousness 80326 Closed skull fracture with subarachnoid, subdural & extradural hemorrhage, loss of consciousness of unspecfied duration 80323 Closed skull fracture with subarachnoid, subdural & extradural hemorrhage, moderate loss of consciousness 80321 Closed skull fracture with subarachnoid, subdural & extradural hemorrhage, no loss of consciousness 80324 Closed skull fracture with subarachnoid, subdural & extradural hemorrhage, prolong loss of consciousness w return 80325 Closed skull fracture with subarachnoid, subdural & extradural hemorrhage, prolong loss of consciousness without return 80320 Closed skull fracture with subarachnoid, subdural & extradural hemorrhage, state of consciousness unspecified 80329 Closed skull fracture with subarachnoid, subdural & extradural hemorrhage, with concussion, unspecified 80302 Closed skull fracture without mention of intracranial injury, brief loss of consciousness 80306 Closed skull fracture without mention of intracranial injury, loss of consciousness of unspecified duration 80303 Closed skull fracture without mention of intracranial injury, moderate loss of consciousness 80301 Closed skull fracture without mention of intracranial injury, no loss of consciousness 80304 Closed skull fracture without mention of intracranial injury, prolong loss of consciousness return to conscious level 80305 Closed skull fracture without mention of intracranial injury, prolong loss of consciousness without return 80300 Closed skull fracture without mention of intracranial injury, unspecified state of consciousness

Page 47: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80309 Closed skull fracture without mention of intracranial injury, with concussion, unspecified 81241 Closed supracondylar fracture of humerus 2864 Coagulation defects, von Willebrand's disease 2866 Coagulation disorders, defibrination syndrome 2865 Coagulation disorders, hemorrhagic disorder due to circulating anticoagulants 1142 Coccidioidal meningitis 0091 Colitis, enteritis, & gastroenteritis of presumed infectious origin 81341 Colles' closed fracture 81351 Colles' open fracture 56960 Colostomy & enterostomy complication, unspecified 78001 Coma 30481 Combinations of drug dependence excluding opioid type drug, continuous 30482 Combinations of drug dependence excluding opioid type drug, episodic 30483 Combinations of drug dependence excluding opioid type drug, in remission 30480 Combinations of drug dependence excluding opioid type drug, unspecified 30471 Combinations of opioid type drug w any other drug dependence, continuous 30472 Combinations of opioid type drug w any other drug dependence, episodic 30473 Combinations of opioid type drug w any other drug dependence, in remission 30470 Combinations of opioid type drug w any other drug dependence, unspecified 42841 Combined systolic & diastolic heart failure, acute 42843 Combined systolic & diastolic heart failure, acute on chronic 42842 Combined systolic & diastolic heart failure, chronic 42840 Combined systolic & diastolic heart failure, unspecified 95890 Compartment syndrome, unspecified 47834 Complete bilateral paralysis of vocal cords or larynx 86613 Complete disruption of kidney parenchyma, with open wound into cavity 86603 Complete disruption of kidney parenchyma, without mention of open wound into cavity 72761 Complete rupture of rotator cuff 78032 Complex febrile convulsions 99699 Complication of other specified reattached body part 99695 Complication of reattached foot & toe(s) 99696 Complication of reattached lower extremity, other & unspecified 99701 Complications affecting central nervous system, not elsewhere classified 99702 Complications affecting latrogenic cerebrovascular infarction or hemorrhage, not elsewhere classified

Page 48: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

99700 Complications affecting nervous system, unspecified, not elsewhere classified 99731 Complications affecting specified body systems, not elsewhere classified; respiratory complications; ventilator associat6393 Complications following abortion and ectopic and molar pregnancies; Kidney failure 4294 Complications of heart disease, functional disturbances following cardiac surgery 4290 Complications of heart disease, myocarditis, unspecified 67910 Complications of in utero procedures; fetal complications 67911 Complications of in utero procedures; fetal complications 67912 Complications of in utero procedures; fetal complications 67913 Complications of in utero procedures; fetal complications 67914 Complications of in utero procedures; fetal complications 67900 Complications of in utero procedures; maternal complications 67901 Complications of in utero procedures; maternal complications 67902 Complications of in utero procedures; maternal complications 67903 Complications of in utero procedures; maternal complications 67904 Complications of in utero procedures; maternal complications 99988 Complications of medical care, not elsewhere classified; other infusion reaction 99989 Complications of medical care, not elsewhere classified; other transfusion reaction 99982 Complications of medical care, not elsewhere classified; extravasation of other vesicant agent 99981 Complications of medical care, not elsewhere classified; extravasation of vesicant chemotherapy 99689 Complications of other specified transplanted organ 99693 Complications of reattached finger(s) 99691 Complications of reattached forearm 99692 Complications of reattached hand 99694 Complications of reattached upper extremity, other & unspecified 99685 Complications of transplanted bone marrow 99683 Complications of transplanted heart 99687 Complications of transplanted intestine 99681 Complications of transplanted kidney 99682 Complications of transplanted liver 99684 Complications of transplanted lung 99686 Complications of transplanted pancreas 99690 Complications of unspecified eeattached extremity 99680 Complications of unspecified transplanted organ 3014 Compulsive personality disorder

Page 49: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

85011 Concussion with brief loss of consciousness 30 minutes or less 85012 Concussion with loss of consciousness 31-59 minutes 8505 Concussion with loss of consciousness unspecified duration 8502 Concussion with moderate loss of consciousness 8500 Concussion with no loss of consciousness 8503 Concussion with prolonged loss of consciousness & return to pre-existing conscious level 8504 Concussion with prolonged loss of consciousness, without return to pre-existing conscious level (Revised 10/2008) 8509 Concussion, unspecified state of consciousness 3481 Conditions of brain, anoxic brain damage 3480 Conditions of brain, cerebral cysts 3485 Conditions of brain, cerebral edema 3484 Conditions of brain, compression of brain 31282 Conduct disorder, adolescent onset type 31281 Conduct disorder, childhood onset type 4269 Conduction disorder, unspecified 4260 Conduction disorders, atrioventricular block, complete 74783 Congenital anomalies, presistent fetal circulation 7711 Congenital cytomegalovirus infection 2863 Congenital deficiency of other clotting factors 2861 Congenital factor IX disorder 2860 Congenital factor VIII disorder 2862 Congenital factor XI deficiency 7700 Congenital pneumonia of fetus & newborn 7710 Congenital rubella 4280 Congestive heart failure, unspecified 03281 Conjunctival diphtheria 37233 Conjunctivitis in mucocutaneous disease 37230 Conjunctivitis, unspecified 56400 Constipation, unspecified 69276 Contact dermatitis & other eczema due to sunburn of second degree 69277 Contact dermatitis & other eczema due to sunburn of third degree V0183 Contact or exposure to escherichia coli V0184 Contact or exposure to meningococcus V0181 Contact with or exposure to anthrax

Page 50: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

V010 Contact with or exposure to cholera 0512 Contagious pustular dermatitis 9222 Contusion of abdominal wall 92421 Contusion of ankle 92302 Contusion of axillary region 9220 Contusion of breast 9221 Contusion of chest wall 92311 Contusion of elbow 9213 Contusion of eyeball 9211 Contusion of eyelids & periocular area 920 Contusion of face, scalp & neck except eye(s) 9233 Contusion of finger 92420 Contusion of foot, excluding toe(s) 92310 Contusion of forearm 9224 Contusion of genital organs 92320 Contusion of hand(s), except fingers alone 86111 Contusion of heart with open wound into thorax 86101 Contusion of heart without mention of open wound into thorax 92401 Contusion of hip 92411 Contusion of knee 92410 Contusion of lower leg 86131 Contusion of lung with open wound into thorax 86121 Contusion of lung without open wound into thorax 9244 Contusion of multiple sites of lower limb 92309 Contusion of multiple sites of shoulder & upper arm 9228 Contusion of multiple sites of trunk 9238 Contusion of multiple sites of upper limb 9248 Contusion of multiple sites, not elsewhere classified 9212 Contusion of orbital tissues 92301 Contusion of scapular region 92300 Contusion of shoulder region 92400 Contusion of thigh 9243 Contusion of toe 9245 Contusion of unspecified part of lower limb

Page 51: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

9229 Contusion of unspecified part of trunk 9239 Contusion of unspecified part of upper limb 9249 Contusion of unspecified site 92303 Contusion of upper arm 92321 Contusion of wrist 7790 Convulsions in newborn 6201 Corpus luteum cyst or hematoma 85112 Cortex contusion with open intracranial wound, brief loss of consciousness 85116 Cortex contusion with open intracranial wound, loss of consciousness of unspecified duration 85113 Cortex contusion with open intracranial wound, moderate loss of consciousness 85111 Cortex contusion with open intracranial wound, no loss of consciousness 85114 Cortex contusion with open intracranial wound, prolonged loss of consciousness with return to conscious state 85115 Cortex contusion with open intracranial wound, prolonged loss of consciousness, without return to conscious state 85110 Cortex contusion with open intracranial wound, unspecified state of consciousness 85119 Cortex contusion with open intracranial wound, with concussion, unspecified 85102 Cortex contusion without mention of open intracranial wound, brief loss of consciousness 85106 Cortex contusion without mention of open intracranial wound, loss of consciousness of unspecified duration 85103 Cortex contusion without mention of open intracranial wound, moderate loss of consciousness 85101 Cortex contusion without mention of open intracranial wound, no loss of consciousness 85105 Cortex contusion without mention of open intracranial wound, prolonged loss of consciousness without return 85104 Cortex contusion without mention of open intracranial wound, prolonged loss of consiousness with return 85100 Cortex contusion without mention of open intracranial wound, state of consciousness unspecified 85109 Cortex contusion without mention of open intracranial wound, with concussion, unspecified 85132 Cortex laceration with open intracranial wound, brief loss of consciousness 85136 Cortex laceration with open intracranial wound, loss of consciousness of unspecified duration 85133 Cortex laceration with open intracranial wound, moderate loss of consciousness 85131 Cortex laceration with open intracranial wound, no loss of consciousness 85134 Cortex laceration with open intracranial wound, prolonged loss of consciousness with return to conscious state 85135 Cortex laceration with open intracranial wound, prolonged loss of consciousness, without return to conscious state 85130 Cortex laceration with open intracranial wound, state of consciousness unspecified 85139 Cortex laceration with open intracranial wound, with concussion, unspecified 85126 Cortex laceration without mention of open intracranial wound, loss of consciousness of unspecified duratation 85123 Cortex laceration without mention of open intracranial wound, moderate loss of consciousnes 85121 Cortex laceration without mention of open intracranial wound, no loss of consciousness

Page 52: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

85124 Cortex laceration without mention of open intracranial wound, prolonged loss of conciousness with return 85125 Cortex laceration without mention of open intracranial wound, prolonged loss of consciousness without return 85120 Cortex laceration without mention of open intracranial wound, state of consciousness unspecified 85122 Cortex laceration without mention of open intracranial wound, with brief loss of consciousness 85129 Cortex laceration without mention of open intracranial wound, with concussion, unspecified 49382 Cough variant asthma 0510 Cowpox and paravaccinia; cowpox and vaccinia not from vaccination (Revised 10/2008) 07420 Coxsackie carditis, unspecified 07422 Coxsackie endocarditis 07423 Coxsackie myocarditis 07421 Coxsackie pericarditis 92821 Crushing injury of ankle 92702 Crushing injury of axillary region 92611 Crushing injury of back 92612 Crushing injury of buttock 92711 Crushing injury of elbow 9260 Crushing injury of external genitalia 9251 Crushing injury of face & scalp 9273 Crushing injury of finger(s) 92820 Crushing injury of foot 92710 Crushing injury of forearm 92720 Crushing injury of hand(s) 92801 Crushing injury of hip 92811 Crushing injury of knee 92810 Crushing injury of lower leg 9288 Crushing injury of multiple sites of lower limb 9268 Crushing injury of multiple sites of trunk 92709 Crushing injury of multiple sites of upper arm 9278 Crushing injury of multiple sites of upper limb 9290 Crushing injury of multiple sites, not elsewhere classified 9252 Crushing injury of neck 92619 Crushing injury of other specified sites of trunk 92701 Crushing injury of scapular region 92700 Crushing injury of shoulder region

Page 53: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

92800 Crushing injury of thigh 9283 Crushing injury of toe(s) 9299 Crushing injury of unspecified site 9289 Crushing injury of unspecified site of lower limb 9269 Crushing injury of unspecified site of trunk 9279 Crushing injury of unspecified site of upper limb 92703 Crushing injury of upper arm 92721 Crushing injury of wrist 0220 Cutaneous anthrax 03285 Cutaneous diphtheria 0311 Cutaneous diseases due to other mycobacteria 7726 Cutaneous hemorrhage of fetus or newborn 0854 Cutaneous leishmaniasis, American 0852 Cutaneous leishmaniasis, Asian desert 0853 Cutaneous leishmaniasis, Ethiopian 0851 Cutaneous leishmaniasis, urban 7825 Cyanosis 77083 Cyanotic attacks of newborn 27701 Cystic Fibrosis With meconium ileus 27702 Cystic Fibrosis With pulmonary manifestations 5959 Cystitis, unspecified 0785 Cytomegaloviral disease 6392 Damage to pelvic organs & tissues following abortion, ectopic & molar pregnancies 7982 Death occurring in less than 24 hours from onset of symptoms, not otherwise explained 65570 Decreased fetal movements, affecting management of mother unspecified episode of care 65573 Decreased fetal movements, affecting management of mother, antepartum condition or complication 65571 Decreased fetal movements, affecting management of mother, delivered 94443 Deep necrosis of tissue due to deep third degree burn of 2 or more digits of hand, not including thumb, wo loss of digit94354 Deep necrosis of tissue due to deep third degree burn of axilla, with loss of axilla 94352 Deep necrosis of tissue due to deep third degree burn of elbow, with loss of elbow 94152 Deep necrosis of tissue due to deep third degree burn of eye, with other parts of face, head & neck, w loss of body part94351 Deep necrosis of tissue due to deep third degree burn of forearm, with loss of forearm 94159 Deep necrosis of tissue due to deep third degree burn of multiple sites of face, head & neck with loss of body part 94359 Deep necrosis of tissue due to deep third degree burn of multiple sites of upper limb, with loss of a body part

Page 54: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

94458 Deep necrosis of tissue due to deep third degree burn of multiple sites of wrist(s) & hand(s), with loss of body part 94356 Deep necrosis of tissue due to deep third degree burn of scapular region, with loss of scapula 94355 Deep necrosis of tissue due to deep third degree burn of shoulder, with loss of shoulder 94454 Deep necrosis of tissue due to deep third degree burn of two or more digits of hand including thumb, with loss of digit 94240 Deep necrosis of tissue due to deep third degree burn of unspecified site of trunk, wo mention loss of body part 94350 Deep necrosis of tissue due to deep third degree burn of unspecified site of upper limb, with loss of a body part 94353 Deep necrosis of tissue due to deep third degree burn of upper arm, with loss of upper arm 94444 Deep necrosis of tissues due to deep third degree burn of 2 or more digits of hand including thumb, wo loss of digit 94448 Deep necrosis of tissues due to deep third degree burn of multiple sites of wrist(s) & hand(s), wo loss of body part 94259 Deep necrosis of tissues due to deep third degree burn of other & multiple sites of trunk, with loss of body part 94249 Deep necrosis of tissues due to deep third degree burn of other & multiple sites of trunk, wo mention loss of body part 94453 Deep necrosis of tissues due to deep third degree burn of two or more digits of hand, not thumb, with loss of digit 94440 Deep necrosis of tissues due to deep third degree burn of unspecified site of hand, wo mention of loss of body part 94340 Deep necrosis of tissues due to deep third degree burn unspecified site of upper limb, wo mention of loss of body part 94141 Deep necrosis of tissues due to third degree burn of any part of ear, without mention of loss of ear 94146 Deep necrosis of tissues due to third degree burn of any part of scalp, without mention of loss of scalp 94144 Deep necrosis of tissues due to third degree burn of chin, without mention of loss of chin 94142 Deep necrosis of tissues due to third degree burn of eye, w other part of face, head & neck wo mention loss of body part94147 Deep necrosis of tissues due to third degree burn of forehead & cheek, without mention of loss of body part 94143 Deep necrosis of tissues due to third degree burn of lip(s), without mention of loss of lip(s) 94149 Deep necrosis of tissues due to third degree burn of multiple sites, of face, head & neck wo mention loss of body part 94148 Deep necrosis of tissues due to third degree burn of neck, without mention of loss of neck 94145 Deep necrosis of tissues due to third degree burn of nose, without mention of loss of nose 94140 Deep necrosis of tissues due to third degree burn of unspecified site face & head wo mention of loss of body part 94540 Deep necrosis of underlying tissues deep third degree burn of unspecified site of lower limb, wo loss of body part 94451 Deep necrosis of underlying tissues due to deep third degree burn of single digit other than thumb, with loss of digit 94253 Deep necrosis of underlying tissues due to deep third degree burn of abdominal wall with loss of abdominal wall 94243 Deep necrosis of underlying tissues due to deep third degree burn of abdominal wall, without mention of loss of abdomin 94543 Deep necrosis of underlying tissues due to deep third degree burn of ankle, without mention of loss of ankle 94244 Deep necrosis of underlying tissues due to deep third degree burn of any part of back, without mention of loss of back 94151 Deep necrosis of underlying tissues due to deep third degree burn of any part of ear, with loss of ear 94156 Deep necrosis of underlying tissues due to deep third degree burn of any part of scalp, with loss of scalp 94556 Deep necrosis of underlying tissues due to deep third degree burn of any part of thigh, with loss of thigh 94546 Deep necrosis of underlying tissues due to deep third degree burn of any part of thigh, without mention of loss of thigh

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

94344 Deep necrosis of underlying tissues due to deep third degree burn of axilla, without mention of loss of axilla 94456 Deep necrosis of underlying tissues due to deep third degree burn of back of hand, with loss of back of hand 94446 Deep necrosis of underlying tissues due to deep third degree burn of back of hand, without mention of loss 94254 Deep necrosis of underlying tissues due to deep third degree burn of back, with loss of back 94251 Deep necrosis of underlying tissues due to deep third degree burn of breast, with loss of breast 94241 Deep necrosis of underlying tissues due to deep third degree burn of breast, without mention of loss of freast 94252 Deep necrosis of underlying tissues due to deep third degree burn of chest wall, with loss of body part 94242 Deep necrosis of underlying tissues due to deep third degree burn of chest wall, without loss of body part 94154 Deep necrosis of underlying tissues due to deep third degree burn of chin, with loss of chin 94342 Deep necrosis of underlying tissues due to deep third degree burn of elbow, without mention of loss of elbow 94552 Deep necrosis of underlying tissues due to deep third degree burn of foot, with loss of foot 94542 Deep necrosis of underlying tissues due to deep third degree burn of foot, without mention of loss of foot 94341 Deep necrosis of underlying tissues due to deep third degree burn of forearm, without mention of loss of forearm 94157 Deep necrosis of underlying tissues due to deep third degree burn of forehead & cheek, with loss of body part 94255 Deep necrosis of underlying tissues due to deep third degree burn of genitalia, with loss of genitalia 94245 Deep necrosis of underlying tissues due to deep third degree burn of genitalia, without mention of loss of genitalia 94555 Deep necrosis of underlying tissues due to deep third degree burn of knee, with loss of knee 94545 Deep necrosis of underlying tissues due to deep third degree burn of knee, without mention of loss of knee 94153 Deep necrosis of underlying tissues due to deep third degree burn of lip(s), with loss of lip(s) 94554 Deep necrosis of underlying tissues due to deep third degree burn of lower leg, with loss of lower leg 94544 Deep necrosis of underlying tissues due to deep third degree burn of lower leg, without mention of loss of lower leg 94549 Deep necrosis of underlying tissues due to deep third degree burn of multiple sites of lower limb(s), wo mention of loss94559 Deep necrosis of underlying tissues due to deep third degree burn of multiple sites of lower limb, w loss of body part 94349 Deep necrosis of underlying tissues due to deep third degree burn of multiple sites of upper limb wo loss of a body part9465 Deep necrosis of underlying tissues due to deep third degree burn of multiple specified sites, with loss of body part 9464 Deep necrosis of underlying tissues due to deep third degree burn of multiple specified sites, without loss of body part94158 Deep necrosis of underlying tissues due to deep third degree burn of neck, with loss of neck 94155 Deep necrosis of underlying tissues due to deep third degree burn of nose, with loss of nose 94455 Deep necrosis of underlying tissues due to deep third degree burn of palm of hand, with loss of palm of hand 94445 Deep necrosis of underlying tissues due to deep third degree burn of palm of hand, without mention of loss of palm 94346 Deep necrosis of underlying tissues due to deep third degree burn of scapular region, without mention of loss scapula 94345 Deep necrosis of underlying tissues due to deep third degree burn of shoulder, without mention of loss of shoulder 94441 Deep necrosis of underlying tissues due to deep third degree burn of single digit other than thumb, wo loss of digit 94452 Deep necrosis of underlying tissues due to deep third degree burn of thumb, with loss of thumb

Page 56: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

94442 Deep necrosis of underlying tissues due to deep third degree burn of thumb, without mention of loss of thumb 94551 Deep necrosis of underlying tissues due to deep third degree burn of toe(s), with loss of toe(s) 94541 Deep necrosis of underlying tissues due to deep third degree burn of toe(s), without mention of loss of toe(s) 94150 Deep necrosis of underlying tissues due to deep third degree burn of unspecified site face & head, w loss of body part 94550 Deep necrosis of underlying tissues due to deep third degree burn of unspecified site lower limb, with loss of body part94450 Deep necrosis of underlying tissues due to deep third degree burn of unspecified site of hand, with loss of part of hand94250 Deep necrosis of underlying tissues due to deep third degree burn of unspecified site of trunk, with loss of body part 94343 Deep necrosis of underlying tissues due to deep third degree burn of upper arm, without mention of loss of upper arm 94457 Deep necrosis of underlying tissues due to deep third degree burn of wrist, with loss of wrist 94447 Deep necrosis of underlying tissues due to deep third degree burn of wrist, without mention of loss of wrist 94553 Deep necrosis of underlying tissues due to deep third degree burn of, with loss of ankle 9495 Deep necrosis of underlying tissues due to deep third degree burn, unspecified site with loss of a body part 9494 Deep necrosis of underlying tissues due to deep third degree burn, unspecified site without mention of loss of body part67133 Deep phlebothrombosis, antepartum condition or complication 67131 Deep phlebothrombosis, antepartum, delivered 67130 Deep phlebothrombosis, antepartum, unspecified episode of care 67142 Deep phlebothrombosis, delivered with postpartum complication 67144 Deep phlebothrombosis, postpartum condition or complication 67140 Deep phlebothrombosis, postpartum, unspecified episode of care 27651 Dehydration 66622 Delayed & secondary postpartum hemorrhage, delivered 66624 Delayed & secondary postpartum hemorrhage, postpartum condition or complication 66620 Delayed & secondary postpartum hemorrhage, unspecified episode of care 6391 Delayed or excessive hemorrhage following abortion, ectopic & molar pregnancies 3151 Delays in development, developmental arithmetical disorder 3154 Delays in development, developmental coordination disorder 31531 Delays in development, developmental language disorder 31501 Delays in development, developmental reading disorder, alexia 31502 Delays in development, developmental reading disorder, dyslexia 31500 Delays in development, developmental reading disorder, unspecified 3155 Delays in development, mixed development disorder 31509 Delays in development, other developmental reading disorder 31539 Delays in development, other developmental speech or language disorder 3152 Delays in development, other specific developmental learning difficulties

Page 57: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

31532 Delays in development, receptive language disorder, mixed 2930 Delirium due to conditions classified elsewhere 29411 Dementia in conditions classified elsewhere w behavioral disturbances 29410 Dementia in conditions classified elsewhere wo behavioral disturbance 3016 Dependent personality disorder 311 Depressive disorder, not elsewhere classified 2980 Depressive type psychosis 71740 Derangement of lateral meniscus, unspecified 71877 Developmental dislocation of joint, ankle & foot 71873 Developmental dislocation of joint, forearm 71874 Developmental dislocation of joint, hand 71876 Developmental dislocation of joint, lower leg 71879 Developmental dislocation of joint, multiple sites 71878 Developmental dislocation of joint, other specified sites 71875 Developmental dislocation of joint, pelvic region & thigh 71871 Developmental dislocation of joint, shoulder region 71870 Developmental dislocation of joint, site unspecified 71872 Developmental dislocation of joint, upper arm 25060 Diabetes w neurological manifestations type II or unspecified not stated as uncontrolled 25081 Diabetes w other specified manifestations, type I not stated as uncontrolled 25083 Diabetes w other specified manifestations, type I, uncontrolled 25082 Diabetes w other specified manifestations, type II or unspecified type, uncontrolled 25080 Diabetes w other specified manifestations, type II or unspecified, not stated as uncontrolled 25021 Diabetes with hyperosmolarity, type I not stated as uncontrolled 25023 Diabetes with hyperosmolarity, type I, uncontrolled 25020 Diabetes with hyperosmolarity, type II or unspecified type, not stated as uncontrolled 25022 Diabetes with hyperosmolarity, type II or unspecified type, uncontrolled 25010 Diabetes with ketoacidosis type II or unspecified type, not stated as uncontrolled 25011 Diabetes with ketoacidosis, type I not stated as uncontrolled 25013 Diabetes with ketoacidosis, type I, uncontrolled 25012 Diabetes with ketoacidosis, type II or unspecified type, uncontrolled 25061 Diabetes with neurological manifestations, type I not stated as uncontrolled 25063 Diabetes with neurological manifestations, type I, uncontrolled 25062 Diabetes with neurological manifestations, type II or unspecified type, uncontrolled

Page 58: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

25031 Diabetes with other coma, type I not stated as uncontrolled 25033 Diabetes with other coma, type I, uncontrolled 25030 Diabetes with other coma, type II or unspecified type, not stated as uncontrolled 25032 Diabetes with other coma, type II or unspecified type, uncontrolled 5513 Diaphragmatic hernia with gangrene 5523 Diaphragmatic hernia with obstruction 78791 Diarrhea 0093 Diarrhea of presumed infectious origin 42831 Diastolic heart failure, acute 42833 Diastolic heart failure, acute on chronic 42832 Diastolic heart failure, chronic 42830 Diastolic heart failure, unspecified 56986 Dieulafoy lesion (hemorrhagic) of intestine 53784 Dieulafoy lesion (hemorrhagic) of stomach & duodenum 9974 Digestive system complications, not elsewhere classified 0329 Diphtheria, unspecified 03284 Diphtheritic cystitis 03282 Diphtheritic myocarditis 03283 Diphtheritic peritonitis 0312 Disease due to disseminated mycobacterium aviumintracellulare complex (DMAC) 53012 Diseases of esophagus, acute esophagitis 53010 Diseases of esophagus, esophagitis, unspecified 47875 Diseases of larynx, laryngeal spasm 5184 Diseases of lung, acute edema of lung, unspecified 5180 Diseases of lung, pulmonary collapse 5185 Diseases of lung, pulmonary insufficiency following trauma & surgery 5186 Diseases of lung,, allergic bronchopulmonary aspergillosis 4171 Diseases of pulmonary circulation, aneurysm of pulmonary artery 5224 Diseases of pulp & periapical tissues, acute apical periodontitis of pulpal origin 5192 Diseases of the respiratory system,, mediastinitis 8322 Dislocation of elbow; Nursemaid's elbow 99642 Dislocation of prosthetic joint 3067 Disorder of organs of special sense arising from mental factors 27951 Disorders involving the immune mechanism; graft-versus-host disease; acute

Page 59: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

5761 Disorders of biliary tract, cholangitis 5764 Disorders of biliary tract, fistula of bile duct 5762 Disorders of biliary tract, obstruction of bile duct 5763 Disorders of biliary tract, perforation of bile duct 5765 Disorders of biliary tract, spasm of sphincter of Oddi 27542 Disorders of calcium metabolism, hypercalcemia 27541 Disorders of calcium metabolism, hypocalcemia 4590 Disorders of circulatory systems, hemorrhage, unspecified 37206 Disorders of conjunctiva; Acute conjunctivitis; Acute chemical conjunctivitis 38011 Disorders of external ear, acute infective otitis externa 38001 Disorders of external ear, acute perichondritis of pinna 38031 Disorders of external ear, hematoma of auricle or pinna 38012 Disorders of external ear, infective otitis externa, acute swimmers' ear 38013 Disorders of external ear, infective otitis externa, other acute infections of external ear 38010 Disorders of external ear, infective otitis externa, unspecified 38014 Disorders of external ear, malignant otitis externa 37992 Disorders of eye & adnexa, swelling or mass of eye 2762 Disorders of fluid, electrolyte, & acid-base balance, acidosis 2763 Disorders of fluid, electrolyte, & acid-base balance, alkalosis 2760 Disorders of fluid, electrolyte, & acid-base balance, hyperosmolality &/or hypernatremia 2761 Disorders of fluid, electrolyte, & acid-base balance, hyposmolality &/or hyponatremia 2764 Disorders of fluid, electrolyte, & acid-base balance, mixed acid-base balance disorder 5361 Disorders of function of stomach, acute dilatation of stomach 5363 Disorders of function of stomach, gastroparesis 53641 Disorders of function of stomach, infection of gastrostomy 53642 Disorders of function of stomach, mechanical complication of gastrostomy 53649 Disorders of function of stomach, other gastrostomy complication 5362 Disorders of function of stomach, persistent vomiting 53640 Disorders of function of stomach, unspecified gastrostomy complications 36051 Disorders of globe, retained intraocular foreign body, magnetic, in anterior chamber of eye 36069 Disorders of globe, retained intraocular foreign body, nonmagnetic in other or multiple sites 36065 Disorders of globe, retained intraocular foreign body, nonmagnetic in posterior wall of eye 36060 Disorders of globe, retained intraocular foreign body, nonmagnetic intraocular unspecified 27703 Disorders of metabolism, cystic fibrosis with gastrointestinal manifestations

Page 60: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

27709 Disorders of metabolism, cystic fibrosis with other manifestations 34981 Disorders of nervous system, cerebrospinal fluid rhinorrhea 34982 Disorders of nervous system, toxic encephalopathy 60781 Disorders of penis, balanitis xerotica obliterans 6073 Disorders of penis, priapism 5370 Disorders of stomach & duodemum, acquired hypertrophic pyloric stenosis 53781 Disorders of stomach & duodemum, pylorospasm 3373 Disorders of the autonomic nervous system, autonomic dysreflexia 33701 Disorders of the autonomic nervous system; Idiopathic peripheral autonomic neuropathy; carotid sinus syndrome 33709 Disorders of the autonomic nervous system; Idiopathic peripheral autonomic neuropathy; other 33700 Disorders of the autonomic nervous system; Idiopathic peripheral autonomic neuropathy; unspecified 38870 Disorders of the ear, otalgia, unspecified 38871 Disorders of the ear, otogenic pain 57512 Disorders of the gallbaldder, acute & chronic cholecystitis 57510 Disorders of the gallbaldder, other cholecystitis, unspecified 36012 Disorders of the globe, other endophthalmitis, panuveitis 36011 Disorders of the globe, other endophthalmitis, sympathetic uveitis 36052 Disorders of the globe, retained intraocular foreign body, magnetic, in iris or ciliary body 36053 Disorders of the globe, retained intraocular foreign body, magnetic, in lens 36059 Disorders of the globe, retained intraocular foreign body, magnetic, in other or multiple sites 36055 Disorders of the globe, retained intraocular foreign body, magnetic, in posterior wall 36054 Disorders of the globe, retained intraocular foreign body, magnetic, in vitreous 36050 Disorders of the globe, retained intraocular foreign body, magnetic, intraocular, unspecified 36061 Disorders of the globe, retained intraocular foreign body, nonmagnetic in anterior chamber 36062 Disorders of the globe, retained intraocular foreign body, nonmagnetic in iris or ciliary body 36063 Disorders of the globe, retained intraocular foreign body, nonmagnetic in lens 36064 Disorders of the globe, retained intraocular foreign body, nonmagnetic in vitreous 3490 Disorders of the nervous system, reaction to spinal or lumbar puncture 37632 Disorders of the orbit, exophthalmic conditions, orbital hemorrhage 56881 Disorders of the peritoneum, hemoperitoneum, nontraumatic 38400 Disorders of tympanic membrane, acute myringitis, unspecified 38401 Disorders of tympanic membrane, bullous myringitis 38409 Disorders of tympanic membrane, other acute myringitis without mention of otitis media 76522 Disorders relating to short gestation & low birth rate, 24 completed weeks

Page 61: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

76523 Disorders relating to short gestation & low birth rate, 25-26 completed weeks 76524 Disorders relating to short gestation & low birth rate, 27-28 completed weeks 76525 Disorders relating to short gestation & low birth rate, 29-30 completed weeks 76526 Disorders relating to short gestation & low birth rate, 31-32 completed weeks 76527 Disorders relating to short gestation & low birth rate, 33-34 completed weeks 76528 Disorders relating to short gestation & low birth rate, 35-36 completed weeks 76529 Disorders relating to short gestation & low birth rate, 37 or more completed weeks 76521 Disorders relating to short gestation & low birth rate, less than 24 complete weeks 76520 Disorders relating to short gestation & low birth rate, unspecified weeks of gestation 67412 Disruption of cesarean wound, delivered with postpartum complication 67414 Disruption of cesarean wound, postpartum condition or complication 67410 Disruption of cesarean wound, unspecified episode of care 67422 Disruption of obstetrical perineal wound, delivered with postpartum complicaton 67424 Disruption of obstetrical perineal wound, postpartum condition or complication 67420 Disruption of obstetrical perineal wound, unspecified episode of care 44321 Dissection of carotid artery 41412 Dissection of coronary artery 44322 Dissection of iliac artery 44329 Dissection of other artery 44323 Dissection of renal artery 44324 Dissection of vertebral artery 1125 Disseminated candidiasis 31221 Disturbance of conduct, socialized conduct disorder, mild 31222 Disturbance of conduct, socialized conduct disorder, moderate 31223 Disturbance of conduct, socialized conduct disorder, severe 31220 Disturbance of conduct, socialized conduct disorder, unspecified 56213 Diverticulitis of colon with hemorrhage 56203 Diverticulitis of small intestine with hemorrhage 56212 Diverticulosis of colon with hemorrhage 56202 Diverticulosis of small intestine with hemorrhage E9101 Drowning while engaged in other sport or recreational activity with diving equipment E9102 Drowning while engaged in other sport or recreational activity without diving equipment E9104 Drowning while in bathtub E9103 Drowning while swimming or diving for purposes other than recreation or sport

Page 62: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

30413 Drug dependence barbiturate & similar acting sedative or hypnotic dependence in remission 30410 Drug dependence barbiturate & similar acting sedative or hypnotic dependence unspecified 30441 Drug dependence, amphetamine & other psychostimulant dependence, continuous 30442 Drug dependence, amphetamine & other psychostimulant dependence, episodic 30443 Drug dependence, amphetamine & other psychostimulant dependence, in remission 30440 Drug dependence, amphetamine & other psychostimulant dependence, unspecified 30411 Drug dependence, barbiturate & similar acting sedative or hypnotic dependence continuous 30412 Drug dependence, barbiturate & similarly acting sedative or hypnotic dependence, episodic 30431 Drug dependence, cannabis dependence, continuous 30432 Drug dependence, cannabis dependence, episodic 30433 Drug dependence, cannabis dependence, in remission 30430 Drug dependence, cannabis dependence, unspecified 30421 Drug dependence, cocaine dependence, continuous 30422 Drug dependence, cocaine dependence, episodic 30423 Drug dependence, cocaine dependence, in remission 30420 Drug dependence, cocaine dependence, unspecified 30451 Drug dependence, hallucinogen dependence, continuous 30452 Drug dependence, hallucinogen dependence, episodic 30453 Drug dependence, hallucinogen dependence, in remission 30450 Drug dependence, hallucinogen dependence, unspecified 30401 Drug dependence, opioid type dependence, continuous use 30402 Drug dependence, opioid type dependence, episodic 30403 Drug dependence, opioid type dependence, in remission 30400 Drug dependence, opioid type dependence, unspecified 29281 Drug induced delirium 29284 Drug induced mood disorder 28803 Drug induced neutropenia 29283 Drug induced persisting amnestic disorder 29282 Drug induced persisting dementia 29211 Drug induced psychotic disorder with delusions 29212 Drug induced psychotic disorder with hallucinosis 29285 Drug induced sleep disorder 7794 Drug reactions & intoxications specific to newborn 2920 Drug withdrawal

Page 63: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

7795 Drug withdrawal syndrome in newborn 53291 Duodenal ulcer, unspecified, without mention of hemorrhage or perforation, with obstruction 53290 Duodenal ulcer, unspecified, without mention of hemorrhage,r perforation or obstruction 53561 Duodenitis with hemorrhage 31234 Dusturbance of conduct, disorders of impulse control, intermittent explosive disorder 31235 Dusturbance of conduct, disorders of impulse control, isolated explosive disorder 31232 Dusturbance of conduct, disorders of impulse control, kleptomania 31231 Dusturbance of conduct, disorders of impulse control, NEC, pathological gambling 31230 Dusturbance of conduct, disorders of impulse control, NEC, unspecified 31233 Dusturbance of conduct, disorders of impulse control, pyromania 31239 Dusturbance of conduct, other disorders of impulse control 5368 Dyspepsia & other specified disorders of function of stomach 3004 Dysthymic disorder 7881 Dysuria 64420 Early onset of delivery, unspecified as to episode of care 64421 Early onset of delivery, with or without mention of antepartum condition 30751 Eating disorder, bulimia 30752 Eating disorder, pica 30753 Eating disorder, psychogenic rumination 30754 Eating disorder, psychogenic vomiting 30750 Eating disorder, unspecified 1222 Echinococcus granulosus infection of thyroid 64260 Eclampsia complicating pregnancy, childbirth or the puerperium, unspecified episode of care 64263 Eclampsia, antepartum complication 64264 Eclampsia, postpartum complication 64261 Eclampsia, with delivery 64262 Eclampsia, with delivery, with mention of postpartum complication 4786 Edema of larynx 9934 Effects of air pressure caused by explosion 9300 Effects of corneal foreign body 9941 Effects of drowning & nonfatal submersion 937 Effects of foreign body in anus & rectum 9390 Effects of foreign body in bladder & urethra 9301 Effects of foreign body in conjunctival sac

Page 64: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

938 Effects of foreign body in digestive system, unspecified 931 Effects of foreign body in ear 9351 Effects of foreign body in esophagus 936 Effects of foreign body in intestine & colon 9302 Effects of foreign body in lacrimal punctum 9331 Effects of foreign body in larynx 9341 Effects of foreign body in main bronchus 9350 Effects of foreign body in mouth 932 Effects of foreign body in nose 9308 Effects of foreign body in other & combined sites of external eye 9348 Effects of foreign body in other specified parts bronchus & lung 9393 Effects of foreign body in penis 9330 Effects of foreign body in pharynx 9349 Effects of foreign body in respiratory tree, unspecified 9352 Effects of foreign body in stomach 9340 Effects of foreign body in trachea 9399 Effects of foreign body in unspecified site in genitourinary tract 9309 Effects of foreign body in unspecified site of external eye 9391 Effects of foreign body in uterus, any part 9392 Effects of foreign body in vulva & vagina 9942 Effects of hunger 9940 Effects of lightning 990 Effects of radiation, unspecified 9943 Effects of thirst 31323 Elective mutism specific to childhood & adolescence 9948 Electrocution & nonfatal effects of electric current 2769 Electrolyte and fluid disorders not elsewhere classified 7962 Elevated blood pressure reading without diagnosis of hypertension 4532 Embolism and thrombosis of inferior vena cava 6396 Embolism following abortion, ectopic & molar pregnancies 99881 Emphysema (subcutaneous) (surgical) resulting from a procedure not elsewhere classified 5100 Empyema with fistula 5109 Empyema without mention of fistula 32351 Encephalitis and encephalomyelitis following immunization procedures

Page 65: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

32301 Encephalitis and encephalomyelitis in viral diseases classified elsewhere 3232 Encephalitis, myelitis, and encephalomyelitis in protozoal diseases classified elsewhere 3231 Encephalitis, myelitis, and encephalomyelitis in rickettsial diseases classified elsewhere 05601 Encephalomyelitis due to rubella 34830 Encephalopathy, unspecified 3077 Encopresis 5856 End stage renal disease 3066 Endocrine disorder arising from mental factors 0211 Enteric tularemia 00864 Enteris due to other small round viruses 00862 Enteritis due to adenovirus 00866 Enteritis due to astrovirus 00867 Enteritis due to enterovirus NEC 00863 Enteritis due to norwalk virus 00869 Enteritis due to other viral enteritis 00861 Enteritis due to rotavirus 3076 Enuresis 3221 Eosinophilic meningitis 0774 Epidemic hemorrhagic conjunctivitis 0771 Epidemic keratoconjunctivitis 0741 Epidemic pleurodynia 34571 Epilepsy, epilepsia partialis continua, w intractable epilepsy 34570 Epilepsy, epilepsia partialis continua, wo mention of intractable epilepsy 3453 Epilepsy, grand mal status 34561 Epilepsy, infantile spasms, w intractable epilepsy 34560 Epilepsy, infantile spasms, wo mention of intractable epilepsy 3452 Epilepsy, petit mal status 34591 Epilepsy, unspecified, w intractable epilepsy 34590 Epilepsy, unspecified, wo mention of intractable epilepsy 7847 Epistaxis 035 Erysipelas 69557 Erythematous conditions; involving 70-79 percent of body surface 69552 Erythematous conditions; involving 20-29 percent of body surface 69553 Erythematous conditions; involving 30-39 percent of body surface

Page 66: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

69554 Erythematous conditions; involving 40-49 percent of body surface 69555 Erythematous conditions; involving 50-59 percent of body surface 69556 Erythematous conditions; involving 60-69 percent of body surface 69558 Erythematous conditions; involving 80-89 percent of body surface 69559 Erythematous conditions; involving 90 percent or more of body surface 69513 Erythematous conditions; erythema multiforme; Stevens-Johnson syndrome 69514 Erythematous conditions; erythema multiforme; Stevens-Johnson syndrome-toxic epidermal 69515 Erythematous conditions; erythema multiforme; toxic epidermal necrolysis 0414 Escherichia coli infection in conditions classified elsewhere & of unspecified site 53082 Esophageal hemorrhage 45620 Esophageal varices in diseases classified elsewhere, with bleeding 23871 Essential thrombocythemia 38150 Eustachian salpingitis, unspecified 7903 Excessive blood level of alcohol 78095 Excessive crying of child, adolescent, or adult (Revision verbiage 10/01/06) 78092 Excessive crying of infant (baby) 65663 Excessive fetal growth affecting management of mother, antepartum condition or complication 65661 Excessive fetal growth affecting management of mother, delivered 65660 Excessive fetal growth affecting management of mother, unspecified episode of care 2981 Excitative type psychosis 49381 Exercise induced bronchospasm 9945 Exhaustion due to excessive exertion 9944 Exhaustion due to exposure E8376 Explosion, fire, or burning in watercraft involving dockers, stevedores E8372 Explosion, fire, or burning in watercraft involving occupant of other watercraft; crew E8373 Explosion, fire, or burning in watercraft involving occupant of other watercraft; non-crew E8371 Explosion, fire, or burning in watercraft involving occupant of small boat; powered E8370 Explosion, fire, or burning in watercraft involving occupant of small boat; unpowered E8378 Explosion, fire, or burning in watercraft involving other specified person E8375 Explosion, fire, or burning in watercraft involving swimmer E8379 Explosion, fire, or burning in watercraft involving unspecified person E8374 Explosion, fire, or burning in watercraft involving water skier 3013 Explosive personality disorder V0182 Exposure to SARS Associated Coronavirus

Page 67: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

4555 External hemorrhoids with other complication 4554 External thrombosed hemorrhoids 85252 Extradural hemorrhage following injury with open intracranial wound, brief loss of consciousness 85256 Extradural hemorrhage following injury with open intracranial wound, loss of consciousness of unspecified duration 85253 Extradural hemorrhage following injury with open intracranial wound, moderate loss of consciousness 85251 Extradural hemorrhage following injury with open intracranial wound, no loss of consciousness 85254 Extradural hemorrhage following injury with open intracranial wound, prolonged loss of consciousness with return 85255 Extradural hemorrhage following injury with open intracranial wound, prolonged loss of consciousness wo return 85250 Extradural hemorrhage following injury with open intracranial wound, state of consciousness unspecified 85259 Extradural hemorrhage following injury with open intracranial wound, with concussion, unspecified 85242 Extradural hemorrhage following injury wo open intracranial wound, brief loss of consciousness 85246 Extradural hemorrhage following injury wo open intracranial wound, loss of consciousness of unspecified duration 85243 Extradural hemorrhage following injury wo open intracranial wound, moderate loss of consciousness 85241 Extradural hemorrhage following injury wo open intracranial wound, no loss of consciousness 85244 Extradural hemorrhage following injury wo open intracranial wound, prolonged loss of consciousness with return 85245 Extradural hemorrhage following injury wo open intracranial wound, prolonged loss of consciousness wo return 85240 Extradural hemorrhage following injury wo open intracranial wound, state of consciousness unspecified 85249 Extradural hemorrhage following injury wo open intracranial wound, with concussion, unspecified 60821 Extravaginal torsion of spermatic cord 49301 Extrinsic asthma with status asthmaticus 49300 Extrinsic asthma, unspecified 49302 Extrinsic asthma, with (acute) exacerbation 3510 Facial nerve disorders, Bell's palsy 7675 Facial nerve injury due to birth trauma 78194 Facial weakness 6382 Failed attempted abortion complicated by damage to pelvic organs or tissues 6381 Failed attempted abortion complicated by delayed or excessive hemorrhage 6386 Failed attempted abortion complicated by embolism 6380 Failed attempted abortion complicated by genital tract & pelvic infection 6384 Failed attempted abortion complicated by metabolic disorder 6383 Failed attempted abortion complicated by renal failure 6385 Failed attempted abortion complicated by shock 6387 Failed attempted abortion with other specified complications 6388 Failed attempted abortion with unspecified complication

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

6389 Failed attempted abortion without mention of complication 78341 Failure to thrive 0840 Falciparum malaria (malignant tertian) E8844 Fall from bed E8842 Fall from chair E8841 Fall from cliff E8846 Fall from commode E8845 Fall from other furniture E8859 Fall from other slipping, tripping, or stumbling E8851 Fall from roller skates E8811 Fall from scaffolding E8852 Fall from skateboard E8853 Fall from skis E8854 Fall from snowboard E8843 Fall from wheelchair E8432 Fall in, on, or from aircraft involving crew of commercial aircraft; surface to surface transport E8438 Fall in, on, or from aircraft involving ground crew, airline employee E8431 Fall in, on, or from aircraft involving occupant of any military aircraft E8434 Fall in, on, or from aircraft involving occupant of commercial aircraft in surface to air transport E8435 Fall in, on, or from aircraft involving occupant of other powered aircraft E8430 Fall in, on, or from aircraft involving occupant of spacecraft E8436 Fall in, on, or from aircraft involving occupant of unpowered aircraft, except parachutist E8433 Fall in, on, or from aircraft involving other occupant of commercial aircraft; surface to surface transport E8439 Fall in, on, or from aircraft involving other person E8437 Fall in, on, or from aircraft involving parachutist; military or other E8041 Fall in, on, or from railway train involving passenger on railway E8040 Fall in, on, or from railway train involving railway employee E8049 Fall in, on, or from railway train involving unspecified person E8839 Fall into other hole or other opening in surface E8809 Fall on or from other stairs or steps E8801 Fall on or from sidewalk curb E8869 Fall on same level from collision, pushing, or shoving by or with other persons other & unspecified activity E8336 Fall on stairs or ladders in water transport involving dockers, stevedores E8332 Fall on stairs or ladders in water transport involving occupant of other watercraft; crew

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8333 Fall on stairs or ladders in water transport involving occupant of other watercraft; non-crew E8331 Fall on stairs or ladders in water transport involving occupant of small boat, powered E8330 Fall on stairs or ladders in water transport involving occupant of small boat, unpowered E8338 Fall on stairs or ladders in water transport involving other specified person E8335 Fall on stairs or ladders in water transport involving swimmer E8339 Fall on stairs or ladders in water transport involving unspecified person E8334 Fall on stairs or ladders in water transport involving water skier E8881 Fall resulting in striking against other object 9581 Fat embolism as an early complication of trauma 0320 Faucial Diphtheria 78031 Febrile convulsions (simple), unspecified (Revised Verbiage 10/01/06) 7833 Feeding difficulties & mismanagement 77012 Fetal & Newborn aspiration meconium aspriation with respiratory symptoms 77011 Fetal & Newborn aspiration, meconium aspriation without respiratory symptoms 77010 Fetal & Newborn aspiration, unspecified 77016 Fetal & Newborn aspiration: Aspiration of blood with respiratory symptoms 77015 Fetal & Newborn aspiration: Aspiration of blood without respiratory symptoms 77014 Fetal & Newborn aspiration: Aspiration of clear amniotic fluid without respiratory symptoms 77017 Fetal & Newborn aspiration: Other fetal & newborn aspiration, without respiratory symptoms 7720 Fetal and neonatal hemorrhage; Fetal blood loss affecting newborn 7680 Fetal death from asphyxia or anoxia before onset of labor or at unspecified time 7681 Fetal death from asphyxia or anoxia during labor 65633 Fetal distress affecting management of mother, antepartum condition or complication 65631 Fetal distress affecting management of mother, delivered 65630 Fetal distress affecting management of mother, unspecified episode of care 7682 Fetal distress before onset of labor, in liveborn infant 7683 Fetal distress first noted during labor and delivery, in liveborn infant 7684 Fetal distress, unspecified as to time of onset, in liveborn infant 65623 Fetal isoimmunization from other & unspecified blood-group incompatibility affecting management of mother, antepartum 65621 Fetal isoimmunization from other & unspecified blood-group incompatibility affecting management of mother, delivered 65613 Fetal rhesus isoimmunization affecting management of mother, antepartum condition 65611 Fetal rhesus isoimmunization affecting management of mother, delivered 65610 Fetal rhesus isoimmunization affecting management of mother, unspecified episode of care 65603 Fetal-maternal hemorrhage affecting management of mother, antepartum condition or complication

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

65601 Fetal-maternal hemorrhage affecting management of mother, delivered 65600 Fetal-maternal hemorrhage affecting management of mother, unspecified episode of care 77013 Fetus & newborn aspiration, Aspiration of clear amniotic fluid without respiratory symptoms 7627 Fetus or newborn affected by chorioamnionitis 7614 Fetus or newborn affected by maternal complications, ectopic pregnancy 7610 Fetus or newborn affected by maternal complications, incompetent cervix 7617 Fetus or newborn affected by maternal complications, malpresentation before labor 7616 Fetus or newborn affected by maternal complications, maternal death 7615 Fetus or newborn affected by maternal complications, multiple pregnancy 7612 Fetus or newborn affected by maternal complications, oligohydramnios 7613 Fetus or newborn affected by maternal complications, polyhydramnios 7611 Fetus or newborn affected by maternal complications, premature rupture of membranes 7626 Fetus or newborn affected by other & unspecified conditions of umbilical cord 7622 Fetus or newborn affected by other & unspecified morphological & functional abnormalities of placenta 7625 Fetus or newborn affected by other compression of umbilical cord 7621 Fetus or newborn affected by other forms of placental separation & hemorrhage 7628 Fetus or newborn affected by other specified abnormalities of chorion & amnion 7620 Fetus or newborn affected by placenta previa 7623 Fetus or newborn affected by placental transfusion syndromes 7624 Fetus or newborn affected by prolapsed umbilical cord 7629 Fetus or newborn affected by unspecified abnormality of chorion & amnion 37023 Filamentary keratitis 8074 Flail chest 7873 Flatulence, eructation & gas pain 2766 Fluid overload 0052 Food poisoning due to Clostridium perfringens (C. Welchii) 0053 Food poisoning due to other Clostridia 0054 Food poisoning due to Vibrio parahaemolyticus 00581 Food poisoning due to Vibro vulnificus 0059 Food poisoning, unspecified 0784 Foot & mouth disease 9984 Foreign body accidentally left during a procedure, not elsewhere classified E8715 Foreign object left in body during aspiration of fluid or tissue, puncture & cartherization E8714 Foreign object left in body during endoscopic examination

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8716 Foreign object left in body during heart catheterization E8711 Foreign object left in body during infusion or transfusion E8713 Foreign object left in body during injection or vaccination E8712 Foreign object left in body during kidney dialysis or other perfusion E8718 Foreign object left in body during other specified procedure E8717 Foreign object left in body during removal of catheter or packing E8710 Foreign object left in body during surgical operation E8719 Foreign object left in body during unspecified procedure 7672 Fracture of clavicle due to birth trauma 82522 Fracture of navicular (scaphoid) bone of foot 81347 Fracture of radius and ulna; Lower end, closed; Torus fracture of radius and ulna 81346 Fracture of radius and ulna; Lower end, closed; Torus fracture of ulna (alone) 9910 Frostbite of face 9912 Frostbite of foot 9911 Frostbite of hand 9913 Frostbite of other & unspecified sites 94233 Full-thickness skin loss due to third degree burn of abdominal wall 94533 Full-thickness skin loss due to third degree burn of ankle 94234 Full-thickness skin loss due to third degree burn of any part of back 94131 Full-thickness skin loss due to third degree burn of any part of ear 94136 Full-thickness skin loss due to third degree burn of any part of scalp 94536 Full-thickness skin loss due to third degree burn of any part of thigh 94334 Full-thickness skin loss due to third degree burn of axilla 94436 Full-thickness skin loss due to third degree burn of back of hand 94231 Full-thickness skin loss due to third degree burn of breast 94232 Full-thickness skin loss due to third degree burn of chest wall, excluding breast & nipple 94134 Full-thickness skin loss due to third degree burn of chin 94332 Full-thickness skin loss due to third degree burn of elbow 94132 Full-thickness skin loss due to third degree burn of eye, with other parts of face, head & neck 94532 Full-thickness skin loss due to third degree burn of foot 94331 Full-thickness skin loss due to third degree burn of forearm 94137 Full-thickness skin loss due to third degree burn of forehead & cheek 94235 Full-thickness skin loss due to third degree burn of genitalia 94535 Full-thickness skin loss due to third degree burn of knee

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

94133 Full-thickness skin loss due to third degree burn of lip(s) 94534 Full-thickness skin loss due to third degree burn of lower leg 94539 Full-thickness skin loss due to third degree burn of multiple sites of lower limb(s) 94339 Full-thickness skin loss due to third degree burn of multiple sites of upper limb, except wrist & hand 94438 Full-thickness skin loss due to third degree burn of multiple sites of wrist(s) & hand(s) 94139 Full-thickness skin loss due to third degree burn of multiple sites, except eye, of face, head & neck 9463 Full-thickness skin loss due to third degree burn of multiple specified sites 94138 Full-thickness skin loss due to third degree burn of neck 94135 Full-thickness skin loss due to third degree burn of nose (septum) 94239 Full-thickness skin loss due to third degree burn of other & multiple sites of trunk 94435 Full-thickness skin loss due to third degree burn of palm of hand 94336 Full-thickness skin loss due to third degree burn of scapular region 94335 Full-thickness skin loss due to third degree burn of shoulder 94431 Full-thickness skin loss due to third degree burn of single digit other than thumb 94432 Full-thickness skin loss due to third degree burn of thumb 94531 Full-thickness skin loss due to third degree burn of toe(s) 94434 Full-thickness skin loss due to third degree burn of two or more digits of hand including thumb 94433 Full-thickness skin loss due to third degree burn of two or more digits of hand, not including thumb 94130 Full-thickness skin loss due to third degree burn of unspecified site of face & head 94430 Full-thickness skin loss due to third degree burn of unspecified site of hand 94530 Full-thickness skin loss due to third degree burn of unspecified site of lower limb 94230 Full-thickness skin loss due to third degree burn of unspecified site of trunk 94330 Full-thickness skin loss due to third degree burn of unspecified site of upper limb 94333 Full-thickness skin loss due to third degree burn of upper arm 94437 Full-thickness skin loss due to third degree burn of wrist 9493 Full-thickness skin loss due to third degree burn, unspecified site 5644 Functional digestive disorders, other postoperative functional disorders 5643 Functional digestive disorders, vomiting following gastrointestinal surgery 78091 Fussy infant (baby) 0863 Gambian trypanosomiasis 7854 Gangrene 0400 Gas gangrene 53521 Gastric mucosal hypertrophy with hemorrhage 53520 Gastric mucosal hypertrophy without mention of hemorrhage

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

53191 Gastric ulcer, unspecified, wo mention of hemorrhage or perforation, with obstruction 53190 Gastric ulcer, unspecified, wo mention of hemorrhage, perforation, or obstruction 53571 Gastritis and duodenitis; eosinophilic gastritis; with hemorrhage 5581 Gastroenteritis & colitis due to radiation 5307 Gastroesophageal laceration-hemorrhage syndrome 0222 Gastrointestinal anthrax 7724 Gastrointestinal hemorrhage of fetus or newborn 5781 Gastrointestinal hemorrhage, blood in stool 5780 Gastrointestinal hemorrhage, hematemesis 3064 Gastrointestinal malfunction arising from mental factors 538 Gastrointestinal mucositis (ulcerative) 53491 Gastrojejunal ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation, with obstruction 53490 Gastrojejunal ulcer, unspecified as acute or chronic, without mention of hemorrhage, perforation or obstruction 78065 General symptoms hypothermia not associated with low environmental temperature 78062 General symptoms postprocedural fever 78063 General symptoms postvaccination fever 78061 General symptoms; fever and other physiologic disturbances of temperature regulation 78060 General symptoms; fever and other physiologic disturbances of temperature regulation; fever, unspecified 78072 General symptoms; malaise and fatigue; functional quadriplegia 34511 Generalized convulsive epilepsy, w intractable epilepsy 34510 Generalized convulsive epilepsy, wo mention of intractable epilepsy 34501 Generalized nonconvulsive epilepsy, w intractable epilepsy 34500 Generalized nonconvulsive epilepsy, wo mention of intractable epilepsy 9990 Generalized vaccinia as a complication of medical care, not elsewhere classified 6390 Genital tract & pelvic infection complications following abortion, ectopic & molar pregnancies 5290 Glossitis of the togue 09850 Gonococcal arthritis 09852 Gonococcal bursitis 09815 Gonococcal cervicitis, acute 09840 Gonococcal conjunctivitis, neonatorum 09811 Gonococcal cystitis, acute 09884 Gonococcal endocarditis 09816 Gonococcal endometritis, acute 09842 Gonococcal endophthalmia

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

09813 Gonococcal epididymo-orchitis, acute 0980 Gonococcal infection, acute, of lower genitourinary tract 09810 Gonococcal infection, acute, of upper genitourinary tract, site unspecified 09841 Gonococcal iridocyclitis 09843 Gonococcal keratitis 09882 Gonococcal meningitis 09883 Gonococcal pericarditis 09886 Gonococcal peritonitis 09812 Gonococcal prostatitis, acute 09817 Gonococcal salpingitis, specified as acute 09814 Gonococcal seminal vesiculitis, acute 09853 Gonococcal spondylitis 09851 Gonococcal synovitis & tenosynovitis 2740 Gouty arthropathy 7801 Hallucinations 0743 Hand, foot, & mouth disease E9838 Hanging, strangulation or suffication other specified means, undetermined if accidentally or purposely inflicted E9839 Hanging, strangulation or suffocation by unspecified means, undetermined if accidentally or purposely inflicted 07981 Hantavirus infection 95901 Head injury unspecified 7840 Headache 4299 Heart disease, unspecified 4289 Heart failure, unspecified 9922 Heat cramps 9927 Heat edema 9924 Heat exhaustion due to salt depletion 9923 Heat exhaustion, anhydrotic 9925 Heat exhaustion, unspecified 9926 Heat fatigue, transient 9920 Heat stroke & sunstroke 9921 Heat syncope 71912 Hemarthorsis joint of upper arm 71917 Hemarthrosis joint of ankle & foot 71913 Hemarthrosis joint of forearm

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

71914 Hemarthrosis joint of hand 71916 Hemarthrosis joint of lower leg 71918 Hemarthrosis joint of other specified sites 71915 Hemarthrosis joint of pelvic region & thigh 71919 Hemarthrosis of joint of multiple sites 71910 Hemarthrosis, joint site unspecified 7773 Hematemesis & melena of newborn due to swallowed maternal blood 86411 Hematoma & contusion of liver with open wound into cavity 86401 Hematoma & contusion of liver without mention of open wound into cavity 99812 Hematoma complicating a procedure NEC 86601 Hematoma of kidney without rupture of capsule or mention of open wound into cavity 86611 Hematoma of kidney without rupture of capsule, with open wound into cavity 86511 Hematoma of spleen, without rupture of capsule, with open wound into cavity 86501 Hematoma of spleen, without rupture of capsule, without mention of open wound into cavity 6207 Hematoma of the broad ligament 7912 Hemoglobinuria 0415 Hemophilus influenzae infection in conditions classified elsewhere and of unspecified site 3200 Hemophilus meningitis 7863 Hemoptysis 2463 Hemorrhage & infarction of thyroid 99811 Hemorrhage complicating a procedure, not elsewhere classified 64113 Hemorrhage from placenta previa, antepartum condition or complication 64111 Hemorrhage from placenta previa, delivered 64110 Hemorrhage from placenta previa, unspecified as to episode of care 7848 Hemorrhage from throat 64003 Hemorrhage in early pregnancy threatened abortion, antepartum condition or complication 64001 Hemorrhage in early pregnancy threatened abortion, delivered 64000 Hemorrhage in early pregnancy threatened abortion, unspecified as to episode of care 5967 Hemorrhage into bladder wall 5789 Hemorrhage of gastrointestinal tract, unspecified 7760 Hemorrhagic disease of newborn 0786 Hemorrhagic nephrosonephritis 5734 Hepatic infarction 07042 Hepatitis Delta wo mention of active hepatitis B, w hepatic coma

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

1305 Hepatitis due to toxoplasmosis 07043 Hepatitis E w hepatic coma 5724 Hepatorenal syndrome 71911 Herarthrosis joint of shoulder region 5518 Hernia of other specified sites, with gangrene 5528 Hernia of other specified sites, with obstruction 5519 Hernia of unspecified site, with gangrene 5529 Hernia of unspecified site, with obstruction 05444 Herpes simplex iridocyclitis 05472 Herpes simplex meningitis 05474 Herpes simplex myelitis 05449 Herpes simplex w other ophthalmic complications 05440 Herpes simplex w unspecified ophthalmic complication 0540 Herpes simplex, eczema herpeticum 0543 Herpes simplex, herpetic meningoencephalitis 0545 Herpes simplex, herpetic septicemia 05320 Herpes zoster dermatitis of eyelid 05322 Herpes zoster iridocyclitis 05321 Herpes zoster keratoconjunctivitis 05314 Herpes zoster myelitis 0530 Herpes zoster w meningitis 05319 Herpes zoster w other nervous system complications 05329 Herpes zoster w other ophthalmic complications 05310 Herpes zoster w unspecified nervous system complication 11591 Histoplasmosis, unspecified meningitis 11593 Histoplasmosis, unspecified, pericarditis 30150 Histrionic personality disorder, unspecified E9687 Homicide & injury inflicted by human bite E9283 Human bite 042 Human immunodeficiency virus disease 591 Hydronephrosis 64313 Hyperemesis gravidarum with metabolic disturbance, antepartum condition 64311 Hyperemesis gravidarum with metabolic disturbance, delivered 64310 Hyperemesis gravidarum with metabolic disturbance, unspecified as to episode of care

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

3141 Hyperkinesis of childhood w developmental delay 3142 Hyperkinetic conduct disorder of childhood 60091 Hyperplasia of prostate, unspecified, with urinary obstruction 2767 Hyperpotassemia 40412 Hypertensive heart & kidney disease, benign with chronic kidney disease 40411 Hypertensive heart & kidney disease, benign with heart failure 40413 Hypertensive heart & kidney disease, benign with heart failure & chronic kidney disease 40402 Hypertensive heart & kidney disease, malignant, with chronic kidney disease 40401 Hypertensive heart & kidney disease, malignant, with heart failure 40403 Hypertensive heart & kidney disease, malignant, with heart failure & chronic kidney disease 40400 Hypertensive heart & kidney disease, malignant, wo heart failure or chronic kidney disease 40493 Hypertensive heart & kidney disease, unspecified with heart failure & chronic kidney disease 40490 Hypertensive heart & kidney disease, unspecified wo heart failure or chronic kidney disease 40492 Hypertensive heart & kidney disease, unspecified, with chronic kidney disease 40491 Hypertensive heart & kidney disease, unspecified, with heart failure 40201 Hypertensive heart disease with heart failure 40211 Hypertensive heart disease, benign, with heart failure 40200 Hypertensive heart disease, malignant, without congestive heart failure 40291 Hypertensive heart disease, unspecified, with heart failure 40391 Hypertensive kidney disease unspecified with chronic kidney didease 40390 Hypertensive kidney disease unspecified without chronic kidney didease 40301 Hypertensive kidney disease, malignent, with chronic kidney disease 40300 Hypertensive kidney disease, malignent, without chronic kidney disease 4251 Hypertrophic obstructive cardiomyopathy 60001 Hypertrophy (benign) of prostate with urinary obstruction 5271 Hypertrophy of salivary gland 30271 Hypoactive sexual desire disorder 7754 Hypocalcemia & hypomagnesemia of newborn 2512 Hypoglycemia, unspecified 2510 Hypoglycemic coma 2768 Hypopotassemia 4589 Hypotension, Unspecified 9916 Hypothermia 27652 Hypovolemia

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

79902 Hypoxemia 77088 Hypoxemia of newborn 5121 Iatrogenic pneumothorax 31382 Identity disorder of childhood or adolescence 34122 Idiopathic transverse myelitis 2914 Idiosyncratic alcohol intoxication 8180 Ill-defined closed fractures of upper limb 0090 Ill-defined intestinal infections infectious colitis, enteritis, & gastroenteritis 8181 Ill-defined open fractures of upper limb 63622 Illegal abortion, complete, complicated by damage to pelvic organs or tissues 63612 Illegal abortion, complete, complicated by delayed or excessive hemorrhage 63662 Illegal abortion, complete, complicated by embolism 63602 Illegal abortion, complete, complicated by genital tract & pelvic infection 63642 Illegal abortion, complete, complicated by metabolic disorder 63632 Illegal abortion, complete, complicated by renal failure 63652 Illegal abortion, complete, complicated by shock 63672 Illegal abortion, complete, with other specified complications 63682 Illegal abortion, complete, with unspecified complication 63692 Illegal abortion, complete, without mention of complication 63621 Illegal abortion, incomplete, complicated by damage to pelvic organs or tissues 63611 Illegal abortion, incomplete, complicated by delayed or excessive hemorrhage 63661 Illegal abortion, incomplete, complicated by embolism 63601 Illegal abortion, incomplete, complicated by genital tract & pelvic infection 63641 Illegal abortion, incomplete, complicated by metabolic disorder 63631 Illegal abortion, incomplete, complicated by renal failure 63651 Illegal abortion, incomplete, complicated by shock 63671 Illegal abortion, incomplete, with other specified complications 63681 Illegal abortion, incomplete, with unspecified complication 63691 Illegal abortion, incomplete, without mention of complication 63620 Illegal abortion, unspecified, complicated by damage to pelvic organs or tissues 63610 Illegal abortion, unspecified, complicated by delayed or excessive hemorrhage 63660 Illegal abortion, unspecified, complicated by embolism 63600 Illegal abortion, unspecified, complicated by genital tract & pelvic infection 63640 Illegal abortion, unspecified, complicated by metabolic disorder

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

63630 Illegal abortion, unspecified, complicated by renal failure 63650 Illegal abortion, unspecified, complicated by shock 63670 Illegal abortion, unspecified, with other specified complications 63680 Illegal abortion, unspecified, with unspecified complication 63690 Illegal abortion, unspecified, without mention of complication 9914 Immersion foot 56031 Impaction of intestine without mention of hernia, gallstone ileus 55221 Incisional ventral hernia with obstruction 55121 Incisional ventral hernia, with gangrene 0770 Inclusion conjunctivitis 0847 Induced malaria 99851 Infected postoperative seroma, not elsewhere classified 99661 Infection & inflammatory reaction due to cardiac device, implant & graft 99664 Infection & inflammatory reaction due to indwelling urinary catheter 99666 Infection & inflammatory reaction due to internal joint prosthesis 99663 Infection & inflammatory reaction due to nervous system device, implant & graft 99665 Infection & inflammatory reaction due to other genitourinary device, implant & graft 99667 Infection & inflammatory reaction due to other internal orthopedic device, implant & graft 99669 Infection & inflammatory reaction due to other internal prosthetic device, implant & graft 99662 Infection & inflammatory reaction due to other vascular device, implant & graft 99668 Infection & inflammatory reaction due to peritoneal dialysis catheter 99660 Infection & inflammatory reaction due to unspecified device, implant, or graft 11501 Infection by histoplasma capsulatum meningitis 11503 Infection by histoplasma capsulatum pericarditis 11511 Infection by histoplasma duboisii meningitis 11513 Infection by histoplasma duboisii pericarditis 65843 Infection of amniotic cavity, antepartum condition or complication 65841 Infection of amniotic cavity, delivered 65840 Infection of amniotic cavity, unspecified episode of care 56961 Infection of colostomy or enterostomy 53086 Infection of esophagostomy 5909 Infection of kidney, unspecified 51901 Infection of tracheostomy 04185 Infections condition classed elsewhere & of unspecified site, other gram-negative organisms

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

64663 Infections of genitourinary tract in pregnancy, antepartum condition 64661 Infections of genitourinary tract in pregnancy, delivered 64662 Infections of genitourinary tract in pregnancy, delivered, with mention of postpartum complication 64664 Infections of genitourinary tract in pregnancy, postpartum condition 64660 Infections of genitourinary tract in pregnancy, unspecified as to episode of care 59011 Infections of kidney, acute pyelonephritis with lesion of renal medullary necrosis 59010 Infections of kidney, acute pyelonephritis without lesion of renal medullary necrosis 59081 Infections of kidney, pyelitis or pyelonephritis in diseases classified elsewhere 59080 Infections of kidney, pyelonephritis, unspecified 5903 Infections of kidney, pyeloureteritis cystica 5902 Infections of kidney, renal & perinephric abscess V1242 Infections of the central nervous system 32361 Infectious acute disseminated encephalomyelitis (ADEM) 0092 Infectious diarrhea 075 Infectious mononucleosis 7280 Infective myositis of muscle, ligament & facia 37962 Inflammation (infection) of postprocedural bleb, stage 2 37963 Inflammation (infection) of postprocedural bleb, stage 3 6163 Inflammatory disease of cervix, vagina & vulva, abscess of Bartholin's gland 6012 Inflammatory diseases of prostate, abscess of prostate 6010 Inflammatory diseases of prostate, acute prostatitis 4881 Influenza due to certain identified influenza viruses; Novel H1N1 influenza virus 4880 Influenza due to identified avian influenza virus 4878 Influenza with other manifestations 4871 Influenza with other respiratory manifestations 4870 Influenza with pneumonia E911 Inhalation & ingestion of food causing obstruction of respiratory tract or suffocation E9856 Injury by air gun, undetermined if accidentally or purposely inflicted E9881 Injury by burns or fire, undetermined if accidentally or purposely inflicted E9887 Injury by caustic substances, except poison, undetermined if accidentally or purposely inflicted E9886 Injury by crashing of aircraft, undetermined if accidentally or purposely inflicted E9885 Injury by crashing of motor vehicle, undetermined if accidentally or purposely inflicted E9884 Injury by electrocution, undetermined if accidentally or purposely inflicted E9855 Injury by explosives, undetermined if accidentally or purposely inflicted

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E9883 Injury by extremes of cold, undetermined if accidentally or purposely inflicted E9872 Injury by fall from natural site, undetermined if accidentally or purposely inflicted E9871 Injury by fall from other man-made structure, undetermined if accidentally or purposely inflicted E9879 Injury by fall from unspecified site, undetermined if accidentally or purposely inflicted E9852 Injury by hunting rifle, undetermined if accidentally or purposely inflicted E9853 Injury by military firearms, undetermined if accidentally or purposely inflicted E9854 Injury by other & unspecified firearm, undetermined if accidentally or purposely inflicted E9888 Injury by other specified means, undetermined if accidentally or purposely inflicted E9857 Injury by paintball gun, undetermined if accidentally or purposely inflicted E9882 Injury by scalding, undetermined if accidentally or purposely inflicted E9851 Injury by shotgun, undetermined if accidentally or purposely inflicted E9831 Injury by suffocation by plastic bag, undetermined if accidentally or purposely inflicted E9889 Injury by unspecified means, undetermined if accidentally or purposely inflicted E9092 Injury caused by avalanche, landslide, or mudslide E9064 Injury caused by bite of nonvenomous arthropod E9062 Injury caused by bite of nonvenomous snakes & lizards E9063 Injury caused by bite of other animal except arthropod E9065 Injury caused by bite of unspecified animal E9083 Injury caused by blizzard; snow & ice E9093 Injury caused by collapse of dam or man-made structure E9084 Injury caused by dust storm E9082 Injury caused by flood E9098 Injury caused by other cataclysmic earth surface movements & eruptions E9088 Injury caused by other cataclysmic storms E9061 Injury caused by rat bite E9094 Injury caused by tidalwave caused by earthquake E9081 Injury caused by tornado E9099 Injury caused by unspecified cataclysmic earth surface moments & eruptions E9089 Injury caused by unspecified cataclysmic storms & floods resulting from storms E9091 Injury caused by volcanic eruption 9020 Injury to abdominal aorta 9513 Injury to abducens nerve 9516 Injury to accessory nerve 9515 Injury to acoustic nerve

Page 82: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

86801 Injury to adrenal gland without mention of open wound into cavity 86811 Injury to adrenal gland, with open wound into cavity 90451 Injury to anterior tibial artery 90452 Injury to anterior tibial vein 86395 Injury to appendix with open wound into cavity 86385 Injury to appendix without mention of open wound into cavity 86351 Injury to ascending (right) colon with open wound into cavity 86341 Injury to ascending (right) colon without mention of open wound into cavity 90301 Injury to axillary artery 9550 Injury to axillary nerve of shoulder girdle 90302 Injury to axillary vein 86812 Injury to bile duct & gallbladder with open wound into cavity 86802 Injury to bile duct & gallbladder without mention of open wound into cavity 8671 Injury to bladder & urethra with open wound into cavity 8670 Injury to bladder & urethra without mention of open wound into cavity 9049 Injury to blood vessels of unspecified site 9031 Injury to brachial blood vessels 9534 Injury to brachial plexus 7676 Injury to brachial plexus due to birth trauma 86231 Injury to bronchus with open wound into cavity 86221 Injury to bronchus without open wound into cavity 9530 Injury to cervical nerve root 9540 Injury to cervical sympathetic nerve, excluding shoulder & pelvic girdles 90001 Injury to common carotid artery 9040 Injury to common femoral artery 9564 Injury to cutaneous sensory nerve, lower limb 9555 Injury to cutaneous sensory nerve, upper limb 9046 Injury to deep plantar blood vessels 86353 Injury to descending (left) colon with open wound into cavity 86343 Injury to descending (left) colon without mention of open wound into cavity 8621 Injury to diaphragm with open wound into thorax 8620 Injury to diaphragm without mention of open wound into cavity 9556 Injury to digital nerve, upper limb 9035 Injury to digitas blood vessels

Page 83: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

9531 Injury to dorsal nerve root 86331 Injury to duodenum with open wound into cavity 86321 Injury to duodenum without mention of open wound into cavity 86232 Injury to esophagus with open wound into cavity 86222 Injury to esophagus without mention of open wound into cavity 90002 Injury to external carotid artery 90081 Injury to external jugular vein 9514 Injury to facial nerve 9561 Injury to femoral nerve 9042 Injury to femoral veins 90221 Injury to gastric artery 90222 Injury to hepatic artery 90211 Injury to hepatic veins of inferior vena cava 90251 Injury to hypogastric artery 90252 Injury to hypogastric vein 9517 Injury to hypoglossal nerve 90253 Injury to iliac artery 90254 Injury to iliac vein 90227 Injury to inferior mesenteric artery 90232 Injury to inferior mesenteric vein 90210 Injury to inferior vena cava, unspecified 9011 Injury to innominate & subclavian arteries 9013 Injury to innominate & subclavian veins 90181 Injury to intercostal artery or vein 90003 Injury to internal carotid artery 9001 Injury to internal jugular vein 90182 Injury to internal mammary artery or vein 9532 Injury to lumbar nerve root 9535 Injury to lumbosacral plexus 9551 Injury to median nerve of shoulder girdle 8629 Injury to multiple & unspecified intrathoracic organs with open wound into cavity 8628 Injury to multiple & unspecified intrathoracic organs without mention of open wound into cavity 86394 Injury to multiple & unspecified sites of pancreas with open wound into cavity 86384 Injury to multiple & unspecified sites of pancreas, without mention of open wound into cavity

Page 84: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

90287 Injury to multiple blood vessels of abdomen & pelvis 90082 Injury to multiple blood vessels of head & neck 90183 Injury to multiple blood vessels of thorax 9578 Injury to multiple nerves in several parts 9568 Injury to multiple nerves of pelvic girdle & lower limb 9558 Injury to multiple nerves of shoulder girdle & upper limb 86356 Injury to multiple sites in colon & rectum with open wound into cavity 86346 Injury to multiple sites in colon & rectum without mention of open wound into cavity 9538 Injury to multiple sites of nerve roots & spinal plexus 9554 Injury to musculocutaneous nerve of shoulder girdle & upper limb 9579 Injury to nerves, unspecified site 9501 Injury to optic chiasm 9502 Injury to optic pathways 86809 Injury to other & multiple intra-abdominal organs without mention of open wound into cavity 86819 Injury to other & multiple intra-abdominal organs, with open wound into cavity 90229 Injury to other celiac & mesenteric arteries 86399 Injury to other gastrointestinal sites with open wound into cavity 86389 Injury to other gastrointestinal sites without mention of open wound into cavity 90259 Injury to other iliac blood vessels 90239 Injury to other portal & splenic veins 90249 Injury to other renal blood vessels 86359 Injury to other site of colon & rectum with open wound into cavity 86339 Injury to other site of small intestine with open wound into cavity 86329 Injury to other site of small intestine without mention of open wound into cavity 86349 Injury to other sites of colon & rectum, without mention of open wound into cavity 86519 Injury to other sites of spleen with open wound into cavity 90289 Injury to other specified blood vessels of abdomen & pelvis 90089 Injury to other specified blood vessels of head & neck 9047 Injury to other specified blood vessels of lower extremity 90189 Injury to other specified blood vessels of thorax 9038 Injury to other specified blood vessels of upper extremity 90224 Injury to other specified branches of celiac axis 90219 Injury to other specified branches of inferior vena cava 9518 Injury to other specified cranial nerves

Page 85: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

86239 Injury to other specified intrathoracic organs with open wound into cavity 86229 Injury to other specified intrathoracic organs without mention of open wound into cavity 9571 Injury to other specified nerve(s) 9565 Injury to other specified nerve(s) of pelvic girdle & lower limb 9557 Injury to other specified nerve(s) of shoulder girdle & upper limb 9548 Injury to other specified nerve(s) of trunk, excluding shoulder & pelvic girdles 8677 Injury to other specified pelvic organs with open wound into cavity 8676 Injury to other specified pelvic organs without mention of open wound into cavity 9541 Injury to other sympathetic nerve, excluding shoulder & pelvic girdles 90281 Injury to ovarian artery 90282 Injury to ovarian vein 9034 Injury to palmar artery 86392 Injury to pancreas body with open wound into cavity 86382 Injury to pancreas body without mention of open wound into cavity 86391 Injury to pancreas head with open wound into cavity 86381 Injury to pancreas head without mention of open wound into cavity 86393 Injury to pancreas tail with open wound into cavity 86383 Injury to pancreas tail without mention of open wound into cavity 86813 Injury to peritoneum with open wound into cavity 86803 Injury to peritoneum without mention of open wound into cavity 9563 Injury to peroneal nerve 90441 Injury to popliteal artery 90442 Injury to popliteal vein 90233 Injury to portal vein 90453 Injury to posterior tibial artery 9562 Injury to posterior tibial nerve 90454 Injury to posterior tibial vein 90226 Injury to primary branches of superior mesenteric artery 90141 Injury to pulmonary artery 90142 Injury to pulmonary vein 9032 Injury to radial blood vessels 9553 Injury to radial nerve of shoulder girdle & upper limb 86355 Injury to rectum with open wound into cavity 86345 Injury to rectum without mention of open wound into cavity

Page 86: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

90241 Injury to renal artery 90242 Injury to renal vein 86814 Injury to retroperitoneum with open wound into cavity 86804 Injury to retroperitoneum without mention of open wound into cavity 9533 Injury to sacral nerve root 9043 Injury to saphenous veins 9560 Injury to sciatic nerve 86354 Injury to sigmoid colon with open wound into cavity 86344 Injury to sigmoid colon without mention of open wound into cavity 7674 Injury to spine & spinal cord due to birth trauma 86514 Injury to spleen with massive parenchyma disruption with open wound into cavity 86504 Injury to spleen with massive parenchymal disruption without mention of open wound into cavity 90223 Injury to splenic artery 90234 Injury to splenic vein 8631 Injury to stomach with open wound into cavity 8630 Injury to stomach without mention of open wound into cavity 9041 Injury to superficial femoral artery 9570 Injury to superficial nerves of head & neck 90225 Injury to superior mesenteric artery of trunk 90231 Injury to superior mesenteric vein & primary subdivisions 9012 Injury to superior vena cava 9010 Injury to thoracic aorta 86352 Injury to transverse colon with open wound into cavity 86342 Injury to transverse colon without mention of open wound into cavity 9512 Injury to trigeminal nerve 9511 Injury to trochlear nerve 9033 Injury to ulnar blood vessels 9552 Injury to ulnar nerve of upper limb 90300 Injury to unspecified axillary vessel(s) 9029 Injury to unspecified blood vessel of abdomen & pelvis 9009 Injury to unspecified blood vessel of head & neck 9048 Injury to unspecified blood vessel of lower extremity 9019 Injury to unspecified blood vessel of thorax 9039 Injury to unspecified blood vessel of upper extremity

Page 87: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

90220 Injury to unspecified celiac & mesenteric arteries 9519 Injury to unspecified cranial nerve 90250 Injury to unspecified iliac blood vessel(s) 86800 Injury to unspecified intra-abdominal organ without mention of open wound into cavity 86810 Injury to unspecified intra-abdominal organ, with open wound into cavity 9569 Injury to unspecified nerve of pelvic girdle & lower limb 9559 Injury to unspecified nerve of shoulder girdle & upper limb 9549 Injury to unspecified nerve(s) of trunk, excluding shoulder & pelvic girdles 9509 Injury to unspecified optic nerve & pathways 8679 Injury to unspecified pelvic organ with open wound into cavity 8678 Injury to unspecified pelvic organ without mention of open wound into cavity 90440 Injury to unspecified popliteal blood vessel(s) 90140 Injury to unspecified pulmonary vessel(s) 90240 Injury to unspecified renal blood vessel(s) 86350 Injury to unspecified site of colon, with open wound into cavity 86340 Injury to unspecified site of colon, without mention of open wound into cavity 86390 Injury to unspecified site of gastrointestinal tract with open wound into cavity 86380 Injury to unspecified site of gastrointestinal tract, without mention of open wound into cavity 86400 Injury to unspecified site of liver without mention of open wound into cavity 9539 Injury to unspecified site of nerve roots & spinal plexus 86330 Injury to unspecified site of small Intestine, with open wound into cavity 86320 Injury to unspecified site of small intestine, without mention of open wound into cavity 86510 Injury to unspecified site of spleen with open wound into cavity 90450 Injury to unspecified tibial blood vessel(s) 8673 Injury to ureter with open wound into cavity 8672 Injury to ureter without mention of open wound into cavity 90255 Injury to uterine artery 90256 Injury to uterine vein 8675 Injury to uterus with open wound into cavity 8674 Injury to uterus without mention of open wound into cavity 9503 Injury to visual cortex 7981 Instantaneous death 4111 Intermediate coronary syndrome 4552 Internal hemorrhoids with other complication

Page 88: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

8691 Internal injury to unspecified or ill-defined organs with open wound into cavity 8690 Internal injury to unspecified or ill-defined organs without mention of open wound into cavity 4551 Internal thrombosed hemorrhoids 92233 Interscapular region contusion 7702 Interstitial emphysema & related conditions of fetus & newborn 0082 Intestinal infection due to aerobacter aerogenes 0081 Intestinal infection due to Arizona group of paracolon bacilli 0085 Intestinal infection due to bacterial enteritis, unspecified 00843 Intestinal infection due to campylobacter 00845 Intestinal infection due to clostridium difficile 00800 Intestinal infection due to E. coli, unspecified 00804 Intestinal infection due to Enterohemorrhagic E. coli 00803 Intestinal infection due to Enteroinvasive E. coli 00801 Intestinal infection due to Enteropathogenic E. coli 00802 Intestinal infection due to Enterotoxigenic E. coli 00846 Intestinal infection due to other anaerobes 00849 Intestinal infection due to other bacteria 00847 Intestinal infection due to other gram-negative bacteria 00809 Intestinal infection due to other intestinal E. coli infections 0088 Intestinal infection due to other organism, not elsewhere classified 0083 Intestinal infection due to proteus (mirabilis) (morganii) 00842 Intestinal infection due to pseudomonas 00841 Intestinal infection due to staphylococcus 00844 Intestinal infection due to yersinia enterocolitica 00865 Intestinal infections due to other organisms; Enteritis due to specified virus; Enteritis due to calicivirus 7772 Intestinal obstruction in newborn due to inspissated milk 5600 Intestinal obstruction without mention of hernia, intussusception 5601 Intestinal obstruction without mention of hernia, paralytic ileus 5602 Intestinal obstruction without mention of hernia, volvulus 56081 Intestinal or peritoneal adhesions with obstruction without mention of hernia 431 Intracerebral hemorrhage 3249 Intracranial & intraspinal abscess of unspecified site 3240 Intracranial abscess 4320 Intracranial hemorrhage, nontraumatic extradural hemorrhage

Page 89: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

4321 Intracranial hemorrhage, subdural hemorrhage 85412 Intracranial injury of other & unspecified nature with open wound, brief loss of consciousness 85416 Intracranial injury of other & unspecified nature with open wound, loss of consciousness of unspecified duration 85413 Intracranial injury of other & unspecified nature with open wound, moderate loss of consciousness 85411 Intracranial injury of other & unspecified nature with open wound, no loss of consciousness 85414 Intracranial injury of other & unspecified nature with open wound, prolonged loss of consciousness with return 85415 Intracranial injury of other & unspecified nature with open wound, prolonged loss of consciousness without return 85410 Intracranial injury of other & unspecified nature with open wound, state of consciousness unspecified 85419 Intracranial injury of other & unspecified nature with open wound, with concussion, unspecified 85402 Intracranial injury of other & unspecified nature wo open wound, brief loss of consciousness 85406 Intracranial injury of other & unspecified nature wo open wound, loss of consciousness of upspecified duration 85403 Intracranial injury of other & unspecified nature wo open wound, moderate loss of consciousness 85401 Intracranial injury of other & unspecified nature wo open wound, no loss of consciousness 85404 Intracranial injury of other & unspecified nature wo open wound, prolonged loss of consciousness with return 85405 Intracranial injury of other & unspecified nature wo open wound, prolonged loss of consciousness wo return 85400 Intracranial injury of other & unspecified nature wo open wound, state of consciousness unspecified 85409 Intracranial injury of other & unspecified nature wo open wound, with concussion, unspecified 3241 Intraspinal abscess 65643 Intrauterine death affecting management of mother, antepartum condition or complication 65641 Intrauterine death affecting management of mother, delivered 65640 Intrauterine death affecting management of mother, unspecified episode of care 76871 Intrauterine hypoxia and birth asphyxia; Hypoxic-ischemic encephalopathy (HIE); Mild hypoxic-ischemic encephalopathy 76872 Intrauterine hypoxia and birth asphyxia; Hypoxic-ischemic encephalopathy (HIE); Moderate hypoxic-ischemic encephalopathy76873 Intrauterine hypoxia and birth asphyxia; Hypoxic-ischemic encephalopathy (HIE); Severe hypoxic-ischemic encephalopathy 76870 Intrauterine hypoxia and birth asphyxia; Hypoxic-ischemic encephalopathy (HIE); Unspecified 60822 Intravaginal torsion of spermatic cord 77211 Intraventricular hemorrhage of fetus or newborn, grade I 77212 Intraventricular hemorrhage of fetus or newborn, grade II 77213 Intraventricular hemorrhage of fetus or newborn, grade III 77214 Intraventricular hemorrhage of fetus or newborn, grade IV 77210 Intraventricular hemorrhage of fetus or newborn, unspecified grade 49311 Intrinsic asthma with status asthmaticus 49310 Intrinsic asthma, unspecified 49312 Intrinsic asthma, with (acute) exacerrbation

Page 90: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

31322 Introverted disorder of childhood 2800 Iron deficiency anemias secondary to blood loss (chronic) 59582 Irradiation cystitis 65620 Isoimmunization from unspecified blood-group incompatibility affecting managment of mother, unspecified episode of care 37003 Keratitis, central corneal ulcer 37004 Keratitis, corneal ulcer, hypopyon ulcer 37007 Keratitis, corneal ulcer, Mooren's ulcer 37000 Keratitis, corneal ulcer, unspecified 37001 Keratitis, marginal corneal ulcer 37005 Keratitis, mycotic corneal ulcer 37006 Keratitis, perforated corneal ulcer 37002 Keratitis, ring corneal ulcer 7747 Kernicterus of fetus or newborn not due to isoimmunization 8702 Laceration of eyelid involving lacrimal passages 8701 Laceration of eyelid, full-thickness, not involving lacrimal passages 86113 Laceration of heart with penetration of heart chambers & open wound into thorax 86103 Laceration of heart with penetration of heart chambers, without mention of open wound into thorax 86102 Laceration of heart without penetration of heart chambers or open wound into thorax 86112 Laceration of heart without penetration of heart chambers, with open wound into thorax 86612 Laceration of kidney with open wound into cavity 86602 Laceration of kidney without mention of open wound into cavity 86132 Laceration of lung with open wound into thorax 86122 Laceration of lung without open wound into thorax 8700 Laceration of skin of eyelid & periocular area 86503 Laceration of spleen extending into parenchyma without mention of open wound into cavity 86513 Laceration of spleen extending into parenchyma, with open wound into cavity 7813 Lack of coordination 0323 Laryngeal diphtheria 9095 Late effect of adverse effect of drug, medicinal or biological substance 9065 Late effect of burn of eye, face, head & neck 9067 Late effect of burn of other extremities 9069 Late effect of burn of unspecified site 9066 Late effect of burn of wrist & hand 9068 Late effect of burns of other specified sites

Page 91: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

9086 Late effect of certain complications of trauma 9094 Late effect of certain other external causes 9093 Late effect of complications of surgical & medical care 9063 Late effect of contusion 9064 Late effect of crushing 9056 Late effect of dislocation 9085 Late effect of foreign body in orifice 9054 Late effect of fracture of lower extremities 9055 Late effect of fracture of multiple & unspecified bones 9053 Late effect of fracture of neck of femur 9050 Late effect of fracture of skull & face bones 9051 Late effect of fracture of spine & trunk without mention of spinal cord lesion 9052 Late effect of fracture of upper extremities 9083 Late effect of injury to blood vessel of head, neck & extremities 9084 Late effect of injury to blood vessel of thorax, abdomen & pelvis 9071 Late effect of injury to cranial nerve 9073 Late effect of injury to nerve root(s), spinal plexus(es), & other nerves of trunk 9079 Late effect of injury to other & unspecified nerve 9075 Late effect of injury to peripheral nerve of pelvic girdle & lower limb 9074 Late effect of injury to peripheral nerve of shoulder girdle & upper limb 9080 Late effect of internal injury to chest 9081 Late effect of internal injury to intra-abdominal organs 9082 Late effect of internal injury to other internal organs 9070 Late effect of intracranial injury without mention of skull fracture 9061 Late effect of open wound of extremities without mention of tendon injury 9060 Late effect of open wound of head, neck & trunk 9099 Late effect of other & unspecified external causes 9090 Late effect of poisoning due to drug, medicinal or biological substance 9092 Late effect of radiation 9072 Late effect of spinal cord injury 9057 Late effect of sprain & strain without mention of tendon injury 9062 Late effect of superficial injury 9058 Late effect of tendon injury 9091 Late effect of toxic effects of nonmedical substances

Page 92: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

9059 Late effect of traumatic amputation 9089 Late effect of unspecified injury 43853 Late effects of cerebrovascular disease, other paralytic syndrome bilateral 29552 Latent schizophrenia, chronic 29554 Latent schizophrenia, chronic w acute exacerbation 29555 Latent schizophrenia, in remission 29551 Latent schizophrenia, subchronic 29553 Latent schizophrenia, subchronic w acute exacerbation 29550 Latent schizophrenia, unspecified 83654 Lateral closed dislocation of tibia, proximal end 83664 Lateral open dislocation of tibia, proximal end 4281 Left heart failure 63522 Legally induced abortion, complete, complicated by damage to pelvic organs or tissues 63512 Legally induced abortion, complete, complicated by delayed or excessive hemorrhage 63562 Legally induced abortion, complete, complicated by embolism 63502 Legally induced abortion, complete, complicated by genital tract & pelvic infection 63542 Legally induced abortion, complete, complicated by metabolic disorder 63532 Legally induced abortion, complete, complicated by renal failure 63552 Legally induced abortion, complete, complicated by shock 63572 Legally induced abortion, complete, with other specified complications 63582 Legally induced abortion, complete, with unspecified complication 63592 Legally induced abortion, complete, without mention of complication 63521 Legally induced abortion, incomplete, complicated by damage to pelvic organs or tissues 63511 Legally induced abortion, incomplete, complicated by delayed or excessive hemorrhage 63561 Legally induced abortion, incomplete, complicated by embolism 63501 Legally induced abortion, incomplete, complicated by genital tract & pelvic infection 63541 Legally induced abortion, incomplete, complicated by metabolic disorder 63531 Legally induced abortion, incomplete, complicated by renal failure 63551 Legally induced abortion, incomplete, complicated by shock 63571 Legally induced abortion, incomplete, with other specified complications 63581 Legally induced abortion, incomplete, with unspecified complication 63591 Legally induced abortion, incomplete, without mention of complication 63520 Legally induced abortion, unspecified, complicated by damage to pelvic organs or tissues 63510 Legally induced abortion, unspecified, complicated by delayed or excessive hemorrhage

Page 93: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

63560 Legally induced abortion, unspecified, complicated by embolism 63500 Legally induced abortion, unspecified, complicated by genital tract & pelvic infection 63540 Legally induced abortion, unspecified, complicated by metabolic disorder 63530 Legally induced abortion, unspecified, complicated by renal failure 63550 Legally induced abortion, unspecified, complicated by shock 63570 Legally induced abortion, unspecified, with other specified complications 63580 Legally induced abortion, unspecified, with unspecified complication 63590 Legally induced abortion, unspecified, without mention of complication 0850 Leishmaniasis visceral, kala-azar 0859 Leishmaniasis, unspecified 10081 Leptospiral meningitis, aseptic 28850 Leukocytopenia, unspecified 5722 Liver abscess and sequelae of chronic liver disease; Hepatic encephalopathy 34541 Localization-rel (focal, partial) epilepsy & epilep synd w/complex partial seizures w intractible epilepsy 00320 Localized salmonella infection, unspecified 34540 Localiz-rel (focal/partial) epilepsy & epilep synd w/complex partial seiz wo mention of intract epilepsy 52511 Loss of teeth due to trauma 9522 Lumbar spinal cord injury without spinal bone injury 2893 Lymphadenitis unspecified except mesenteric 28851 Lymphocytopenia E8366 Machinery accident in water transport involving dockers, stevedores E8362 Machinery accident in water transport involving occupant of other watercraft; crew E8363 Machinery accident in water transport involving occupant of other watercraft; non-crew E8361 Machinery accident in water transport involving occupant of small boat; powered E8360 Machinery accident in water transport involving occupant of small boat; unpowered E8368 Machinery accident in water transport involving other specified person E8365 Machinery accident in water transport involving swimmer E8369 Machinery accident in water transport involving unspecified person E8364 Machinery accident in water transport involving water skier 37022 Macular keratitis 29636 Major depressive disorder, recurrent episode, in full remission 29635 Major depressive disorder, recurrent episode, in partial or unspecified remission 29631 Major depressive disorder, recurrent episode, mild 29632 Major depressive disorder, recurrent episode, moderate

Page 94: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

29634 Major depressive disorder, recurrent episode, severe, specified as w psychotic behavior 29633 Major depressive disorder, recurrent episode, severe, wo mention of psychotic behavior 29630 Major depressive disorder, recurrent episode, unspecified 29625 Major depressive disorder, single episode, in partial or unspecified remission 29620 Major depressive disorder, single episode, unspecified 29626 Major depressive disorder, single episode, in full remission 29621 Major depressive disorder, single episode, mild 29622 Major depressive disorder, single episode, moderate 29623 Major depressive disorder, single episode, severe wo mention of psychotic behavior 29624 Major depressive disorder, single episode, severe, specified as w psychotic behavior 86414 Major laceration of liver with open wound into cavity 86404 Major laceration of liver without mention of open wound into cavity 67082 Major puerperal infection; Other major puerperal infection; Delivered, with mention of postpartum complication 67084 Major puerperal infection; Other major puerperal infection; Postpartum condition or complication 67080 Major puerperal infection; Other major puerperal infection; Unspecified as to episode of care or not applicable 67012 Major puerperal infection; Puerperal endometritis; Delivered, with mention of postpartum complication 67014 Major puerperal infection; Puerperal endometritis; Postpartum condition or complication 67010 Major puerperal infection; Puerperal endometritis; Unspecified as to episode of care or not applicable 67022 Major puerperal infection; Puerperal sepsis; Delivered, with mention of postpartum complication 67024 Major puerperal infection; Puerperal sepsis; Postpartum condition or complication 67020 Major puerperal infection; Puerperal sepsis; Unspecified as to episode of care or not applicable 67032 Major puerperal infection; Puerperal septic thrombophlebitis; Delivered, with mention of postpartum complication 67034 Major puerperal infection; Puerperal septic thrombophlebitis; Postpartum condition or complication 67030 Major puerperal infection; Puerperal septic thrombophlebitis; Unspecified as to episode of care or not applicable 67000 Major puerperal infection; Unspecifid; As to episode of care or not applicable 67002 Major puerperal infection; Unspecified; Delivered, with mention of postpartum complication 67004 Major puerperal infection; Unspecified; Postpartum condition or complication 0846 Malaria, unspecified 4010 Malignant essential hypertension 99586 Malignant hyperthermia 40501 Malignant secondary hypertension, renovascular hypertension 29616 Manic disorder, recurrent episode, in full remission 29615 Manic disorder, recurrent episode, in partial or unspecified remission 29611 Manic disorder, recurrent episode, mild

Page 95: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

29612 Manic disorder, recurrent episode, moderate degree 29614 Manic disorder, recurrent episode, severe, specified as w psychotic behavior 29613 Manic disorder, recurrent episode, severe, wo mention of psychotic behavior 29610 Manic disorder, recurrent episode, unspecified 05571 Measles keratoconjunctivitis 05579 Measles w other specified complications 0558 Measles w unspecified complication 0559 Measles wo mention of complication 0550 Measles, postmeasles encephalitis 0552 Measles, postmeasles otitis media 0551 Measles, postmeasles pneumonia 99604 Mechanical complication due to automatic implantable cardiac defibrillator 99654 Mechanical complication due to breast prosthesis 99601 Mechanical complication due to cardiac pacemaker (electrode) 99603 Mechanical complication due to coronary bypass graft 99652 Mechanical complication due to graft of other tissue, not elsewhere classified 99602 Mechanical complication due to heart valve prosthesis 99632 Mechanical complication due to intrauterine contraceptive device 99653 Mechanical complication due to ocular lens prosthesis 99631 Mechanical complication due to urethral (indwelling) catheter 56962 Mechanical complication of colostomy & enterostomy 53087 Mechanical complication of esophagostomy 9962 Mechanical complication of nervous system device, implant & graft 99659 Mechanical complication of other implant & internal device, not elsewhere classfied 9961 Mechanical complication of other vascular device, implant & graft 99651 Mechanical complication of prosthetic corneal graft 51902 Mechanical complication of tracheostomy 99630 Mechanical complication of unspecified genitourinary device, implant & graft 99655 Mechanical complications due to artificial skin graft & decellularized allodermis 99656 Mechanical complications due to peritoneal dialysis catheter 99600 Mechanical complications of unspecified cardiac device, implant & graft 7771 Meconium obstruction in fetus or newborn 83653 Medial closed dislocation of tibia, proximal end 83663 Medial open dislocation of tibia, proximal end

Page 96: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

7816 Meningismus 32081 Meningitis due to anaerobic meningitis 0470 Meningitis due to coxsackie virus 3210 Meningitis due to cryptococcal meningitis 0471 Meningitis due to ECHO virus 32082 Meningitis due to gram-negative bacteria, not elsewhere classified 3218 Meningitis due to other nonbacterial organisms classified elsewhere 32089 Meningitis due to other specified bacteria 3213 Meningitis due to trypanosomiasis 3209 Meningitis due to unspecified bacterium 3212 Meningitis due to viruses not elsewhere classified 3207 Meningitis in other bacterial diseases classified elsewhere 3211 Meningitis in other fungal diseases 3214 Meningitis in sarcoidosis 3229 Meningitis, unspecified 03682 Meningococcal arthropathy 03640 Meningococcal carditis, unspecified 0361 Meningococcal encephalitis 03642 Meningococcal endocarditis 03689 Meningococcal infection, unspecified 0369 Meningococcal Infection, Unspecified 0360 Meningococcal meningitis 03643 Meningococcal myocarditis 03681 Meningococcal optic neuritis 03641 Meningococcal pericarditis 0362 Meningococcemia 1300 Meningoencephalitis due to toxoplasmosis 6394 Metabolic disorders following abortion, ectopic & molar pregnancies 34831 Metabolic encephalopathy 34681 Migraine other forms w intractable migraine so stated wo mention of status migrainosus (Revised 10/2008) 34690 Migraine unspecified wo mention of intractable migraine wo mention of status migrainosus (Revised 10/2008) 34671 Migraine; chronic migraine without aura; with intractable migraine, so stated 34673 Migraine; chronic migraine without aura; with intractable migraine, so stated, with status migrainosus 34672 Migraine; chronic migraine without aura; without mention of intractable migraine with status migrainosus

Page 97: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

34632 Migraine; hemiplegic migraine 34630 Migraine; hemiplegic migraine without mention of status migrainosus 34631 Migraine; hemiplegic migraine without mention of status migrainosus 34633 Migraine; hemiplegic migraine; with intractable migraine, so stated, with status migrainosus 34643 Migraine; menstrual migraine; with intractable migraine, so stated, with status migrainosus 34641 Migraine; menstrual migraine; with intractable migraine, so stated, without mention of status migrainosus 34642 Migraine; menstrual migraine; without mention of intractable migraine with status migrainosus 34640 Migraine; menstrual migraine; without mention of intractable migraine without mention of status migrainosus 34683 Migraine; other forms; with intractable migraine, so stated, with status migrainosus 34682 Migraine; other forms; without mention of intractable migraine with status migrainosus 34660 Migraine; persistent migraine aura with cerebral infarction 34661 Migraine; persistent migraine aura with cerebral infarction 34662 Migraine; persistent migraine aura with cerebral infarction 34663 Migraine; persistent migraine aura with cerebral infarction 34650 Migraine; persistent migraine aura without cerebral infarction 34651 Migraine; persistent migraine aura without cerebral infarction 34652 Migraine; persistent migraine aura without cerebral infarction 34653 Migraine; persistent migraine aura without cerebral infarction 34691 Migraine; unspecified; w intractable migraine so stated wot mention of status migrainosus (Revised 10/2008) 34693 Migraine; unspecified; with intractable migraine, so stated, with status migrainosus 34692 Migraine; unspecified; without mention of intractable migraine with status migrainosus 34622 Migraine; variants of migraine without mention of intractable migraine with status migrainosus 34621 Migraine; variants of migraine; NOC; w intractible migraine wo mention of status migrainosus (Revised 10/2008) 34623 Migraine; variants of migraine;with intractable migraine, so stated, with status migrainosus 34601 Migraine; w aura; w intractable migraine, so stated, wo mention of status migrainosus (Revised 10/2008) 34603 Migraine; with aura; with intractable migraine, so stated, with status migrainosus 34602 Migraine; with aura; without mention of intractable migraine with status migrainosus 34613 Migraine; without aura; with intractable migraine, so stated, with status migrainosus 34612 Migraine; without aura; without mention of intractable migraine with status migrainosus 34611 Migraine; wo aura; w intractable migraine, so stated wo mention of status migrainosus (Revised 10/2008) 317 Mild mental retardation, IQ 50 - 70 7686 Mild or moderate birth asphyxia 86412 Minor laceration of liver with open wound into cavity 86402 Minor laceration of liver without mention of open wound into cavity

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

3131 Misery & unhappiness disorder specific to childhood & adolescence 632 Missed abortion 3084 Mixed disorders as reaction to stress 3124 Mixed disturbance of conduct & emotions 0845 Mixed malaria 86413 Moderate laceration of liver with open wound into cavity 86403 Moderate laceration of liver without mention of open wound into cavity 3180 Moderate mental retardation, IQ 35 - 49 0502 Modified smallpox 29383 Mood disorders in conditions classified elsewhere 0654 Mosquito-borne hemorrhagic fever 0622 Mosquito-borne viral eastern equine encephalitis 0624 Mosquito-borne viral encephalitis, Australian encephalitis 0625 Mosquito-borne viral encephalitis, California virus encephalitis 0623 Mosquito-borne viral encephalitis, St. Louis encephalitis 0629 Mosquito-borne viral encephalitis, unspecified 0620 Mosquito-borne viral Japanese encephalitis 0621 Mosquito-borne viral western equine encephalitis 9946 Motion sickness E8125 Motor vehicle collision with other motor vehicle & rider of animal; occupant of animal-drawn vehicle E8161 Motor vehicle traffic accident due to loss of control wo collision & passenger in motor vehicle not motorcycle E8165 Motor vehicle traffic accident due to loss of control wo collision & rider or occupant of animal-drawn vehicle E8160 Motor vehicle traffic accident due to loss of control wo collision on highway & driver of motor vehicle not motorcycle E8162 Motor vehicle traffic accident due to loss of control wo collision on the highway & motorcyclist E8164 Motor vehicle traffic accident due to loss of control wo collision on the highway & occupant of streetcar E8168 Motor vehicle traffic accident due to loss of control wo collision on the highway & other specified person E8163 Motor vehicle traffic accident due to loss of control wo collision on the highway & passenger on motorcycle E8166 Motor vehicle traffic accident due to loss of control wo collision on the highway & pedal cyclist E8167 Motor vehicle traffic accident due to loss of control wo collision on the highway & pedestrian E8169 Motor vehicle traffic accident due to loss of control wo collision on the highway & unspecified person E8140 Motor vehicle traffic accident involving collision with pedestrian & driver of vehicle other than motorcycle E8142 Motor vehicle traffic accident involving collision with pedestrian & motorcyclist E8144 Motor vehicle traffic accident involving collision with pedestrian & occupant of streetcar E8148 Motor vehicle traffic accident involving collision with pedestrian & other specified person

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8141 Motor vehicle traffic accident involving collision with pedestrian & passenger in motor vehicle other than motorcycle E8143 Motor vehicle traffic accident involving collision with pedestrian & passenger on motorcycle E8146 Motor vehicle traffic accident involving collision with pedestrian & pedal cyclist E8147 Motor vehicle traffic accident involving collision with pedestrian & pedestrian E8145 Motor vehicle traffic accident involving collision with pedestrian & rider of animal; occupant of animal-drawn vehicle E8149 Motor vehicle traffic accident involving collision with pedestrian & unspecified person E8108 Motor vehicle traffic accident involving collision with train & other specified person E8106 Motor vehicle traffic accident involving collision with train & pedal cyclist E8107 Motor vehicle traffic accident involving collision with train & pedestrian E8105 Motor vehicle traffic accident involving collision with train & rider of animal; occupant of animal-drawn vehicle E8109 Motor vehicle traffic accident involving collision with train & unspecified person E8101 Motor vehicle traffic accident involving collision with train involving assenger in motor vehicle other than motorcycle E8102 Motor vehicle traffic accident involving collision with train involving motorcyclist E8104 Motor vehicle traffic accident involving collision with train involving occupant of streetcar E8103 Motor vehicle traffic accident involving collision with train involving passenger on motorcycle E8135 Motor vehicle traffic accident involving collisions w other vehicle & rider of animal; occupant of animal-drawn vehicle E8130 Motor vehicle traffic accident involving collisions with other vehicle & driver of vehicle other than motorcycle E8132 Motor vehicle traffic accident involving collisions with other vehicle & motorcyclist E8134 Motor vehicle traffic accident involving collisions with other vehicle & occupant of streetcar E8138 Motor vehicle traffic accident involving collisions with other vehicle & other specified person E8131 Motor vehicle traffic accident involving collisions with other vehicle & passenger in motor vehicle not a motorcycle E8133 Motor vehicle traffic accident involving collisions with other vehicle & passenger on motorcycle E8136 Motor vehicle traffic accident involving collisions with other vehicle & pedal cyclist E8137 Motor vehicle traffic accident involving collisions with other vehicle & pedestrian E8139 Motor vehicle traffic accident involving collisions with other vehicle & unspecified person E8115 Motor vehicle traffic accident involving re-entrant collision & rider of animal; occupant of animal-drawn vehicle E8111 Motor vehicle traffic accident involving re-entrant collision w another & passenger in motor vehicle not motorcycle E8113 Motor vehicle traffic accident involving re-entrant collision with another motor vehicle & passenger on motorcycle E8112 Motor vehicle traffic accident involving re-entrant collision with another motor vehicle & motorcyclist E8114 Motor vehicle traffic accident involving re-entrant collision with another motor vehicle & occupant of streetcar E8118 Motor vehicle traffic accident involving re-entrant collision with another motor vehicle & other specified person E8116 Motor vehicle traffic accident involving re-entrant collision with another motor vehicle & pedal cyclist E8117 Motor vehicle traffic accident involving re-entrant collision with another motor vehicle & pedestrian E8119 Motor vehicle traffic accident involving re-entrant collision with another motor vehicle & unspecified person

Page 100: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8190 Motor vehicle traffic accident of unspecified nature involving driver of motor vehicle other than motorcycle E8192 Motor vehicle traffic accident of unspecified nature involving motorcyclist E8194 Motor vehicle traffic accident of unspecified nature involving occupant of streetcar E8198 Motor vehicle traffic accident of unspecified nature involving other specified person E8191 Motor vehicle traffic accident of unspecified nature involving passenger in motor vehicle other than motorcycle E8193 Motor vehicle traffic accident of unspecified nature involving passenger on motorcycle E8196 Motor vehicle traffic accident of unspecified nature involving pedal cyclist E8197 Motor vehicle traffic accident of unspecified nature involving pedestrian E8195 Motor vehicle traffic accident of unspecified nature involving rider or occupant of animal-drawn vehicle E8199 Motor vehicle traffic accident of unspecified nature involving unspecified person 0855 Mucocutaneous leishmaniasis, American 4911 Mucopurulent chronic bronchitis 52801 Mucositis (ulcerative) due to antineoplastic therapy 52802 Mucositis (ulcerative) due to other drugs 61681 Mucositis (ulcerative) of cervix, vagina, and vulva 8941 Multiple & unspecified open wound of lower limb, complicated 8942 Multiple & unspecified open wound of lower limb, with tendon involvement 8940 Multiple & unspecified open wound of lower limb, without mention of complication 8841 Multiple & unspecified open wound of upper limb, complicated 8842 Multiple & unspecified open wound of upper limb, with tendon involvement 8840 Multiple & unspecified open wound of upper limb, without mention of complication 8280 Multiple closed fractures involving both lower limbs, lower w upper limb & lower limb(s) w rib(s) & sternum 8190 Multiple closed fractures involving both upper limbs & upper limb with rib(s) & sternum 8170 Multiple closed fractures of hand bones 80843 Multiple closed pelvic fractures with disruption of pelvic circle 65171 Multiple gestation following (elective) fetal reduction-delivered, w/wo mention of antepartum condition 8281 Multiple open fractures involving both lower limbs, lower w upper limb & lower limb(s) w rib(s) & sternum 8191 Multiple open fractures involving both upper limbs & upper limb with rib(s) & sternum 8171 Multiple open fractures of hand bones 80853 Multiple open pelvic fractures with disruption of pelvic circle 9528 Multiple sites of spinal cord injury without spinal bone injury 1308 Multisystemic disseminated toxoplasmosis 0722 Mumps encephalitis 07271 Mumps hepatitis

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

0721 Mumps meningitis 0720 Mumps orchitis 0723 Mumps pancreatitis 07272 Mumps polyneuropathy 07279 Mumps w other specified complications 0728 Mumps w unspecified complication 0729 Mumps wo mention of complication 35971 Muscular dystrophies and other myopathies; Inflammatory and immune myopathies, NEC; Inclusion body myositis 35979 Muscular dystrophies and other myopathies; Inflammatory and immune myopathies, NEC; Other inflammatory and immune myopat3060 Musculoskeletal malfunction arising from mental factors 35801 Myasthenia gravis with (acute) exacerbation 32352 Myelitis following immunization procedures 32302 Myelitis in viral diseases classified elsewhere 1303 Myocarditis due to toxoplasmosis 7913 Myoglobinuria 0321 Nasopharyngeal Diphtheria 0403 Necrobacillosis 4475 Necrosis of artery 72886 Necrotizing fasciitis 77981 Neonatal bradycardia 7717 Neonatal candida infection 7716 Neonatal conjunctivitis & dacryocystitis 7751 Neonatal diabetes mellitus 7715 Neonatal infective mastitis 7752 Neonatal myasthenia gravis 77982 Neonatal tachycardia 7753 Neonatal thyrotoxicosis 3383 Neoplasm related pain (acute) (chronic) 58181 Nephrotic syndrome in diseases classified elsewhere 5812 Nephrotic syndrome with lesion of membranoproliferative glomerulonephritis 5811 Nephrotic syndrome with lesion of membranous glomerulonephritis 5813 Nephrotic syndrome with lesion of minimal change glomerulonephritis 5810 Nephrotic syndrome with lesion of proliferative glomerulonephritis 58189 Nephrotic syndrome with other specified pathological lesion in kidney

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

5819 Nephrotic syndrome with unspecified pathological lesion in kidney 3491 Nervous system complications from surgically implanted device 0941 Neurosyphilis, general paresis 0942 Neurosyphilis, syphilitic meningitis 30002 Neurotic disorders, anxiety state, generalized anxiety disorder 30000 Neurotic disorders, anxiety state, unspecified 3006 Neurotic disorders, depersonalization syndrome 3007 Neurotic disorders, hypochondriasis 30013 Neurotic disorders, hysteria psychogenic fugue 30011 Neurotic disorders, hysteria, conversion disorder 30015 Neurotic disorders, hysteria, dissociative disorder or reaction, unspecified 30016 Neurotic disorders, hysteria, factitious illness w psychological symptoms 30014 Neurotic disorders, hysteria, multiple personality 30019 Neurotic disorders, hysteria, other & unspecified factitious illness 30012 Neurotic disorders, hysteria, psychogenic amnesia 30010 Neurotic disorders, hysteria, unspecified 3005 Neurotic disorders, neurasthenia 3003 Neurotic disorders, obsessive compulsive disorders 30009 Neurotic disorders, other anxiety states 30021 Neurotic disorders, phobic disorders, agoraphobia w panic attacks 30022 Neurotic disorders, phobic disorders, agoraphobia wo mention of panic attacks 30029 Neurotic disorders, phobic disorders, other isolated or simple phobias 30023 Neurotic disorders, phobic disorders, social phobia 30020 Neurotic disorders, phobic disorders, unspecified 28804 Neutropenia due to infection 28800 Neutropenia, unspecified 60011 Nodular prostate with urinary obstruction 0490 Non-Arthopod borne lymphocytic choriomeningitis 0491 Non-arthopod borne meningitis due to adenovirus E8171 Noncollision motor vehicle traffic accident while boarding or alighting passenger in motor vehicle other than motorcycleE8172 Noncollision motor vehicle traffic accident while boarding or alighting with motorcyclist E8174 Noncollision motor vehicle traffic accident while boarding or alighting with occupant of streetcar E8178 Noncollision motor vehicle traffic accident while boarding or alighting with other specified person E8173 Noncollision motor vehicle traffic accident while boarding or alighting with passenger on motorcycle

Page 103: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8176 Noncollision motor vehicle traffic accident while boarding or alighting with pedal cyclist E8177 Noncollision motor vehicle traffic accident while boarding or alighting with pedestrian E8175 Noncollision motor vehicle traffic accident while boarding or alighting with rider or occupant of animal-drawn vehicle E8179 Noncollision motor vehicle traffic accident while boarding or alighting with unspecified person E8170 Noncollision motor vehicle traffic accident while boarding or alighting, driver of motor vehicle other than motorcycle 30501 Nondependent abuse of drugs, alcohol abuse, continuous 30502 Nondependent abuse of drugs, alcohol abuse, episodic 30503 Nondependent abuse of drugs, alcohol abuse, in remission 30500 Nondependent abuse of drugs, alcohol abuse, unspecified 30581 Nondependent abuse of drugs, antidepressant type abuse, continuous 30591 Nondependent abuse of drugs, antidepressant type abuse, continuous 30582 Nondependent abuse of drugs, antidepressant type abuse, episodic 30592 Nondependent abuse of drugs, antidepressant type abuse, episodic 30583 Nondependent abuse of drugs, antidepressant type abuse, in remission 30593 Nondependent abuse of drugs, antidepressant type abuse, in remission 30580 Nondependent abuse of drugs, antidepressant type abuse, unspecified 30590 Nondependent abuse of drugs, antidepressant type abuse, unspecified use 30521 Nondependent abuse of drugs, cannabis abuse, continuous 30522 Nondependent abuse of drugs, cannabis abuse, episodic 30523 Nondependent abuse of drugs, cannabis abuse, in remission 30520 Nondependent abuse of drugs, cannabis abuse, unspecified 30531 Nondependent abuse of drugs, hallucinogen abuse, continuous 30532 Nondependent abuse of drugs, hallucinogen abuse, episodic 30533 Nondependent abuse of drugs, hallucinogen abuse, in remission 30530 Nondependent abuse of drugs, hallucinogen abuse, unspecified 3051 Nondependent abuse of drugs, tobacco use disorder 30551 Nondependent abuse of opioid drugs, continuous 30552 Nondependent abuse of opioid drugs, episodic 30553 Nondependent abuse of opioid drugs, in remission 30550 Nondependent abuse of opioid drugs, unspecified 30541 Nondependent barbiturate & similarly acting sedative or hypnotic drug abuse, continuous 30542 Nondependent barbiturate & similarly acting sedative or hypnotic drug abuse, episodic 30543 Nondependent barbiturate & similarly acting sedative or hypnotic drug abuse, in remission 30540 Nondependent barbiturate & similarly acting sedative or hypnotic drug abuse, unspecified

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

30571 Nondependent drug abuse, amphetamine or related acting sympathomimetic, continuous 30572 Nondependent drug abuse, amphetamine or related acting sympathomimetic, episodic 30573 Nondependent drug abuse, amphetamine or related acting sympathomimetic, in remission 30570 Nondependent drug abuse, amphetamine or related acting sympathomimetic, unspecified 30561 Nondependent drug abuse, cocaine, continuous 30562 Nondependent drug abuse, cocaine, episodic 30563 Nondependent drug abuse, cocaine, in remission 30560 Nondependent drug abuse, cocaine, unspecified 99883 Non-healing surgical wound, not elsewhere classified 3100 Nonpsychotic mental disorders due to frontal lobe syndrome 3101 Nonpsychotic mental disorders due to organic personality syndrome 3102 Nonpsychotic mental disorders due to postconcussion syndrome 3220 Nonpyogenic meningitis 79531 Nonspecific positive findings for anthrax E8200 Nontraffic accident involving motor-driven snow vehicle involving driver of motor vehicle other than motorcycle E8202 Nontraffic accident involving motor-driven snow vehicle involving motorcyclist E8204 Nontraffic accident involving motor-driven snow vehicle involving occupant of streetcar E8208 Nontraffic accident involving motor-driven snow vehicle involving other specified person E8201 Nontraffic accident involving motor-driven snow vehicle involving passenger in motor vehicle other than motorcycle E8203 Nontraffic accident involving motor-driven snow vehicle involving passenger on motorcycle E8206 Nontraffic accident involving motor-driven snow vehicle involving pedal cyclist E8207 Nontraffic accident involving motor-driven snow vehicle involving pedestrian E8205 Nontraffic accident involving motor-driven snow vehicle involving rider or occupant of animal-drawn vehicle E8209 Nontraffic accident involving motor-driven snow vehicle involving unspecified person E8210 Nontraffic accident involving other off-road motor vehicle involving driver of motor vehicle other than motorcycle E8212 Nontraffic accident involving other off-road motor vehicle involving motorcyclist E8214 Nontraffic accident involving other off-road motor vehicle involving occupant of streetcar E8218 Nontraffic accident involving other off-road motor vehicle involving other specified person E8211 Nontraffic accident involving other off-road motor vehicle involving passenger in motor vehicle other than motorcycle E8213 Nontraffic accident involving other off-road motor vehicle involving passenger on motorcycle E8216 Nontraffic accident involving other off-road motor vehicle involving pedal cyclist E8217 Nontraffic accident involving other off-road motor vehicle involving pedestrian E8215 Nontraffic accident involving other off-road motor vehicle involving rider or occupant of animal-drawn vehicle E8219 Nontraffic accident involving other off-road motor vehicle involving unspecified person

Page 105: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

72973 Nontraumatic compartment syndrome of abdomen 72972 Nontraumatic compartment syndrome of lower extremity 72979 Nontraumatic compartment syndrome of other sites 72971 Nontraumatic compartment syndrome of upper extremity 72767 Nontraumatic rupture of achilles tendon 72763 Nontraumatic rupture of extensor tendons of hand & wrist 72764 Nontraumatic rupture of flexor tendons of hand & wrist 72769 Nontraumatic rupture of other tendon 72768 Nontraumatic rupture of other tendons of foot & ankle 72766 Nontraumatic rupture of patellar tendon 72765 Nontraumatic rupture of quadriceps tendon 72762 Nontraumatic rupture of tendons of biceps (long head) 5966 Nontraumatic rupture of the bladder 72760 Nontraumatic rupture of unspecified tendon 7322 Nontraumatic slipped upper femoral epiphysis 9135 Nonvenomous insect bite of elbow, forearm & wrist, infected 9134 Nonvenomous insect bite of elbow, forearm & wrist, without mention of infection 9105 Nonvenomous insect bite of face, neck & scalp except eye, infected 9155 Nonvenomous insect bite of fingers, infected 9175 Nonvenomous insect bite of foot & toe(s), infected 9145 Nonvenomous insect bite of hand(s), except finger(s) alone, infected 9165 Nonvenomous insect bite of hip, thigh, leg & ankle, infected 9195 Nonvenomous insect bite of other, multiple & unspecified sites, infected 9125 Nonvenomous insect bite of shoulder & upper arm, infected 9115 Nonvenomous insect bite of trunk, infected 4257 Nutritional & metabolic cardiomyopathy 4252 Obscure cardiomyopathy of Africa 5752 Obstruction of gallbladder 49121 Obstructive chronic bronchitis, with (acute) exacerbation 43301 Occlusion & stenosis of basilar artery with cerebral infarction 43300 Occlusion & stenosis of basilar artery without mention of cerebral infarction 43311 Occlusion & stenosis of carotid artery with cerebral infarction 43310 Occlusion & stenosis of carotid artery without mention of cerebral infarction 43331 Occlusion & stenosis of multiple & bilateral precerebral arteries with cerebral infarction

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

43330 Occlusion & stenosis of multiple & bilateral precerebral arteries wo mention of cerebral infarction 43381 Occlusion & stenosis of other specified precerebral artery with cerebral infarction 43380 Occlusion & stenosis of other specified precerebral artery wo mention of cerebral infarction 43391 Occlusion & stenosis of unspecified precerebral artery with mention of cerebral infarction 43390 Occlusion & stenosis of unspecified precerebral artery wo mention of cerebral infarction 43321 Occlusion & stenosis of vertebral artery with cerebral infarction 43320 Occlusion & stenosis of vertebral artery without mention of cerebral infarction 43411 Occlusion of cerebral arteries, cerebral embolism with cerebral infarction 43410 Occlusion of cerebral arteries, cerebral embolism without mention of cerebral infarction 43401 Occlusion of cerebral arteries, cerebral thrombosis with cerebral infarction 43400 Occlusion of cerebral arteries, cerebral thrombosis without mention of cerebral infarction 8711 Ocular laceration with prolapse or exposure of intraocular tissue 8710 Ocular laceration without prolapse of intraocular tissue 0213 Oculoglandular tularemia E8058 Oher specified person hit by rolling stock, railway accident 412 Old myocardial infarction (healed) 7885 Oliguria & anuria 7714 Omphalitis of the newborn 68102 Onychia & paronychia of finger 68111 Onychia & paronychia of toe 83211 Open anterior dislocation of elbow 83111 Open anterior dislocation of humerus 83412 Open dislocation interphalangeal joint, hand 83114 Open dislocation of acromioclavicular joint 8371 Open dislocation of ankle 83314 Open dislocation of carpometacarpal joint 83910 Open dislocation of cervical bertebra, unspecified 83951 Open dislocation of coccyx 83210 Open dislocation of elbow, unspecified site 83915 Open dislocation of fifth cervical vertebra 83410 Open dislocation of finger, unspecified part 83911 Open dislocation of first cervical vertebra 83810 Open dislocation of foot, unspecified part 83914 Open dislocation of fourth cervical vertebra

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

83510 Open dislocation of hip, unspecified site 83816 Open dislocation of interphalangeal joint of foot 8301 Open dislocation of jaw 83660 Open dislocation of knee, unspecified part 83930 Open dislocation of lumbar vertebra 83315 Open dislocation of metacarpal bone, proximal end 83411 Open dislocation of metacarpophalangeal joint 83814 Open dislocation of metatarsal bone, joint unspecified 83815 Open dislocation of metatarsophalangeal joint 83313 Open dislocation of midcarpal joint 83812 Open dislocation of midtarsal joint 83918 Open dislocation of multiple cervical vertebrae 83819 Open dislocation of other part of foot 83319 Open dislocation of other part of wrist 83219 Open dislocation of other site of elbow 83119 Open dislocation of other site of shoulder 83959 Open dislocation of other vertebra 8364 Open dislocation of patella 83312 Open dislocation of radiocarpal joint 83311 Open dislocation of radioulnar joint, distal 83952 Open dislocation of sacrum, sacroiliac joint 83912 Open dislocation of second cervical vertebra 83917 Open dislocation of seventh cervical vertebra 83110 Open dislocation of shoulder, unspecified 83916 Open dislocation of sixth cervical vertebra 83971 Open dislocation of sternum, sternoclavicular joint 83811 Open dislocation of tarsal bone, joint unspecified 83813 Open dislocation of tarsometatarsal joint 83913 Open dislocation of third cervical vertebra 83931 Open dislocation of thoracic vertebra 8399 Open dislocation of vertebra of multiple & ill-defined sites 83979 Open dislocation of vertebra of other location 83950 Open dislocation of vertebra, unspecified site 83310 Open dislocation of wrist, unspecified part

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80194 Open fracture base of skull w intracranial injury of other & unspecified nature, prolong loss of consciousness w return 80195 Open fracture base of skull w intracranial injury of other & unspecified nature, prolong loss of consciousness wo return80196 Open fracture base of skull w intracranial injury other & unspecified nature, loss of consciousness unspecified duration80186 Open fracture base of skull w other & unspecified intracranial hemorrhage, loss of consciousness of unspecified duration80176 Open fracture base of skull w subarachnoid, subdural & extradural hemorrhage, loss of consciousness unspecified duration80162 Open fracture base of skull with cerebral laceration & contusion, brief loss of consciousness 80166 Open fracture base of skull with cerebral laceration & contusion, loss of consciousness of unspecified duration 80163 Open fracture base of skull with cerebral laceration & contusion, moderate loss of consciousness 80161 Open fracture base of skull with cerebral laceration & contusion, no loss of consciousness 80164 Open fracture base of skull with cerebral laceration & contusion, prolong loss of consciousness with return 80165 Open fracture base of skull with cerebral laceration & contusion, prolong loss of consciousness without return 80160 Open fracture base of skull with cerebral laceration & contusion, unspecified state of consciousness 80169 Open fracture base of skull with cerebral laceration & contusion, with concussion, unspecified 80192 Open fracture base of skull with intracranial injury of other & unspecified nature, brief loss of consciousness 80193 Open fracture base of skull with intracranial injury of other & unspecified nature, moderate loss of consciousness 80191 Open fracture base of skull with intracranial injury of other & unspecified nature, no loss of consciousness 80190 Open fracture base of skull with intracranial injury of other & unspecified nature, state of consciousness unspecified 80199 Open fracture base of skull with intracranial injury of other & unspecified nature, with concussion, unspecified 80182 Open fracture base of skull with other & unspecified intracranial hemorrhage, brief loss of consciousness 80183 Open fracture base of skull with other & unspecified intracranial hemorrhage, moderate loss of conciousness 80181 Open fracture base of skull with other & unspecified intracranial hemorrhage, no loss of consciousness 80184 Open fracture base of skull with other & unspecified intracranial hemorrhage, prolong loss of consciousness w return 80185 Open fracture base of skull with other & unspecified intracranial hemorrhage, prolong loss of consciousness wo return 80180 Open fracture base of skull with other & unspecified intracranial hemorrhage, unspecified state of consciousness 80189 Open fracture base of skull with other & unspecified intracranial hemorrhage, with concussion, unspecified 80172 Open fracture base of skull with subarachnoid, subdural & extradural hemorrhage, brief loss of consciousness 80173 Open fracture base of skull with subarachnoid, subdural & extradural hemorrhage, moderate loss of consciousness 80171 Open fracture base of skull with subarachnoid, subdural & extradural hemorrhage, no loss of consciousness 80174 Open fracture base of skull with subarachnoid, subdural & extradural hemorrhage, prolong loss of consciousness w return 80175 Open fracture base of skull with subarachnoid, subdural & extradural hemorrhage, prolong loss of consciousness wo return80170 Open fracture base of skull with subarachnoid, subdural & extradural hemorrhage, state of consciousness unspecified 80179 Open fracture base of skull with subarachnoid, subdural & extradural hemorrhage, with concussion, unspecified 80152 Open fracture base of skull without mention of intracranial injury, brief loss of consciousness 80156 Open fracture base of skull without mention of intracranial injury, loss of consciousness of unspecified duration

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80153 Open fracture base of skull without mention of intracranial injury, moderate loss of consciousness 80151 Open fracture base of skull without mention of intracranial injury, no loss of consciousness 80154 Open fracture base of skull without mention of intracranial injury, prolong loss of conscious with return 80155 Open fracture base of skull without mention of intracranial injury, prolong loss of consciousness without return 80150 Open fracture base of skull without mention of intracranial injury, unspecified state of consciousness 80159 Open fracture base of skull without mention of intracranial injury, with concussion, unspecified 8081 Open fracture of acetabulum 81013 Open fracture of acromial end of clavicle 81111 Open fracture of acromial process of scapula 80237 Open fracture of alveolar border of body of mandible 81212 Open fracture of anatomical neck of humerus 80235 Open fracture of angle of jaw 82531 Open fracture of astragalus 82013 Open fracture of base of neck of femur 81512 Open fracture of base of other metacarpal bone(s) 81511 Open fracture of base of thumb (first) metacarpal 8245 Open fracture of bimalleolar 8091 Open fracture of bones of trunk 80613 Open fracture of C1 - C4 level cervical vertebrae with central cord syndrome 80611 Open fracture of C1 - C4 level cervical vertebrae with complete lesion of spinal cord 80614 Open fracture of C1 - C4 level cervical vertebrae with other specified spinal cord injury 80610 Open fracture of C1 - C4 level cervical vertebrae with unspecified spinal cord injury 80612 Open fracture of C1 - C4 level cervical verterbrae with anterior spinal cord syndrome 80617 Open fracture of C5 - C7 level cervical vertebrae with anterior spinal cord syndrome 80618 Open fracture of C5 - C7 level cervical vertebrae with central spinal cord syndrome 80616 Open fracture of C5 - C7 level cervical vertebrae with complete lesion of spinal cord 80619 Open fracture of C5 - C7 level cervical vertebrae with other specified spinal cord injury 80615 Open fracture of C5 - C7 level cervical vertebrae with unspecified spinal cord injury 8251 Open fracture of calcaneus 81417 Open fracture of capitate bone (os magnum) of wrist 81410 Open fracture of carpal bone, unspecified 80510 Open fracture of cervical vertebra without mention of spinal cord injury, unspecified level 81010 Open fracture of clavicle, unspecified part 80231 Open fracture of condylar process of mandible

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

81112 Open fracture of coracoid process of scapula 80233 Open fracture of coronoid process of mandible 81312 Open fracture of coronoid process of ulna 82533 Open fracture of cuboid bone 82534 Open fracture of cuneiform bone of foot 81353 Open fracture of distal end of ulna 81612 Open fracture of distal phalanx or phalanges of hand 8053 Open fracture of dorsal (thoracic) vertebra without mention of spinal cord injury 80718 Open fracture of eight or more ribs 82011 Open fracture of epiphysis of neck of femur 82131 Open fracture of femoral condyle 80515 Open fracture of fifth cervical vertebra without mention of spinal cord injury 80511 Open fracture of first cervical vertebra without mention of spinal cord injury 80715 Open fracture of five ribs 80714 Open fracture of four ribs 80514 Open fracture of fourth cervical vertebra without mention of spinal cord injury 81113 Open fracture of glenoid cavity & neck of scapula 81213 Open fracture of greater tuberosity of humerus 81418 Open fracture of hamate (unciform) bone of wrist 81315 Open fracture of head of radius 80851 Open fracture of ilium 82031 Open fracture of intertrochanteric section of neck of femur 80852 Open fracture of ischium 8076 Open fracture of larynx & trachea 81252 Open fracture of lateral condyle of humerus 8243 Open fracture of lateral malleolus 82130 Open fracture of lower end of femur, unspecified part 81350 Open fracture of lower end of forearm, unspecified 81354 Open fracture of lower end of radius with ulna 82132 Open fracture of lower epiphysis of femur 8055 Open fracture of lumbar vertebra without mention of spinal cord injury 8065 Open fracture of lumbar with spinal cord injury 81412 Open fracture of lunate (semilunar) bone of wrist 8025 Open fracture of malar & maxillary bones

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

81253 Open fracture of medial condyle of humerus 8241 Open fracture of medial malleolus 81510 Open fracture of metacarpal bone(s), site unspecified 82535 Open fracture of metatarsal bone(s) 82012 Open fracture of midcervical section of neck of femur 81611 Open fracture of middle or proximal phalanx or phalanges of hand 80518 Open fracture of multiple cervical vertebra without mention of spinal cord injury 80719 Open fracture of multiple ribs, unspecified 80239 Open fracture of multiple sites of mandible 81519 Open fracture of multiple sites of metacarpus 81613 Open fracture of multiple sites of phalanx or phalanges of hand 8021 Open fracture of nasal bones 82532 Open fracture of navicular (scaphoid) bone of foot 81411 Open fracture of navicular (scaphoid) bone of wrist 81514 Open fracture of neck of metacarpal bone(s) 81316 Open fracture of neck of radius 81311 Open fracture of olecranon process of Ulna 8261 Open fracture of one or more phalanges of foot 80711 Open fracture of one rib 8027 Open fracture of orbital bloor (blow-out) 80238 Open fracture of other & unspecified part of body of mandible 81419 Open fracture of other bone of wrist 8029 Open fracture of other facial bones 81119 Open fracture of other part of scapula 80859 Open fracture of other specified part of pelvis 8221 Open fracture of patella 81610 Open fracture of phalanx or phalanges of hand, unspecified 81414 Open fracture of pisiform bone of wrist 8083 Open fracture of pubis 81318 Open fracture of radius with ulna, upper end 80710 Open fracture of rib(s), unspecified 80671 Open fracture of sacrum & coccyx with complete cauda equina lesion 80672 Open fracture of sacrum & coccyx with other cauda equina injury 80679 Open fracture of sacrum & coccyx with other spinal cord injury

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80670 Open fracture of sacrum & coccyx with unspecified spinal cord injury 8057 Open fracture of sacrum & coccyx without mention of spinal cord injury 81110 Open fracture of scapula, unspecified part 80512 Open fracture of second cervical vertebra without mention of spinal cord injury 80717 Open fracture of seven ribs 80517 Open fracture of seventh cervical vertebra without mention of spinal cord injury 81012 Open fracture of shaft of clavicle 82111 Open fracture of shaft of femur 82331 Open fracture of shaft of fibula 82332 Open fracture of shaft of fibula with tibia 81231 Open fracture of shaft of humerus 81513 Open fracture of shaft of metacarpal bone(s) 81331 Open fracture of shaft of radius 81330 Open fracture of shaft of radius or ulna 81333 Open fracture of shaft of radius with ulna 82330 Open fracture of shaft of tibia 81332 Open fracture of shaft of ulna 80716 Open fracture of six ribs 80516 Open fracture of sixth cervical vertebra without mention of spinal cord injury 80482 Open fracture of skull or face & other bones, unspecified intracranial hemorrhage, brief loss of consciousness 80483 Open fracture of skull or face & other bones, unspecified intracranial hemorrhage, moderate loss of consciousness 80481 Open fracture of skull or face & other bones, unspecified intracranial hemorrhage, no loss of consciousness 80480 Open fracture of skull or face & other bones, unspecified intracranial hemorrhage, state of consciousness unspecified 80489 Open fracture of skull or face & other bones, unspecified intracranial hemorrhage, with concussion, unspecified 81011 Open fracture of sternal end of clavicle 8073 Open fracture of sternum 80232 Open fracture of subcondylar process of mandible 82032 Open fracture of subtrochanteric section of neck of femur 81211 Open fracture of surgical neck of humerus 80236 Open fracture of symphysis of body of mandible 80632 Open fracture of T1 - T6 level dorsal vertebrae with anterior spinal cord syndrome 80633 Open fracture of T1 - T6 level dorsal vertebrae with central spinal cord syndrome 80631 Open fracture of T1 - T6 level dorsal vertebrae with complete lesion of spinal cord 80634 Open fracture of T1 - T6 level dorsal vertebrae with other specified spinal cord injury

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80630 Open fracture of T1 - T6 level dorsal vertebrae with unspecified spinal cord injury 80637 Open fracture of T7 - T12 level dorsal vertebrae with anterior spinal cord syndrome 80638 Open fracture of T7 - T12 level dorsal vertebrae with central spinal cord syndrome 80636 Open fracture of T7 - T12 level dorsal vertebrae with complete lesion of spinal cord 80639 Open fracture of T7 - T12 level dorsal vertebrae with other specified spinal cord injury 80635 Open fracture of T7 - T12 level dorsal vertebrae with unspecified spinal cord injury 80513 Open fracture of third cervical vertebra without mention of spinal cord injury 80713 Open fracture of three ribs 81415 Open fracture of trapezium bone (larger multangular) of wrist 81416 Open fracture of trapezoid bone (smaller multangular) of wrist 8247 Open fracture of trimalleolar 81413 Open fracture of triquetral (cuneiform) bone of wrist 80712 Open fracture of two ribs 8291 Open fracture of unspecified bone 82530 Open fracture of unspecified bone(s) of foot (except toes) 81254 Open fracture of unspecified condyle(s) of humerus 82010 Open fracture of unspecified intracapsular section of neck of femur 8249 Open fracture of unspecified part of ankle 82110 Open fracture of unspecified part of femur 82391 Open fracture of unspecified part of fibula 82392 Open fracture of unspecified part of fibula with tibia 81390 Open fracture of unspecified part of forearm 81230 Open fracture of unspecified part of humerus 81250 Open fracture of unspecified part of lower end of humerus 8209 Open fracture of unspecified part of neck of femur 81391 Open fracture of unspecified part of radius 81393 Open fracture of unspecified part of radius with ulna 80234 Open fracture of unspecified part of ramus of mandible 82390 Open fracture of unspecified part of tibia 81392 Open fracture of unspecified part of ulna 8059 Open fracture of unspecified part of vertebral column without mention of spinal cord injury 80230 Open fracture of unspecified site of mandible 82030 Open fracture of unspecified trochanteric section of neck of femur 8069 Open fracture of unspecified vertebra with spinal cord injury

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

82311 Open fracture of upper end of fibula 82312 Open fracture of upper end of fibula with tibia 81310 Open fracture of upper end of forearm, unspecified 81210 Open fracture of upper end of humerus, unpsecified part 82310 Open fracture of upper end of tibia 80066 Open fracture of vault of skull with cerebral laceration & contusion, loss of consciousness of unspecified duration 80063 Open fracture of vault of skull with cerebral laceration & contusion, moderate loss of consciousness 80061 Open fracture of vault of skull with cerebral laceration & contusion, no loss of consciousness 80064 Open fracture of vault of skull with cerebral laceration & contusion, prolonged loss of consciousness w return 80065 Open fracture of vault of skull with cerebral laceration & contusion, prolonged loss of consciousness wo return 80060 Open fracture of vault of skull with cerebral laceration & contusion, unspecified state of consciousness 80062 Open fracture of vault of skull with cerebral laceration & contusion, with brief loss of consciousness 80069 Open fracture of vault of skull with cerebral laceration & contusion, with concussion, unspecified 80052 Open fracture of vault of skull without mention of intracranial injury, brief loss of consciousness 80056 Open fracture of vault of skull without mention of intracranial injury, loss of consciousness of unspecified duration 80053 Open fracture of vault of skull without mention of intracranial injury, moderate loss of consciousness 80051 Open fracture of vault of skull without mention of intracranial injury, no loss of consciousness 80054 Open fracture of vault of skull without mention of intracranial injury, prolonged loss of consciousness w return 80055 Open fracture of vault of skull without mention of intracranial injury, prolonged loss of consciousness wo return 80050 Open fracture of vault of skull without mention of intracranial injury, state of consciousness unspecified 80059 Open fracture of vault of skull without mention of intracranial injury, with concussion, unspecified 80486 Open fracture skull or face & other bones unspecified intracranial hemorrhage loss of consciousness unspecified duration80484 Open fracture skull or face & other bones, unspecified intracranial hemorrhage, prolong loss of consciousness w return 80485 Open fracture skull or face & other bones, unspecified intracranial hemorrhage, prolong loss of consciousness wo return 80495 Open fracture skull or face w other bone intracranial injury unspecified nature pronlong loss of consciousness wo return80496 Open fracture skull or face w other bone unspecified intracranial injury loss of consciousness unspecified duration 80094 Open fracture vault of skull w intracranial injury of other & unspecified nature, prolong loss of consciousness w return80096 Open fracture vault of skull w intracranial injury other & unspecified nature loss of consciousness unspecified duration80095 Open fracture vault of skull w intracranial injury other & unspecified nature, prolong loss of consciousness wo return 80076 Open fracture vault of skull w subarachnoid, subdural & extradural hemorrhage loss of consciousness unspecified duration80072 Open fracture vault of skull w subarachnoid, subdural & extradural hemorrhage, brief loss of consciousness 80073 Open fracture vault of skull w subarachnoid, subdural & extradural hemorrhage, moderate loss of consciousness 80071 Open fracture vault of skull w subarachnoid, subdural & extradural hemorrhage, no loss of consciousness 80074 Open fracture vault of skull w subarachnoid, subdural & extradural hemorrhage, prolonged loss of consciousness w return

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80075 Open fracture vault of skull w subarachnoid, subdural & extradural hemorrhage, prolonged loss of consciousness wo return80070 Open fracture vault of skull w subarachnoid, subdural & extradural hemorrhage, unspecified state of consciousness 80079 Open fracture vault of skull w subarachnoid, subdural & extradural hemorrhage, with concussion, unspecified 80092 Open fracture vault of skull with intracranial injury of other & unspecified nature, brief loss of consciousness 80093 Open fracture vault of skull with intracranial injury of other & unspecified nature, moderate loss of consciousness 80091 Open fracture vault of skull with intracranial injury of other & unspecified nature, no loss of consciousness 80090 Open fracture vault of skull with intracranial injury of other & unspecified nature, state of consciousness unspecified 80099 Open fracture vault of skull with intracranial injury of other & unspecified nature, with concussion, unspecified 80082 Open fracture vault of skull with other & unspecified intracranial hemorrhage, brief loss of consciousness 80086 Open fracture vault of skull with other & unspecified intracranial hemorrhage, loss of consciousness unspecfied duration80083 Open fracture vault of skull with other & unspecified intracranial hemorrhage, moderate loss of consciousness 80081 Open fracture vault of skull with other & unspecified intracranial hemorrhage, no loss of consciousness 80084 Open fracture vault of skull with other & unspecified intracranial hemorrhage, prolong loss of consciousness w return 80085 Open fracture vault of skull with other & unspecified intracranial hemorrhage, prolong loss of consciousness wo return 80080 Open fracture vault of skull with other & unspecified intracranial hemorrhage, state of consciousness unspecified 80089 Open fracture vault of skull with other & unspecified intracranial hemorrhage, with concussion, unspecified 80462 Open fractures of skull or face w other bones, cerebral laceration & contusion, brief loss of consciousness 80463 Open fractures of skull or face w other bones, cerebral laceration & contusion, moderate loss of consciousness 80461 Open fractures of skull or face w other bones, cerebral laceration & contusion, no loss of consciousness 80464 Open fractures of skull or face w other bones, cerebral laceration & contusion, prolong loss of consciousness w return 80465 Open fractures of skull or face w other bones, cerebral laceration & contusion, prolong loss of consciousness wo return 80460 Open fractures of skull or face w other bones, cerebral laceration & contusion, state of consciousness unspecified 80469 Open fractures of skull or face w other bones, cerebral laceration & contusion, with concussion, unspecified 80493 Open fractures of skull or face w other bones, intracranial injury unspecified nature moderate loss of consciousness 80492 Open fractures of skull or face w other bones, intracranial injury unspecified nature, breif loss of consciousness 80491 Open fractures of skull or face w other bones, intracranial injury unspecified nature, no loss of consciousness 80490 Open fractures of skull or face w other bones, intracranial injury unspecified nature, unspecified loss of consciousness80499 Open fractures of skull or face w other bones, intracranial injury unspecified nature, with concussion, unspecified 80452 Open fractures of skull or face w other bones, wo intracranial injury, brief loss of consciousness 80456 Open fractures of skull or face w other bones, wo intracranial injury, loss of consciousness of unspecified duration 80453 Open fractures of skull or face w other bones, wo intracranial injury, moderate loss of consciousness 80451 Open fractures of skull or face w other bones, wo intracranial injury, no loss of consciousness 80454 Open fractures of skull or face w other bones, wo intracranial injury, prolong loss of consciousness w return 80455 Open fractures of skull or face w other bones, wo intracranial injury, prolong loss of consciousness wo return

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80450 Open fractures of skull or face w other bones, wo intracranial injury, state of consciousness unspecified 80459 Open fractures of skull or face w other bones, wo intracranial injury, with concussion, Unspecified 80472 Open fractures of skull or face, subarachnoid, subdural & extradural hemorrhage, brief loss of consciousness 80473 Open fractures of skull or face, subarachnoid, subdural & extradural hemorrhage, moderate loss of consciousness 80471 Open fractures of skull or face, subarachnoid, subdural & extradural hemorrhage, no loss of consciousness 80474 Open fractures of skull or face, subarachnoid, subdural & extradural hemorrhage, prolon loss of consciousness w return 80475 Open fractures of skull or face, subarachnoid, subdural & extradural hemorrhage, prolong loss of consciousness wo return80470 Open fractures of skull or face, subarachnoid, subdural & extradural hemorrhage, state of consciousness unspecified 80479 Open fractures of skull or face, subarachnoid, subdural & extradural hemorrhage, with concussion, unspecified 80494 Open fractures skull or face w other bones intracranial injury unspecified nature prolong loss of consciousness w return80466 Open fractures skull or face w other bones, cerebral laceration & contusion, loss of consciousness unspecified duration 80476 Open fractures skull or face, subarachnoid, subdural & extradural hemorrhage, loss of consciousness unspecified duration83113 Open inferior dislocation of humerus 83214 Open lateral dislocation of elbow 83213 Open medial dislocation of elbow 81313 Open Monteggia's fracture 83512 Open obturator dislocation of hip 83212 Open posterior dislocation of elbow 83511 Open posterior dislocation of hip 83112 Open posterior dislocation of humerus 80396 Open skull fracture w intracranial injury of other & unspecified nature, loss of consciousness of unspecified duration 80362 Open skull fracture with cerebral laceration & contusion, brief loss of consciousness 80366 Open skull fracture with cerebral laceration & contusion, loss of consciousness of unspecified duration 80363 Open skull fracture with cerebral laceration & contusion, moderate loss of consciousness 80361 Open skull fracture with cerebral laceration & contusion, no loss of consciousness 80364 Open skull fracture with cerebral laceration & contusion, prolong loss of consciousness with return to conscious state 80365 Open skull fracture with cerebral laceration & contusion, prolong loss of consciousness wo return to conscious state 80360 Open skull fracture with cerebral laceration & contusion, state of consciousness unspecified 80369 Open skull fracture with cerebral laceration & contusion, with concussion, unspecified 80392 Open skull fracture with intracranial injury of other & unspecified nature, brief loss of consciousness 80393 Open skull fracture with intracranial injury of other & unspecified nature, moderate loss of consciousness 80391 Open skull fracture with intracranial injury of other & unspecified nature, no loss of consciousness 80394 Open skull fracture with intracranial injury of other & unspecified nature, prolong loss of consciousness with return 80395 Open skull fracture with intracranial injury of other & unspecified nature, prolong loss of consciousness without return

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

80390 Open skull fracture with intracranial injury of other & unspecified nature, state of consciousness unspecified 80399 Open skull fracture with intracranial injury of other & unspecified nature, with concussion, unspecified 80382 Open skull fracture with other & unspecified intracranial hemorrhage, brief loss of conciousness 80386 Open skull fracture with other & unspecified intracranial hemorrhage, loss of consciousness of unspecified duration 80383 Open skull fracture with other & unspecified intracranial hemorrhage, moderate loss of consciousness 80381 Open skull fracture with other & unspecified intracranial hemorrhage, no loss of consciousness 80384 Open skull fracture with other & unspecified intracranial hemorrhage, prolong loss of consciousness with return 80385 Open skull fracture with other & unspecified intracranial hemorrhage, prolong loss of consciousness without return 80380 Open skull fracture with other & unspecified intracranial hemorrhage, state of consciousness unspecified 80389 Open skull fracture with other & unspecified intracranial hemorrhage, with concussion, unspecified 80372 Open skull fracture with subarachnoid, subdural & extradural hemorrhage, brief loss of consciousness 80376 Open skull fracture with subarachnoid, subdural & extradural hemorrhage, loss of consciousness of unspecified duration 80373 Open skull fracture with subarachnoid, subdural & extradural hemorrhage, moderate loss of conciousness 80371 Open skull fracture with subarachnoid, subdural & extradural hemorrhage, no loss of consciousness 80374 Open skull fracture with subarachnoid, subdural & extradural hemorrhage, prolong loss of consciousness with return 80375 Open skull fracture with subarachnoid, subdural & extradural hemorrhage, prolong loss of consciousness wo return 80370 Open skull fracture with subarachnoid, subdural & extradural hemorrhage, state of consciousness unspecified 80379 Open skull fracture with subarachnoid, subdural & extradural hemorrhage, with concussion, unspecified 80352 Open skull fracture without mention of intracranial injury, brief loss of consciousness 80356 Open skull fracture without mention of intracranial injury, loss of consciousness of unspecified duration 80353 Open skull fracture without mention of intracranial injury, moderate loss of consciousness 80351 Open skull fracture without mention of intracranial injury, no loss of consciousness 80354 Open skull fracture without mention of intracranial injury, prolong loss of consciousness w return to conscious state 80355 Open skull fracture without mention of intracranial injury, prolong loss of consciousness wo return to conscious state 80350 Open skull fracture without mention of intracranial injury, state of consciousness unspecified 80359 Open skull fracture without mention of intracranial injury, with concussion, unspecified 82133 Open supracondylar fracture of femur 81251 Open supracondylar fracture of humerus 8792 Open wound of aneteior abdominal wall, without mention of complication 8793 Open wound of anterior abdominal wall, complicated 87212 Open wound of auditory canal, complicated 87202 Open wound of auditory canal, without mention of complication 87201 Open wound of auricle of ear, without mention of complication 87211 Open wound of auricle, complicated

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

88012 Open wound of axillary region, complicated 88022 Open wound of axillary region, with tendon involvement 88002 Open wound of axillary region, without mention of complication 8761 Open wound of back, complicated 8760 Open wound of back, without mention of complication 8791 Open wound of breast, complicated 8790 Open wound of breast, without mention of complication 87371 Open wound of buccal mucosa, complicated 87361 Open wound of buccal mucosa, without mention of complication 8771 Open wound of buttock, complicated 8770 Open wound of buttock, without mention of complication 87351 Open wound of cheek, complicated 87341 Open wound of cheek, without mention of complication 8751 Open wound of chest wall, complicated 8750 Open wound of chest wall, without mention of complication 87274 Open wound of cochlea, complicated 87264 Open wound of cochlea, without mention of complication 87271 Open wound of ear drum, complicated 87261 Open wound of ear drum, without mention of complication 88111 Open wound of elbow, complicated 88121 Open wound of elbow, with tendon involvement 88101 Open wound of elbow, without mention of complication 87273 Open wound of eustachian tube, complicated 87263 Open wound of eustachian tube, without mention of complication 8831 Open wound of fingers, complicated 8832 Open wound of fingers, with tendon involvement 8830 Open wound of fingers, without mention of complication 8921 Open wound of foot except toe(s) alone, complicated 8922 Open wound of foot except toe(s) alone, with tendon involvement 8920 Open wound of foot except toe(s) alone, without mention of complication 88110 Open wound of forearm, complicated 88120 Open wound of forearm, with tendon involvement 88100 Open wound of forearm, without mention of complication 87352 Open wound of forehead, complicated

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

87342 Open wound of forehead, without mention of complication 87372 Open wound of gum (alveolar process), complicated 87362 Open wound of gum (alveolar process), without mention of complication 8821 Open wound of hand except fingers alone, complicated 8822 Open wound of hand except fingers alone, with tendon involvement 8820 Open wound of hand except fingers alone, without mention of complication 8901 Open wound of hip & thigh, complicated 8902 Open wound of hip & thigh, with tendon involvement 8900 Open wound of hip & thigh, without mention of complication 87360 Open wound of internal structure of unspecified site of mouth, without mention of complication 87370 Open wound of internal structures of unspecified site of mouth, complicated 87354 Open wound of jaw, complicated 87344 Open wound of jaw, without mention of complication 8911 Open wound of knee, leg (except thigh), & ankle, complicated 8912 Open wound of knee, leg (except thigh), & ankle, with tendon involvement 8910 Open wound of knee, leg (except thigh), & ankle, without mention of complication 87410 Open wound of larynx with trachea, complicated 87400 Open wound of larynx with trachea, without mention of complication 87411 Open wound of larynx, complicated 87401 Open wound of larynx, without mention of complication 8795 Open wound of lateral abdominal wall, complicated 8794 Open wound of lateral abdominal wall, without mention of complication 87353 Open wound of lip, complicated 87343 Open wound of lip, without mention of complication 88019 Open wound of multiple sites of shoulder & upper arm, complicated 88029 Open wound of multiple sites of shoulder & upper arm, with tendon involvement 88009 Open wound of multiple sites of shoulder & upper arm, without mention of complication 87339 Open wound of multiple sites of the ear, complicated 87329 Open wound of multiple sites of the nose, without mention of complication 87332 Open wound of nasal cavity, complicated 87322 Open wound of nasal cavity, without mention of complication 87331 Open wound of nasal septum, complicated 87321 Open wound of nasal septum, without mention of complication 87333 Open wound of nasal sinus, complicated

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

87323 Open wound of nasal sinus, without mention of complication 87272 Open wound of ossicles, complicated 87262 Open wound of ossicles, without mention of complication 87379 Open wound of other & multiple sites of internal structures of mouth, complicated 87369 Open wound of other & multiple sites of internal structures of mouth, without mention of complication 87279 Open wound of other & multiple sites of the ear, complicated 87269 Open wound of other & multiple sites of the ear, without mention of complication 87359 Open wound of other & multiple sites of the face, complicated 87349 Open wound of other & multiple sites of the face, without mention of complication 8789 Open wound of other & unspecified parts of genital organs, complicated 8788 Open wound of other & unspecified parts of genital organs, without mention of complication 8749 Open wound of other & unspecified parts of neck, complicated 8748 Open wound of other & unspecified parts of neck, without mention of complication 8797 Open wound of other & unspecified parts of trunk, complicated 8796 Open wound of other & unspecified parts of trunk, without mention of complication 87375 Open wound of palate, complicated 87365 Open wound of palate, without mention of complication 8781 Open wound of penis, complicated 8780 Open wound of penis, without mention of complication 8745 Open wound of pharynx, complicated 8744 Open wound of pharynx, without mention of complication 8731 Open wound of scalp, complicated 8730 Open wound of scalp, without mention of complication 88011 Open wound of scapular region, complicated 88021 Open wound of scapular region, with tendon involvement 88001 Open wound of scapular region, without mention of complication 8783 Open wound of scrotum & testes, complicated 8782 Open wound of scrotum & testes, without mention of complication 88010 Open wound of shoulder region, complicated 88020 Open wound of shoulder region, with tendon involvement 88000 Open wound of shoulder region, without mention of complication 8743 Open wound of thyroid gland, complicated 8742 Open wound of thyroid gland, without mention of complication 8931 Open wound of toe(s), complicated

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

8932 Open wound of toe(s), with tendon involvement 8930 Open wound of toe(s), without mention of complication 87374 Open wound of tongue & floor of mouth, complicated 87364 Open wound of tongue & floor of mouth, without mention of complication 87412 Open wound of trachea, complicated 87402 Open wound of trachea, without mention of complication 8729 Open wound of unspecified part of ear, complicated 8728 Open wound of unspecified part of ear, without mention of complication 87210 Open wound of unspecified site of external ear, complicated 87350 Open wound of unspecified site of face, complicated 87340 Open wound of unspecified site of face, without mention of complication 87330 Open wound of unspecified site of nose, complicated 87320 Open wound of unspecified site of nose, without mention of complication 88013 Open wound of upper arm, complicated 88023 Open wound of upper arm, with tendon involvement 88003 Open wound of upper arm, without mention of complication 8787 Open wound of vagina, complicated 8786 Open wound of vagina, without mention of complication 8785 Open wound of vulva, complicated 8784 Open wound of vulva, without mention of complication 88112 Open wound of wrist, complicated 88122 Open wound of wrist, with tendon involvement 88102 Open wound of wrist, without mention of complication 87200 Open wound unspecified site of external ear, without mention of complication 8799 Open wound(s) (multiple) of unspecified site(s), complicated 8798 Open wound(s) (multiple) of unspecified site(s), without mention of complication 31381 Oppositional disorder of childhood or adolescence 9500 Optic nerve injury 60491 Orchitis & epididymitis in diseases classified elsewhere 60490 Orchitis & epididymitis, unspecified 6040 Orchitis, epididymitis, & epididymo-orchitis, with abscess 4580 Orthostatic hypotension 7797 Other & ill-defined conditions originating in the perinatal period, periventricular leukomalacia 2851 Other & unspecified anemias, acute posthemorrhagic anemia

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

4139 Other & unspecified angina pectoris 7705 Other & unspecified atelectasis of newborn 7791 Other & unspecified cerebral irritability in newborn 85196 Other & unspecified cerebral laceration & contusion w open intracranial wound loss of consciousness unspecified duration85199 Other & unspecified cerebral laceration & contusion w open intracranial wound with concussion, unspecified 85192 Other & unspecified cerebral laceration & contusion w open intracranial wound, brief loss of consciousness 85193 Other & unspecified cerebral laceration & contusion w open intracranial wound, moderate loss of consciousness 85191 Other & unspecified cerebral laceration & contusion w open intracranial wound, no loss of consciousness 85194 Other & unspecified cerebral laceration & contusion w open intracranial wound, prolonged loss of consciousness w return 85195 Other & unspecified cerebral laceration & contusion w open intracranial wound, prolonged loss of consciousness wo return85190 Other & unspecified cerebral laceration & contusion w open intracranial wound, state of consciousness unspecified 85182 Other & unspecified cerebral laceration & contusion, wo open intracranial wound, brief loss of consciousness 85183 Other & unspecified cerebral laceration & contusion, wo open intracranial wound, moderate loss of consciousness 85181 Other & unspecified cerebral laceration & contusion, wo open intracranial wound, no loss of consciousness 85184 Other & unspecified cerebral laceration & contusion, wo open intracranial wound, prolong loss of consciousness w return 85185 Other & unspecified cerebral laceration & contusion, wo open intracranial wound, prolong loss of consciousness wo return85180 Other & unspecified cerebral laceration & contusion, wo open intracranial wound, state of consciousness unspecified 85189 Other & unspecified cerebral laceration & contusion, wo open intracranial wound, with concussion, unspecified 81307 Other & unspecified closed fractures of proximal end of radius 81304 Other & unspecified closed fractures of proximal end of ulna 9999 Other & unspecified complications of medical care, not elsewhere classified 9932 Other & unspecified effects of high altitude E8356 Other & unspecified fall in water transport involving dockers, stevedores E8352 Other & unspecified fall in water transport involving occupant of other watercraft; crew E8353 Other & unspecified fall in water transport involving occupant of other watercraft; non-crew E8351 Other & unspecified fall in water transport involving occupant of small boat, powered E8350 Other & unspecified fall in water transport involving occupant of small boat, unpowered E8358 Other & unspecified fall in water transport involving other specified person E8355 Other & unspecified fall in water transport involving swimmer E8359 Other & unspecified fall in water transport involving unspecified person E8354 Other & unspecified fall in water transport involving water skier 85312 Other & unspecified intracranial hemorrhage following injury w open wound, brief loss of consciousness 85316 Other & unspecified intracranial hemorrhage following injury w open wound, loss of consciousness unspecified duration 85313 Other & unspecified intracranial hemorrhage following injury w open wound, moderate loss of consciousness

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

85311 Other & unspecified intracranial hemorrhage following injury w open wound, no loss of consciousness 85315 Other & unspecified intracranial hemorrhage following injury w open wound, prolonged loss of consciousness wo return 85314 Other & unspecified intracranial hemorrhage following injury w open wound, prolonged loss of consciousness w return 85310 Other & unspecified intracranial hemorrhage following injury w open wound, state of consciousness unspecified 85319 Other & unspecified intracranial hemorrhage following injury w open wound, with concussion, unspecified 85302 Other & unspecified intracranial hemorrhage following injury, wo open wound, brief loss of consciousness 85306 Other & unspecified intracranial hemorrhage following injury, wo open wound, loss of consciousness unspsecified duration85303 Other & unspecified intracranial hemorrhage following injury, wo open wound, moderate loss of consciousness 85301 Other & unspecified intracranial hemorrhage following injury, wo open wound, no loss of consciousness 85304 Other & unspecified intracranial hemorrhage following injury, wo open wound, prolong loss of consciousness w return 85305 Other & unspecified intracranial hemorrhage following injury, wo open wound, prolong loss of consciousness wo return 85300 Other & unspecified intracranial hemorrhage following injury, wo open wound, state of consciousness unspecified 85309 Other & unspecified intracranial hemorrhage following injury, wo open wound, with concussion, unspecified 5589 Other & unspecified noninfectious gastroenteritis & colitis 81317 Other & unspecified open fractures of proximal end of radius 81314 Other & unspecified open fractures of proximal end of ulna 8738 Other & unspecified open wound of head without mention of complication 8739 Other & unspecified open wound of head, complicated 2988 Other & unspecified reactive psychosis 3079 Other & unspecified special symptoms or syndromes, not elsewhere classified 9189 Other & unspecified superficial injuries of eye 9139 Other & unspecified superficial injury of elbow, forearm & wrist, infected 9138 Other & unspecified superficial injury of elbow, forearm & wrist, without mention of infection 9109 Other & unspecified superficial injury of face, neck & scalp, infected 9108 Other & unspecified superficial injury of face, neck & scalp, without mention of infection 9158 Other & unspecified superficial injury of fingers without mention of infection 9159 Other & unspecified superficial injury of fingers, infected 9179 Other & unspecified superficial injury of foot & toe(s), infected 9149 Other & unspecified superficial injury of hand(s) except finger(s) alone, infected 9148 Other & unspecified superficial injury of hand(s) except finger(s) alone, without mention of infection 9169 Other & unspecified superficial injury of hip, thigh, leg & ankle, infected 9199 Other & unspecified superficial injury of other, multiple & unspecified sites, infected 9129 Other & unspecified superficial injury of shoulder & upper arm, infected 9128 Other & unspecified superficial injury of shoulder & upper arm, without mention of infection

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

9119 Other & unspecified superficial injury of trunk, infected E8386 Other & unspecified water transport accident involving dockers, stevedores E8382 Other & unspecified water transport accident involving occupant of other watercraft; crew E8383 Other & unspecified water transport accident involving occupant of other watercraft; non-crew E8381 Other & unspecified water transport accident involving occupant of small boat; powered E8380 Other & unspecified water transport accident involving occupant of small boat; unpowered E8388 Other & unspecified water transport accident involving other specified person E8385 Other & unspecified water transport accident involving swimmer E8389 Other & unspecified water transport accident involving unspecified person E8384 Other & unspecified water transport accident involving water skier 7906 Other abnormal blood chemistry E9108 Other accidental drowning or submersion E8326 Other accidental submersion or drowning in water transport accident involving dockers, stevedores E8322 Other accidental submersion or drowning in water transport accident involving occupant of other watercraft; crew E8323 Other accidental submersion or drowning in water transport accident involving occupant of other watercraft; non-crew E8321 Other accidental submersion or drowning in water transport accident involving occupant of small boat, powered E8320 Other accidental submersion or drowning in water transport accident involving occupant of small boat, unpowered E8328 Other accidental submersion or drowning in water transport accident involving other specified person E8325 Other accidental submersion or drowning in water transport accident involving swimmer E8329 Other accidental submersion or drowning in water transport accident involving unspecified person E8324 Other accidental submersion or drowning in water transport accident involving water skier E8918 Other accidents resulting from conflagration in other & unspecified building or structure E8908 Other accidents resulting from conflagration of private dwelling 77581 Other acidosis of newborn 41189 Other acute & subacute forms of ischemic heart disease 5063 Other acute & subacute respiratory conditions due to fumes & vapors 42299 Other acute myocarditis 33819 Other acute pain 42099 Other acute pericarditis 33818 Other acute postoperative pain 3083 Other acute reactions to stress 3918 Other acute rheumatic heart disease 4618 Other acute sinusitis 0773 Other adenoviral conjunctivitis

Page 125: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

30929 Other adjustment reactions w predominant disturbance of other emotions 99585 Other adult abuse & neglect 78009 Other alteration of consciousness 9950 Other anaphylactic shock, not elsewhere classified 77931 Other and ill-defined conditions originating in the perinatal period; Disorder of stomach function and feeding problems 77932 Other and ill-defined conditions originating in the perinatal period; Disorder of stomach function and feeding problems 77933 Other and ill-defined conditions originating in the perinatal period; Disorder of stomach function and feeding problems 77934 Other and ill-defined conditions originating in the perinatal period; Disorder of stomach function and feeding problems 29689 Other and unspecified bipolar disorders, other 34931 Other and unspecified disorders of the nervous system; dural tear; 34939 Other and unspecified disorders of the nervous system; dural tear; other E8888 Other and unspecified fall, other fall 41419 Other aneurysm of heart 64183 Other antepartum hemorrhage, antepartum complication 64180 Other antepartum hemorrhage, unspecified as to episode of care 64181 Other antepartum hemorrhage, with delivery 77082 Other apnea of newborn 542 Other appendicitis 0663 Other arthropod-born viral diseases, other mosquito-borne fever 0660 Other arthropod-born viral diseases, phlebotomus fever 0661 Other arthropod-born viral diseases, tick-borne fever 0662 Other arthropod-born viral diseases, Venezuelan equine fever 0664 Other arthropod-born viral diseases, West Nile fever 0880 Other arthropod-borne diseases, bartonellosis 00589 Other bacterial food poisoning 48242 Other bacterial pneumonia; Methicillin resistant pneumonia due to Staphylococcus aureus 48241 Other bacterial pneumonia; Methicillin susceptible pneumonia due to Staphylococcus aureus (Revised 10/2008) 9404 Other burn of cornea & conjunctival sac 9401 Other burns of eyelids & periocular area 32381 Other causes of encephalitis and encephalomyelitis 32382 Other causes of myelitis 33181 Other cerebral degeneration, Reye's syndrome 3314 Other cerebral degenerations, obstructive hydrocephalus 85186 Other cerebral laceration & contusion, wo open intracranial wound, loss of consciousness unspecified duration

Page 126: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

78659 Other chest pain 99559 Other child abuse & neglect 83503 Other closed anterior dislocation of hip 83659 Other closed dislocation of knee 82129 Other closed fracture of lower end of femur 82529 Other closed fracture of tarsal & metatarsal bones 81342 Other closed fractures of distal end of radius 81249 Other closed fractures of lower end of humerus 81209 Other closed fractures of upper end of humerus 56969 Other colostomy or enterostomy complication 99676 Other complications due to genitourinary device, implant & graft 99671 Other complications due to heart valve prosthesis 99677 Other complications due to internal joint prosthesis 99675 Other complications due to nervous system device, implant & graft 99672 Other complications due to other cardiac device, implant & graft 99678 Other complications due to other internal orthopedic device, implant & graft 99679 Other complications due to other internal prosthetic device, implant & graft 99674 Other complications due to other vascular device, implant & graft 99673 Other complications due to renal dialysis device, implant & graft 99670 Other complications due to unspecified device, implant & graft 66983 Other complications of labor & delivery, antepartum condition or complication 66981 Other complications of labor & delivery, delivered 66982 Other complications of labor & delivery, delivered with postpartum complication 66984 Other complications of labor & delivery, postpartum condition or complication 66980 Other complications of labor & delivery, unspecified episode of care 67432 Other complications of obstetrical surgical wounds, delivered with postpartum complication 67434 Other complications of obstetrical surgical wounds, postpartum condition or complication 67430 Other complications of obstetrical surgical wounds, unspecified episode of care 99832 Other complications of procedures, NOC; disruption of wound; external operation (surgical) wound (Revised 10/2008) 99831 Other complications of procedures, NOC; disruption of wound; internal operation (surgical) wound (Revised 10/2008) 67482 Other complications of the puerperium, delivered with postpartum complication 67484 Other complications of the puerperium, postpartum condition or complication 67480 Other complications of the puerperium, unspecified episode of care 34881 Other conditions of brain; Other conditions of brain; Temporal sclerosis

Page 127: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

64971 Other conditions or status of the mother complicating pregnancy, childbirth 7712 Other congenital infections specific to the perinatal period 37239 Other conjunctivitis 56409 Other constipation 78039 Other convulsions 7677 Other cranial & peripheral nerve injuries due to birth trauma 28859 Other decreased white blood cell count 2892 Other diseases of blood & blood-forming organs nonspecific mesenteric lymphadenitis 2897 Other diseases of blood & blood-forming organs, methemoglobinemia 28984 Other diseases of blood and blood-forming organs; other specified; heparin-induced thrombocytopenia (HIT) 4241 Other diseases of endocardium, aortic valve disorders 42491 Other diseases of endocardium, endocarditis in diseases classified elsewhere 42490 Other diseases of endocardium, endocarditis, valve unspecified, unspecified cause 4240 Other diseases of endocardium, mitral valve disorders 42499 Other diseases of endocardium, other endocarditis, valve unspecified 4243 Other diseases of endocardium, pulmonary valve disorders 4242 Other diseases of endocardium, tricuspid valve disorders, specified as nonrheumatic 51884 Other diseases of lung, acute & chronic respiratory failure 51883 Other diseases of lung, chronic respiratory failure 51881 Other diseases of lung, respiratory failure 4231 Other diseases of pericardium, adhesive pericarditis 4232 Other diseases of pericardium, constrictive pericarditis 4230 Other diseases of pericardium, hemopericardium 73396 Other disorders of bone and cartilage; other and unspecified; stress fracture of femoral neck 73398 Other disorders of bone and cartilage; other and unspecified; stress fracture of pelvis 73397 Other disorders of bone and cartilage; other and unspecified; stress fracture of shaft of femur 30759 Other disorders of eating 5750 Other disorders of gallbladder, acute cholecystitis 36081 Other disorders of globe, luxation of globe 56942 Other disorders of intestine, anal or rectal pain 5693 Other disorders of intestine, hemorrhage of rectum & anus 5691 Other disorders of intestine, rectal prolapse 56979 Other disorders of intestine; Complications of intestinal pouch; Other 56971 Other disorders of intestine; Complications of intestinal pouch; Pouchitis

Page 128: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

56987 Other disorders of intestine; Other specified disorders of intestine; Vomiting of fecal matter 59971 Other disorders of urethra and urinary tract; hematuria; gross 59970 Other disorders of urethra and urinary tract; hematuria; unspecified 78609 Other dyspnea & respiratory abnormality 9588 Other early complications of trauma 63381 Other ectopic pregnancy with intrauterine pregnancy 63380 Other ectopic pregnancy without intrauterine pregnancy 9949 Other effects of external causes 31389 Other emotional disturbances of childhood or adolescence 32341 Other encephalitis and encephalomyelitis due to infection classified elsewhere 34839 Other encephalopathy 048 Other enterovirus diseases of central nervous system E8849 Other fall from one level to another E8346 Other fall from one level to another in water transport involving dockers, stevedores E8342 Other fall from one level to another in water transport involving occupant of other watercraft; crew E8343 Other fall from one level to another in water transport involving occupant of other watercraft; non-crew E8341 Other fall from one level to another in water transport involving occupant of small boat powered E8340 Other fall from one level to another in water transport involving occupant of small boat, unpowered E8348 Other fall from one level to another in water transport involving other specified person E8345 Other fall from one level to another in water transport involving swimmer E8349 Other fall from one level to another in water transport involving unspecified person E8344 Other fall from one level to another in water transport involving water skier 77018 Other fetal & newborn aspiration, with respiratory symptoms 34581 Other forms of epilepsy, w intractable epilepsy 34580 Other forms of epilepsy, wo mention of intractable epilepsy 56489 Other functional disorders of intestine 7137 Other general diseases with articular involvement 78099 Other general symptoms 30659 Other genitourinary malfunction arising from mental factors 09885 Other gonococcal heart disease 09849 Other gonococcal infection of eye 09859 Other gonococcal infection of joint 09819 Other gonococcal infection, acute of upper genitourinary tract 33900 Other headache syndromes cluster headache syndrome, unspecified

Page 129: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

33901 Other headache syndromes episodic cluster headache 33941 Other headache syndromes hemicrania continua 33942 Other headache syndromes new daily persistent headache 33943 Other headache syndromes primary thunderclap headache 33904 Other headache syndromes; chronic paroxysmal hemicrania 33902 Other headache syndromes; chronic cluster headache 33944 Other headache syndromes; complicated headache syndromes; other 3393 Other headache syndromes; drug induced headache, not elsewhere classified 33903 Other headache syndromes; episodic paroxysmal hemicrania 33982 Other headache syndromes; other specified; headache associated with sexual activity 33981 Other headache syndromes; other specified; hypnic headache 33989 Other headache syndromes; other specified; other 33983 Other headache syndromes; other specified; primary cough headache 33984 Other headache syndromes; other specified; primary exertional headache 33985 Other headache syndromes; other specified; primary stabbing headache 33909 Other headache syndromes; other trigeminal autonomic cephalgias 33921 Other headache syndromes; post-traumatic headache; acute 33922 Other headache syndromes; post-traumatic headache; chronic 33920 Other headache syndromes; post-traumatic headache; unspecified 33912 Other headache syndromes; tension type headache; chronic 33911 Other headache syndromes; tension type headache; episodic 33910 Other headache syndromes; tension type headache; unspecified 33905 Other headache syndromes;short lasting unilateral neuralgiform headache with conjunctival injection and tearing 30159 Other histrionic personality disorder 7991 Other ill-defined & unknown causes of morbidity & mortality, respiratory arrest 79982 Other ill-defined and unknown causes of morbidity and mortality; Other ill-defined conditions; Apparent life threatening4378 Other ill-defined cerebrovascular disease 66612 Other immediate postpartum hemorrhage, delivered 66614 Other immediate postpartum hemorrhage, postpartum condition or complication 66610 Other immediate postpartum hemorrhage, unspecified episode of care 56039 Other Impaction of intestine without mention of hernia 73080 Other infections involving bone in diseases classified elsewhere, site unspecified 73087 Other infections involving bone of ankle & foot in diseases classified elsewhere 73089 Other infections involving bone of multiple sites in diseases classified elsewheree

Page 130: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

73088 Other infections involving bone of other specified sites in diseases classified elsewhere 73084 Other infections involving bone of the hand in diseases classified elsewhere 73085 Other infections involving bone of the pelvic region & thigh in diseases classified elsewhere 73083 Other infections involving forearm bone in diseases classified elsewhere 73086 Other infections involving lower leg bone in diseases classified elsewhere 73081 Other infections involving shoulder bone in diseases classified elsewhere 73082 Other infections involving upper arm bone in diseases classified elsewhere 77189 Other infections specific to the perinatal period 61689 Other inflammatory disease of cervix, vagina and vulva 7673 Other injuries to skeleton due to birth trauma 86419 Other injury to liver with open wound into cavity 86409 Other injury to liver without mention of open wound into cavity 86509 Other injury to spleen without mention of open wound into cavity 68609 Other local infection of skin & subcutaneous tissue, other pyoderma 68601 Other local infection of skin & subcutaneous tissue, pyoderma, gangrenosum 68600 Other local infection of skin & subcutaneous tissue, pyoderma, unspecified 00329 Other localized salmonella infection 5948 Other lower urinary tract calculus 78079 Other malaise and fatigue 0844 Other malaria 40509 Other malignant secondary hypertension 99609 Other mechanical complication of cardiac device, implant & graft 99639 Other mechanical complication of genitourinary device, implant & graft E8220 Other motor vehicle nontraffic accident involving collision w moving object & driver of motor vehicle not a motorcycle E8221 Other motor vehicle nontraffic accident involving collision w moving object & passenger in motor vehicle not motorcycle E8225 Other motor vehicle nontraffic accident involving collision w moving object & rider or occupant of animal-drawn vehicle E8231 Other motor vehicle nontraffic accident involving collision w stationary object passenger motor vehicle not motorcycleE8230 Other motor vehicle nontraffic accident involving collision w stationary object & driver of motor vehicle not motorcycleE8235 Other motor vehicle nontraffic accident involving collision w stationary object & rider or occupant animal-drawn vehicleE8222 Other motor vehicle nontraffic accident involving collision with moving object & motorcyclist E8224 Other motor vehicle nontraffic accident involving collision with moving object & occupant of streetcar E8228 Other motor vehicle nontraffic accident involving collision with moving object & other specified person E8223 Other motor vehicle nontraffic accident involving collision with moving object & passenger on motorcycle E8226 Other motor vehicle nontraffic accident involving collision with moving object & pedal cyclist

Page 131: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8227 Other motor vehicle nontraffic accident involving collision with moving object & pedestrian E8229 Other motor vehicle nontraffic accident involving collision with moving object & unspecified person E8232 Other motor vehicle nontraffic accident involving collision with stationary object & motorcyclist E8234 Other motor vehicle nontraffic accident involving collision with stationary object & occupant of streetcar E8238 Other motor vehicle nontraffic accident involving collision with stationary object & other specified person E8233 Other motor vehicle nontraffic accident involving collision with stationary object & passenger on motorcycle E8236 Other motor vehicle nontraffic accident involving collision with stationary object & pedal cyclist E8237 Other motor vehicle nontraffic accident involving collision with stationary object & pedestrian E8239 Other motor vehicle nontraffic accident involving collision with stationary object & unspecified person E8250 Other motor vehicle nontraffic accident of other & unspecified nature involving driver of motor vehicle not a motorcycleE8252 Other motor vehicle nontraffic accident of other & unspecified nature involving motorcyclist E8254 Other motor vehicle nontraffic accident of other & unspecified nature involving occupant of streetcar E8258 Other motor vehicle nontraffic accident of other & unspecified nature involving other specified person E8253 Other motor vehicle nontraffic accident of other & unspecified nature involving passenger on motorcycle E8256 Other motor vehicle nontraffic accident of other & unspecified nature involving pedal cyclist E8257 Other motor vehicle nontraffic accident of other & unspecified nature involving pedestrian E8255 Other motor vehicle nontraffic accident of other & unspecified nature involving rider or occupant animal-drawn vehicle E8259 Other motor vehicle nontraffic accident of other & unspecified nature involving unspecified person E8251 Other motor vehicle nontraffic accident other & unspecified nature involving passenger in motor vehicle not motorcycle E8240 Other motor vehicle nontraffic accident while boarding & alighting involving driver of motor vehicle not a motorcycle E8242 Other motor vehicle nontraffic accident while boarding & alighting involving motorcyclist E8244 Other motor vehicle nontraffic accident while boarding & alighting involving occupant of streetcar E8248 Other motor vehicle nontraffic accident while boarding & alighting involving other specified person E8241 Other motor vehicle nontraffic accident while boarding & alighting involving passenger in motor vehicle not a motorcycleE8243 Other motor vehicle nontraffic accident while boarding & alighting involving passenger on motorcycle E8246 Other motor vehicle nontraffic accident while boarding & alighting involving pedal cyclist E8247 Other motor vehicle nontraffic accident while boarding & alighting involving pedestrian E8245 Other motor vehicle nontraffic accident while boarding & alighting involving rider or occupant animal-drawn vehicle E8249 Other motor vehicle nontraffic accident while boarding & alighting involving unspecified person E8150 Other motor vehicle traffic accident involving collision on the highway & driver of motor vehicle other than motorcycle E8152 Other motor vehicle traffic accident involving collision on the highway & motorcyclist E8154 Other motor vehicle traffic accident involving collision on the highway & occupant of streetcar E8158 Other motor vehicle traffic accident involving collision on the highway & other specified person E8151 Other motor vehicle traffic accident involving collision on the highway & passenger in motor vehicle not a motorcycle

Page 132: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8153 Other motor vehicle traffic accident involving collision on the highway & passenger on motorcycle E8156 Other motor vehicle traffic accident involving collision on the highway & pedal cyclist E8157 Other motor vehicle traffic accident involving collision on the highway & pedestrian E8155 Other motor vehicle traffic accident involving collision on the highway & rider or occupant of animal-drawn vehicle E8159 Other motor vehicle traffic accident involving collision on the highway & unspecified person E8121 Other motor vehicle traffic accident involving collision w motor vehicle & passenger in motor vehicle not a motorcycle E8122 Other motor vehicle traffic accident involving collision with motor vehicle & motorcyclist E8124 Other motor vehicle traffic accident involving collision with motor vehicle & occupant of streetcar E8128 Other motor vehicle traffic accident involving collision with motor vehicle & other specified person E8123 Other motor vehicle traffic accident involving collision with motor vehicle & passenger on motorcycle E8126 Other motor vehicle traffic accident involving collision with motor vehicle & pedal cyclist E8127 Other motor vehicle traffic accident involving collision with motor vehicle & pedestrian E8129 Other motor vehicle traffic accident involving collision with motor vehicle & unspecified person 37203 Other mucopurulent conjunctivitis 32342 Other myelitis due to infection classified elsewhere 99709 Other nervous system complications, not elsewhere classified 30089 Other neurotic disorders, not otherwise specified 30081 Other neurotic disorders, somatization disorder 30082 Other neurotic disorders, undifferentiated somatoform disorder E8180 Other noncollision motor vehicle accident involving driver of motor vehicle other than motorcycle E8182 Other noncollision motor vehicle accident involving motorcyclist E8184 Other noncollision motor vehicle accident involving occupant of streetcar E8188 Other noncollision motor vehicle accident involving other specified person E8181 Other noncollision motor vehicle accident involving passenger in motor vehicle other than motorcycle E8183 Other noncollision motor vehicle accident involving passenger on motorcycle E8186 Other noncollision motor vehicle accident involving pedal cyclist E8187 Other noncollision motor vehicle accident involving pedestrian E8185 Other noncollision motor vehicle accident involving rider or occupant of animal-drawn vehicle E8189 Other noncollision motor vehicle accident involving unspecified person 2989 Other nonorganic psychoses unspecified psychosis 2872 Other nonthrombocytopenic purpuras 5373 Other obstruction of duodenum 83513 Other open anterior dislocation of hip 83669 Other open dislocation of knee

Page 133: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

82139 Other open fracture of lower end of femur 81259 Other open fracture of lower end of humerus 81219 Other open fracture of upper end of humerus 81352 Other open fractures of distal end of radius 82539 Other open fractures of tarsal & metatarsal bones 60499 Other orchitis, epididymitis & epididymo-orchitis, without mention of abscess 34402 Other paralytic syndromes quadriplegia & quadriparesis, C1 - C4, incomplete 34401 Other paralytic syndromes quadriplegia & quadriparesis, C1- C4, complete 34403 Other paralytic syndromes quadriplegia & quadriparesis, C5 - C7, complete 34404 Other paralytic syndromes quadriplegia & quadriparesis, C5 - C7, incomplete 34400 Other paralytic syndromes quadriplegia, unspecified 34461 Other paralytic syndromes, cauda equina syndrome w neurogenic bladder 34460 Other paralytic syndromes, cauda equina syndrome wo mention of neurogenic bladder 34409 Other paralytic syndromes, other quadriplegia & quadriparesis 3441 Other paralytic syndromes, paraplegia 0849 Other pernicious complications of malaria 2948 Other persistent mental disorders due to conditions classified elsewhere 30189 Other personality disorders 30182 Other personality disorders, avoidant personality 30183 Other personality disorders, borderline personality 30181 Other personality disorders, narcissistic personality 30184 Other personality disorders, passive aggressive personality 65673 Other placental conditions affecting management of mother, antepartum 65671 Other placental conditions affecting management of mother, delivered 65670 Other placental conditions affecting management of mother, unspecified episode of care 32362 Other postinfectious encephalitis and encephalomyelitis 99859 Other postoperative infection, not elsewhere classified 4254 Other primary cardiomyopathies 28730 Other primary thrombocytopenia 51882 Other pulmonary insufficiency, not elsewhere classified 77089 Other respiratory problems after birth 77086 Other respiratory problems after birth: Aspiration postnatal stomach contents w/respiratory symptoms 77085 Other respiratory problems after birth: Aspiration postnatal stomach contents wo respiratory symptoms 56738 Other retroperitoneal abscess

Page 134: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

56739 Other retroperitoneal infections 0830 Other rickettsioses, Q fever 0832 Other rickettsioses, rickettsialpox 0831 Other rickettsioses, trench fever E8294 Other road vehicle accidents involving occupant of streetcar E8298 Other road vehicle accidents involving other specified person E8290 Other road vehicle accidents involving pedestrian E8299 Other road vehicle accidents involving unspecified person 03849 Other septicemia due to gram-negative organisms 5728 Other sequelae of chronic liver disease 9995 Other serum reaction, not elsewhere classified 78559 Other shock without mention of trauma 28269 Other sickle-cell disease with crisis 30749 Other sleep disorders of nonorganic origin, 30989 Other specified adjustment reactions 99589 Other specified adverse effects, not elsewhere classified E8442 Other specified air transport accidents involving crew of commercial aircraft; surface to surface transport E8448 Other specified air transport accidents involving ground crew, airline employee E8441 Other specified air transport accidents involving occupant of any military aircraft E8444 Other specified air transport accidents involving occupant of commercial aircraft in surface to air transport E8445 Other specified air transport accidents involving occupant of other powered aircraft E8440 Other specified air transport accidents involving occupant of spacecraft E8446 Other specified air transport accidents involving occupant of unpowered aircraft except parachutist E8443 Other specified air transport accidents involving other occupant of commercial aircraft; surface to surface transport E8449 Other specified air transport accidents involving other person E8447 Other specified air transport accidents involving parachutist; military or other 29189 Other specified alcohol induced mental disorders (anxiety, mood, sexual dysfunction, sleep) 08882 Other specified arthropod-borne diseases, babesiosis 08881 Other specified arthropod-borne diseases, lyme disease 08889 Other specified arthropod-borne diseases, other 0658 Other specified arthropod-borne hemorrhagic fever 0668 Other specified arthropod-borne viral diseases 04089 Other specified bacterial diseases 04189 Other Specified Bacterial Infections in Conditions Classified Elsewhere and of Unspecified Site, Other Specified Bacteri

Page 135: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

7678 Other specified birth trauma 42789 Other specified cardiac dysrhythmias 6398 Other specified complications following abortion, ectopic & molar pregnancies 76389 Other specified complications of labor & delivery affecting fetus and newborn 99889 Other specified complications of procedures not elsewhere classified 77989 Other specified conditions originating in the perinatal period 71287 Other specified crystal arthropathies, ankle & foot 71283 Other specified crystal arthropathies, forearm 71284 Other specified crystal arthropathies, hand 71286 Other specified crystal arthropathies, lower leg 71289 Other specified crystal arthropathies, multiple sites 71288 Other specified crystal arthropathies, other specified sites 71285 Other specified crystal arthropathies, pelvic region & thigh 71281 Other specified crystal arthropathies, shoulder region 71280 Other specified crystal arthropathies, site unspecified 71282 Other specified crystal arthropathies, upper arm 3158 Other specified delays in development 03289 Other specified diphtheria 0748 Other specified diseases due to coxsackie virus 4238 Other specified diseases of pericardium 5968 Other specified disorders of the bladder 53789 Other specified disorders of the stomach & duodenum 31289 Other specified disturbance of conduct, not elsewhere classified 30461 Other specified drug dependence, continuous 30462 Other specified drug dependence, episodic 30463 Other specified drug dependence, in remission 30460 Other specified drug dependence, unspecified 29289 Other specified drug induced mental disorders 9938 Other specified effects of air pressure 9918 Other specified effects of reduced temperature 29699 Other specified episodic mood disorder 65683 Other specified fetal & placental problems affecting management of mother, antepartum condition or complication 65681 Other specified fetal & placental problems affecting management of mother, delivered 65680 Other specified fetal & placental problems affecting management of mother, unspecified episode of care

Page 136: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

4148 Other specified forms of chronic ischemic heart disease 53541 Other specified gastritis with hemorrhage 9928 Other specified heat effects 64083 Other specified hemorrhage in early pregnancy, antepartum condition or complication 64081 Other specified hemorrhage in early pregnancy, delivered 64080 Other specified hemorrhage in early pregnancy, unspecified as to episode of care 7728 Other specified hemorrhage of fetus or newborn 2878 Other specified hemorrhagic conditions 4588 Other specified hypotension 6148 Other specified inflammatory disease of female pelvic organs & tissues E9068 Other specified injury caused by animal 56089 Other specified intestinal obstruction without mention of hernia 20701 Other specified leukemia, acute erythremia & erythroleukemia, in remission 20700 Other specified leukemia, acute erythremia & erythroleukemia, wo mention of remission 0228 Other specified manifestations of anthrax 3148 Other specified manifestations of hyperkinetic syndrome of childhood 7618 Other specified maternal complications of pregnancy affecting fetus or newborn 0628 Other specified mosquito-borne viral encephalitis 0318 Other specified mycobacterial diseases 0498 Other specified non-arthropod-borne viral diseases of central nervous system 3108 Other specified nonpsychotic mental disorders following organic brain damage 8708 Other specified open wounds of ocular adnexa 2978 Other specified paranoid states 7778 Other specified perinatal disorders of digestive system 5678 Other specified peritonitis 56789 Other specified peritonitis E8048 Other specified person fall in, on, or from railway train 29980 Other specified pervasive developmental disorders, current or active state 29981 Other specified pervasive developmental disorders, residual state 3068 Other specified psychophysiological malfunction arising from mental factors 30289 Other specified psychosexual disorders 30281 Other specified psychosexual disorders, fetishism 30285 Other specified psychosexual disorders, gender identity disorder of adolescent or adult life 30283 Other specified psychosexual disorders, sexual masochism

Page 137: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

30284 Other specified psychosexual disorders, sexual sadism 30282 Other specified psychosexual disorders, voyeurism E8068 Other specified railway accident involving other specified person E8061 Other specified railway accident involving passenger on railway E8063 Other specified railway accident involving pedal cyclist E8062 Other specified railway accident involving pedestrian E8069 Other specified railway accident involving unspecified person 78829 Other specified retention of urine 0838 Other specified rickettsioses 0038 Other specified salmonella infections 2908 Other specified senile psychotic conditions 0388 Other specified septicemias 0048 Other specified shigella infections 0828 Other specified tick-borne rickettsioses 0638 Other specified tick-borne viral encephalitis 4358 Other specified transient cerebral ischemias 29389 Other specified transient organic mental disorders (Catatonic disorder in conditions classified elsewhere 01380 Other specified tuberculosis of central nervous system, unspecified examination 0218 Other specified tularemia 59589 Other specified types of cystitis 0208 Other specified types of plague 29582 Other specified types of schizophrenia, chronic state 29584 Other specified types of schizophrenia, chronic w acute exacerbation 29585 Other specified types of schizophrenia, in remission 29581 Other specified types of schizophrenia, subchronic 29583 Other specified types of schizophrenia, subchronic w acute exacerbation 29580 Other specified types of schizophrenia, unspecified 07049 Other specified viral hepatitis w hepatic coma 07041 Other specified viral hepatitis w hepatic coma, acute or unspecified hepatitis C w coma 0478 Other specified viral meningitis 5128 Other spontaneous pneumothorax 84509 Other sprain or strain of ankle 84519 Other sprain or strain of foot 84219 Other Sprain or strain of hand

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TennCareSelect 09/01/09

8468 Other sprain or strain of specified sites of sacroiliac region 84849 Other sprain or strain of sternum 84209 Other sprains or strains of wrist 03819 Other staphylococcal septicemia 52809 Other stomatitis and mucositis (ulcerative) E9179 Other striking against with or without subsequent fall 5672 Other suppurative peritonitis 56729 Other suppurative peritonitis 7899 Other symptoms involving abdomen & pelvis 7897 Other symptoms involving abdomen and pelvis; Colic 78199 Other symptoms involving nervous and musculoskeletal systems 7869 Other symptoms involving respiratory system & chest 8362 Other tear of cartilage or meniscus of knee, current injury 64413 Other threatened labor, antepartum condition 64410 Other threatened labor, unspecified as to episode of care 51909 Other tracheostomy complication 82009 Other transcervical closed fracture of femur 82019 Other transcervical open fracture of neck of femur 7755 Other transitory neonatal electrolyte disturbances 5934 Other ureteric obstruction 9992 Other vascular complications of medical care, not elsewhere classified 45384 Other venous embolism and thrombosis; Acute venous embolism and thrombosis of other specified veins; Axillary veins 45382 Other venous embolism and thrombosis; Acute venous embolism and thrombosis of other specified veins; Deep veins of upper45386 Other venous embolism and thrombosis; Acute venous embolism and thrombosis of other specified veins; Internal jugular ve45389 Other venous embolism and thrombosis; Acute venous embolism and thrombosis of other specified veins; Other specified vei45387 Other venous embolism and thrombosis; Acute venous embolism and thrombosis of other specified veins; Other thoracic vein45385 Other venous embolism and thrombosis; Acute venous embolism and thrombosis of other specified veins; Subclavian veins 45381 Other venous embolism and thrombosis; Acute venous embolism and thrombosis of other specified veins; Superficial veins 45383 Other venous embolism and thrombosis; Acute venous embolism and thrombosis of other specified veins; Upper extremity, un55129 Other ventral hernia with gangrene 55229 Other ventral hernia with obstruction 8270 Other, multiple & ill-defined closed fractures of lower limb 8271 Other, multiple & ill-defined open fractures of lower limb 30789 Other, pain disorder related to psychological factors

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

56402 Outlet dysfunction constipation 0843 Ovale malaria 63321 Ovarian pregnancy with intrauterine pregnancy 63320 Ovarian pregnancy without intrauterine pregnancy 3130 Overanxious disorder specific to childhood & adolescence 78838 Overflow incontinence 62579 Pain and other symptoms associated with female genital organs; vulvodynia; other 62570 Pain and other symptoms associated with female genital organs; vulvodynia; unspecified 62571 Pain and other symptoms associated with female genital organs; vulvodynia; vulvar vestibulitis 71943 Pain in forearm joint 71944 Pain in hand joint 71947 Pain in joint of ankle & foot 71949 Pain in joint of multiple sites 71948 Pain in joint of other specified sites 71945 Pain in joint of pelvic region & thigh 71941 Pain in joint of shoulder region 71940 Pain in joint, site unspecified 7295 Pain in limb 71946 Pain in lower leg joint 37991 Pain in or around eye 71942 Pain in upper arm joint 78652 Painful respiration 7851 Palpitations 2841 Pancytopenia 30001 Panic disorder without agoraphobia 59653 Paralysis of bladder 47832 Paralysis of vocal cords or larynx, unilateral, complete 47831 Paralysis of vocal cords or larynx, unilateral, partial 47830 Paralysis of vocal cords or larynx, unspecified 2971 Paranoia 3010 Paranoid personality disorder 2970 Paranoid state, simple 47822 Parapharyngeal abscess 2972 Paraphrenia

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

0021 Paratyphoid fever A 0022 Paratyphoid fever B 0023 Paratyphoid fever C 0029 Paratyphoid fever, unspecified 0519 Paravaccinia, unspecified 47833 Partial bilateral paralysis of vocal cords or larynx 34550 Partial epilepsy, wo mention of impairment of consciousness, or intractable epilepsy 34551 Partial epilepsy, wo mention of impairment of consciousness, w intractable epilepsy E8051 Passenger on railway hit by rolling stock 73312 Pathologic fracture of distal radius & ulna 73311 Pathologic fracture of humerus 73314 Pathologic fracture of neck of femur 73315 Pathologic fracture of other specified part of femur 73319 Pathologic fracture of other specified site 73316 Pathologic fracture of tibia or fibula 73313 Pathologic fracture of vertebrae 73310 Pathologic fracture, unspecified site 71827 Pathological dislocation of ankle & foot joint 71823 Pathological dislocation of forearm joint 71824 Pathological dislocation of hand joint 71826 Pathological dislocation of joint of lower leg 71829 Pathological dislocation of joint of multiple sites 71828 Pathological dislocation of joint of other specified sites 71825 Pathological dislocation of joint of pelvic region & thigh 71821 Pathological dislocation of joint of shoulder region 71820 Pathological dislocation of joint, site unspecified 71822 Pathological dislocation of upper arm joint 2922 Pathological drug intoxication E8263 Pedal cycle accident involving occupant of animal-drawn vehicle E8264 Pedal cycle accident involving occupant of streetcar E8268 Pedal cycle accident involving other unspecified person E8261 Pedal cycle accident involving pedal cyclist E8260 Pedal cycle accident involving pedestrian E8262 Pedal cycle accident involving rider of animal

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8269 Pedal cycle accident involving unspecified person E8043 Pedal cyclist fall in, on, or from railway train E8053 Pedal cyclist hit by rolling stock, railway accident E8052 Pedestrian hit by rolling stock, railway accident E8042 Pedestrian fall in, on, or from railway train 8704 Penetrating wound of orbit with foreign body 8703 Penetrating wound of orbit, without mention of foreign body 8715 Penetration of eyeball with magnetic foreign body 8716 Penetration of eyeball with nonmagnetic foreign body 53391 Peptic ulcer of unspecified site, without mention of hemorrhage or perforation with obstruction 53390 Peptic ulcer of unspecified site, without mention of hemorrhage, perforation or obstruction 5304 Perforation of esophagus 5754 Perforation of gallbladder 56983 Perforation of intestine 5227 Periapical abscess with sinus 5225 Periapical abscess without sinus 7775 Perinatal disorders of digestive system; necrotizing enterocolitis in newborn (Revised 10/2008) 77751 Perinatal disorders of digestive system; necrotizing enterocolitis in newborn; stage I 77752 Perinatal disorders of digestive system; necrotizing enterocolitis in newborn; stage II 77753 Perinatal disorders of digestive system; necrotizing enterocolitis in newborn; stage III 77750 Perinatal disorders of digestive system; necrotizing enterocolitis in newborn; unspecified 7776 Perinatal intestinal perforation 7744 Perinatal jaundice due to hepatocellular damage 9972 Peripheral vascular complications, not elsewhere classified 4430 Peripheral vascular disease, Raynaud's syndrome 4431 Peripheral vascular disease, thromboangiitis obliterans (Buerger's disease) 99644 Peri-prosthetic fracture around prosthetic joint 99645 Peri-prosthetic osteolysis 56722 Peritoneal abscess 56721 Peritonitis (acute) generalized 5670 Peritonitis in infectious diseases classified elsewhere 475 Peritonsillar abscess 9986 Persistent postoperative fistula, not elsewhere classified 78003 Persistent vegetative state

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

0772 Pharyngoconjunctival fever 45111 Phlebitis & thrombophlebitis of deep veins of femoral vein (deep) (superficial) 45119 Phlebitis & thrombophlebitis of deep veins of lower extremities, other 45183 Phlebitis & thrombophlebitis of deep veins of upper extremities 45181 Phlebitis & thrombophlebitis of iliac vein 325 Phlebitis & thrombophlebitis of intracranial venous sinuses 4512 Phlebitis & thrombophlebitis of lower extremities, unspecified 45189 Phlebitis & thrombophlebitis of other sites 45182 Phlebitis & thrombophlebitis of superficial veins of upper extremities 4510 Phlebitis & thrombophlebitis of superficial vessels of lower extremities 4519 Phlebitis & thrombophlebitis of unspecified site 45184 Phlebitis & thrombophlebitis of upper extremities, unspecified 37024 Photokeratitis 33111 Pick's disease 6850 Pilonidal cyst with abscess E9808 Pisoning by arsenic & its compounds, undetermined if accidentally or purposely inflicted 64103 Placenta previa without hemorrhage, antepartum condition or complication 64101 Placenta previa without hemorrhage, delivered 64100 Placenta previa without hemorrhage, unspecified as to episode of care 67442 Placental polyp, delivered with postpartum complication 67444 Placental polyp, postpartum condition or complication 67440 Placental polyp, unspecified episode of care 0209 Plague, unspecified 5111 Pleurisy with effusion, with mention of a bacterial cause other than tuberculosis 5110 Pleurisy without mention of effusion or current tuberculosis 51181 Pleurisy; other specified forms of effusion, except tuberculous; malignant pleural effusion 51189 Pleurisy; other specified forms of effusion, except tuberculous; other 3201 Pneumococcal meningitis 5671 Pneumococcal peritonitis 481 Pneumococcal pneumonia, streptococcus pneumonia 0382 Pneumococcal septicemia 0412 Pneumococcus infection in conditions classified elsewhere & of unspecified site 4800 Pneumonia due to adenovirus 4831 Pneumonia due to Chlamydia

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Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

4830 Pneumonia due to mycoplasma pneumoniae 48289 Pneumonia due to other specified bacteria 4838 Pneumonia due to other specified organism 4808 Pneumonia due to other virus not elsewhere classified 4802 Pneumonia due to parainfluenza virus 4801 Pneumonia due to respiratory syncytial virus 4803 Pneumonia due to SARS Associated Coronavirus 4845 Pneumonia in anthrax 4846 Pneumonia in aspergillosis 4841 Pneumonia in cytomegalic inclusion disease 4848 Pneumonia in other infectious diseases classified elsewhere 4847 Pneumonia in other systemic mycoses 4843 Pneumonia in whooping cough 486 Pneumonia, organism unspecified 0205 Pneumonic plague, unspecified 5070 Pneumonitis due to inhalation of food or vomitus 5071 Pneumonitis due to inhalation of oils & essences 5078 Pneumonitis due to other solids & liquids 1304 Pneumonitis due to toxoplasmosis 96569 Poisioning by other antirheumatics E8532 Poisoned by benzodiazepine-based tranquilizers E9057 Poisoning and toxic reaction caused by other plants 9632 Poisoning by acidifying agents 9620 Poisoning by adrenal cortical steroids E9807 Poisoning by agricultural or horticultural chemical, undetermined if accidentally or purposely inflicted 9773 Poisoning by alcohol deterrents 9633 Poisoning by alkalizing agents 9700 Poisoning by analeptics 9621 Poisoning by androgens & anabolic congeners 9730 Poisoning by antacids & antigastric secretion drugs 9624 Poisoning by anterior pituitary hormones 9616 Poisoning by anthelmintics 9630 Poisoning by antiallergic & antiemetic drugs 9757 Poisoning by antiasthmatics

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

9645 Poisoning by anticoagulant antagonists & other coagulants 9642 Poisoning by anticoagulants 9756 Poisoning by anti-common cold drugs 9690 Poisoning by antidepressants 9735 Poisoning by antidiarrheal drugs 9772 Poisoning by antidotes & chelating agents, not elsewhere classified 9601 Poisoning by antifungal antibiotics 9766 Poisoning by anti-infectives & other drugs & preparations for ear, nose & throat 9722 Poisoning by antilipemic & antiarteriosclerotic drugs 9614 Poisoning by antimalarials & drugs acting on other blood protozoa 9606 Poisoning by antimycobacterial antibiotics 9631 Poisoning by antineoplastic & immunosuppressive drugs 9607 Poisoning by antineoplastic antibiotics 9664 Poisoning by anti-parkinsonism drugs 9761 Poisoning by antipruritics 9628 Poisoning by antithyroid agents 9754 Poisoning by antitussives 9727 Poisoning by antivaricose drugs, including sclerosing agents 9617 Poisoning by antiviral drugs 9654 Poisoning by aromatic analgesics, not elsewhere classified 9611 Poisoning by arsenical anti-infectives 9670 Poisoning by barbiturates E9801 Poisoning by barbiturates, undetermined if accidentally or purposely inflicted 9780 Poisoning by BCG vaccine 9694 Poisoning by benzodiazepine-based tranquilizers 9673 Poisoning by bromine compounds 9692 Poisoning by butyrophenone-based tranquilizers 9728 Poisoning by capillary-active drugs 9742 Poisoning by carbonic acid anhydrase inhibitors 9720 Poisoning by cardiac rhythm regulators 9721 Poisoning by cardiotonic glycosides & drugs of similar action 9680 Poisoning by central nervous system muscle-tone depressants 9605 Poisoning by cephalosporin group 9671 Poisoning by chloral hydrate group

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

9602 Poisoning by chloramphenicol group 9782 Poisoning by cholera vaccine 9724 Poisoning by coronary vasodilators E9806 Poisoning by corrosive & caustic substances, undetermined if accidentally or purposely inflicted 9767 Poisoning by dental drugs topically applied 9770 Poisoning by dietetics 9734 Poisoning by digestants 9785 Poisoning by diphtheria vaccine 9745 Poisoning by electrolytic, caloric & water-balance agents 9736 Poisoning by emetics 9732 Poisoning by emollient cathartics 9763 Poisoning by emollients, demulcents & protectants 9634 Poisoning by enzymes, not elsewhere classified 9603 Poisoning by erythromycin & other macrolides 9755 Poisoning by expectorants 9765 Poisoning by eye anti-infectives & other eye drugs 9644 Poisoning by fibrinolysis-affecting drugs 9646 Poisoning by gamma globulin 9723 Poisoning by ganglion-blocking agents 9675 Poisoning by glutethimide group 9681 Poisoning by halothane 9612 Poisoning by heavy metal anti-infectives 96501 Poisoning by heroin 9661 Poisoning by hydantoin derivatives 9623 Poisoning by insulins & antidiabetic agents 9683 Poisoning by intravenous anesthetics 9640 Poisoning by iron & its compounds 9731 Poisoning by irritant cathartics 9764 Poisoning by keratolytics, keratoplastics, other hair treatment drugs & preparations 9771 Poisoning by lipotropic drugs E9811 Poisoning by liquefied petroleum gas distributed in mobile containers, undetermined accidental or purpose infliction 9641 Poisoning by liver preparations & other antianemic agents 9760 Poisoning by local anti-infectives & anti-inflammatory drugs 9762 Poisoning by local astringents & local detergents

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

9794 Poisoning by measles vaccine 9740 Poisoning by mercurial diuretics 96502 Poisoning by methadone 9674 Poisoning by methaqualone compounds 9789 Poisoning by mixed bacterial vaccines, except combinations with a pertussis component 9676 Poisoning by mixed sedatives, not elsewhere classified 9797 Poisoning by mixed viral-rickettsial & bacterial vaccines, except combinations with a pertussis component 9647 Poisoning by natural blood & blood products 9701 Poisoning by opiate antagonists 96500 Poisoning by opium (alkaloids), unspecified 9729 Poisoning by other & unspecified agents primarily affecting the cardiovascular system 9663 Poisoning by other & unspecified anticonvulsants 9619 Poisoning by other & unspecified anti-infectives 9788 Poisoning by other & unspecified bacterial vaccines 9753 Poisoning by other & unspecified drugs acting on muscles 9684 Poisoning by other & unspecified general anesthetics 9629 Poisoning by other & unspecified hormones & synthetic substitutes 9689 Poisoning by other & unspecified local anesthetics 9758 Poisoning by other & unspecified respiratory drugs E9809 Poisoning by other & unspecified solid or liquid substance, undetermined if accidentally or purposely inflicted 9799 Poisoning by other & unspecified vaccines & biological substances 9796 Poisoning by other & unspecified viral & rickettsial vaccines 9768 Poisoning by other agents primarily affecting skin & mucous membrane 9726 Poisoning by other antihypertensive agents 9618 Poisoning by other antimycobacterial drugs 9615 Poisoning by other antiprotozoal drugs 9693 Poisoning by other antipsychotics, neuroleptics & major tranquilizers E9821 Poisoning by other carbon monoxide, undetermined if accidentally or purposely inflicted 9733 Poisoning by other cathartics, including intestinal atonia 9744 Poisoning by other diuretics 9682 Poisoning by other gaseous anesthetics 9746 Poisoning by other mineral salts, not elsewhere classified 9657 Poisoning by other non-narcotic analgesics 96509 Poisoning by other opiates & related narcotics

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Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

9678 Poisoning by other sedatives & hypnotics E9802 Poisoning by other sedatives and hypnotics, undetermined if accidentally or purposely inflicted 9648 Poisoning by other specified agents affecting blood constituents 9738 Poisoning by other specified agents primarily affecting the gastrointestinal system 9658 Poisoning by other specified analgesics & antipyretics 9608 Poisoning by other specified antibiotics 9708 Poisoning by other specified central nervous system stimulants 9778 Poisoning by other specified drugs & medicinal substances E9804 Poisoning by other specified drugs & medicinal substances, undetermined if accidentally or purposely inflicted E9828 Poisoning by other specified gases & vapors, undetermined if accidentally or purposely inflicted 9698 Poisoning by other specified psychotropic agents 9638 Poisoning by other specified systemic agents 9695 Poisoning by other tranquilizers E9818 Poisoning by other utility gas, undetermined if accidentally or purposely inflicted 9725 Poisoning by other vasodilators 9622 Poisoning by ovarian hormones & synthetic substitutes 9660 Poisoning by oxazolidine derivatives 9750 Poisoning by oxytocic agents 9672 Poisoning by paraldehyde 9711 Poisoning by parasympatholytics (anticholinergics & antimuscarinics) & spasmolytics 9710 Poisoning by parasympathomimetics (cholinergics) 9626 Poisoning by parathyroid & parathyroid derivatives 9600 Poisoning by penicillins 9686 Poisoning by peripheral nerve- & plexus-blocking anesthetics 9786 Poisoning by pertussis vaccine, including combinations with a pertussis component 9774 Poisoning by pharmaceutical excipients 9691 Poisoning by phenothiazine-based tranquilizers 9783 Poisoning by plague vaccine 9795 Poisoning by poliomyelitis vaccine 9625 Poisoning by posterior pituitary hormones 9696 Poisoning by psychodysleptics (hallucinogens) 9697 Poisoning by psychostimulants 96900 Poisoning by psychotropic agents; Antidepressant, unspecified 96901 Poisoning by psychotropic agents; Monoamine oxidase inhibitors

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

96909 Poisoning by psychotropic agents; Other antidepressants 96972 Poisoning by psychotropic agents; Psychostimulants; Amphetamines 96971 Poisoning by psychotropic agents; Psychostimulants; Caffeine 96973 Poisoning by psychotropic agents; Psychostimulants; Methylphenidate 96979 Poisoning by psychotropic agents; Psychostimulants; Other psychostimulants 96970 Poisoning by psychotropic agents; Psychostimulants; Psychostimulant, unspecified 96902 Poisoning by psychotropic agents; Selective serotonin and norepinephrine reuptake inhibitors 96903 Poisoning by psychotropic agents; Selective serotonin reuptake inhibitors 96904 Poisoning by psychotropic agents; Tetracyclic antidepressants 96905 Poisoning by psychotropic agents; Tricyclic antidepressants 9741 Poisoning by purine derivative diuretics 9655 Poisoning by pyrazole derivatives 9613 Poisoning by quinoline & hydroxyquinoline derivatives 9791 Poisoning by rabies vaccine 9651 Poisoning by salicylates 9743 Poisoning by saluretics 9752 Poisoning by skeletal muscle relaxants 9790 Poisoning by smallpox vaccine 9751 Poisoning by smooth muscle relaxants 9687 Poisoning by spinal anesthetics 9662 Poisoning by succinimides 9610 Poisoning by sulfonamides anti-infectives 9685 Poisoning by surface (topical) & infiltration anesthetics 9713 Poisoning by sympatholytics (antiadrenergics) 9712 Poisoning by sympathomimetics (adrenergics) 9784 Poisoning by tetanus vaccine 9604 Poisoning by tetracycline group 9627 Poisoning by thyroid & thyroid derivatives E9803 Poisoning by tranquilizers & other psychotropic agents, undetermined if accidentally or purposely inflicted 9781 Poisoning by typhoid & paratyphoid vaccine 9792 Poisoning by typhus vaccine 9649 Poisoning by unspecified agent affecting blood constituents 9769 Poisoning by unspecified agent primarily affecting skin & mucous membrane 9739 Poisoning by unspecified agent primarily affecting the gastrointestinal system

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Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

9609 Poisoning by unspecified antibiotic 9709 Poisoning by unspecified central nervous system stimulant 9779 Poisoning by unspecified drug or medicinal substance E9805 Poisoning by unspecified drug or medicinal substance, undetermined if accidentally or purposely inflicted 9719 Poisoning by unspecified drug primarily affecting autonomic nervous system E9829 Poisoning by unspecified gases & vapors, undetermined if accidentally or purposely inflicted 9699 Poisoning by unspecified psychotropic agent 9679 Poisoning by unspecified sedative or hypnotic 9659 Poisoning by unspecified snalgesic & antipyretic 9639 Poisoning by unspecified systemic agent 9747 Poisoning by uric acid metabolism drugs 9643 Poisoning by vitamin K (phytonadione) 9635 Poisoning by vitamins, not elsewhere classified 9793 Poisoning by yellow fever vaccine E9054 Poisoning or toxic reaction caused by centipedes & venomous millipedes (tropical) E9053 Poisoning or toxic reaction caused by hornets, wasps & bees E9058 Poisoning or toxic reaction caused by other specified venomous animals & plants E9059 Poisoning or toxic reaction caused by other unspecified venomous animals & plants E9055 Poisoning or toxic reaction caused by other venomous arthropods E9052 Poisoning or toxic reaction caused by scorpions E9056 Poisoning or toxic reaction caused by venomous marine animals & plants E9051 Poisoning or toxic reaction caused by venomous spiders 96561 Poisonings by propionic acid derivatives 71431 Polyarticular juvenile rheumatoid arthritis, acute 7835 Polydipsia 7836 Polyphagia 78842 Polyuria 65653 Poor fetal growth affecting management of mother, antepartum condition or complication 65651 Poor fetal growth affecting management of mother, delivered 65650 Poor fetal growth affecting management of mother, unspecified episode of care 5721 Portal pyemia 452 Portal vein thrombosis 71137 Postdysenteric arthropathy, ankle & foot 71133 Postdysenteric arthropathy, forearm

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TennCareSelect 09/01/09

71134 Postdysenteric arthropathy, hand 71136 Postdysenteric arthropathy, lower leg 71139 Postdysenteric arthropathy, multiple sites 71138 Postdysenteric arthropathy, other specified sites 71135 Postdysenteric arthropathy, pelvic region & thigh 71131 Postdysenteric arthropathy, shoulder region 71130 Postdysenteric arthropathy, site unspecified 71132 Postdysenteric arthropathy, upper arm 83652 Posterior closed dislocation of tibia, proximal end 83662 Posterior open dislocation of tibia, proximal end 32363 Postinfectious myelitis 4110 Postmyocardial infarction syndrome 9980 Postoperative shock, not elsewhere classified 66632 Postpartum coagulation defects, delivered 66634 Postpartum coagulation defects, postpartum condition or complication 66630 Postpartum coagulation defects, unspecified episode of care 9583 Posttraumatic wound infection not elsewhere classified 0522 Postvaricella myelitis 79001 Precipitous drop in hematocrit 78651 Precordial pain 64273 Pre-eclampsia or eclampsia superimposed on pre-existing hypertension, antepartum 64274 Pre-eclampsia or eclampsia superimposed on pre-existing hypertension, postpartum 64271 Pre-eclampsia or eclampsia superimposed on pre-existing hypertension, with delivery 64272 Pre-eclampsia or eclampsia superimposed on pre-existing hypertension, with delivery & mention of postpartum complication64270 Pre-eclampsia or eclampsia with pre-existing hypertension, complicating pregnancy, childbirth or the puerperium 64123 Premature separation of placenta, antepartum complication 64120 Premature separation of placenta, unspecified as to episode of care 64121 Premature separation of placenta, with delivery 29011 Presenile dementia with delirium 29012 Presenile dementia with delusional features 29013 Presenile dementia with depressive features 29010 Presenile dementia, uncomplicated 77081 Primary apnea of newborn 7704 Primary atelectasis of newborn

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

28981 Primary hypercoagulable state 36401 Primary iridocyclitis 0203 Primary pneumonic plague 3182 Profound mental retardation, IQ under 20 6204 Prolapse or hernia of ovary & fallopian tube 5995 Prolapsed urethral mucosa 3091 Prolonged depressive reaction 99643 Prosthetic joint implant failure 0416 Proteus infection in conditions classified elsewhere & of unspecified site 0511 Pseudocowpox 37204 Pseudomembranous conjunctivitis 0417 Pseudomonas infection in conditions classified elsewhere & of unspecified site 56731 Psoas muscle abscess 30780 Psychalgia, psychogenic pain, site unspecified 30781 Psychalgia, tension headache 316 Psychic factors associated w diseases classified elsewhere 30652 Psychogenic dysmenorrhea malfunction arising from mental factors 30653 Psychogenic dysuria malfunction arising from mental factors 30650 Psychogenic genitourinary malfunction arising from mental factors, unspecified 2984 Psychogenic paranoid psychosis 30651 Psychogenic vaginismus malfunction arising from mental factors 29381 Psychotic disorders with delusions in conditions classified elsewhere 29382 Psychotic disorders with hallucinations in conditions classified elsewhere 0221 Pulmonary anthrax 514 Pulmonary congestion & hypostasis 0310 Pulmonary diseases due to other mycobacteria 7703 Pulmonary hemorrhage of fetus & newborn 0212 Pulmonary tularemia 37021 Punctate keratitis E9684 Purposeful homicide or injury assault by criminal neglect E9681 Purposeful homicide or injury assault by pushing from a high place E9682 Purposeful homicide or injury assault by striking with blunt or thrown object E9686 Purposeful homicide or injury assault with air gun E9683 Purposeful homicide or injury assault with hot liquid

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Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E9685 Purposeful homicide or injury assault with transport vehicle E9629 Purposeful homicide or injury inflicted by assault by unspecified poisoning E9655 Purposeful homicide or injury inflicted by assault using antipersonnel bomb E9656 Purposeful homicide or injury inflicted by assault using gasoline bomb E9652 Purposeful homicide or injury inflicted by assault using hunting rifle E9657 Purposeful homicide or injury inflicted by assault using letter bomb E9653 Purposeful homicide or injury inflicted by assault using military firearms E9654 Purposeful homicide or injury inflicted by assault using other and unspecified firearm E9658 Purposeful homicide or injury inflicted by assault using other specified explosive E9651 Purposeful homicide or injury inflicted by assault using shotgun E9659 Purposeful homicide or injury inflicted by assault using unspecified explosive E9622 Purposeful homicide or injury inflicted by assault with other gases and vapors E9621 Purposeful homicide or injury inflicted by assault with other solid and liquid substances E9688 Purposeful homicide or injury inflicted by other specified means E9601 Purposeful homicide or injury inflicted by rape E9689 Purposeful homicide or injury inflicted by unspecified means 2871 Purpura & other hemorrhagic conditions, qualitative platelet defects 2874 Purpura & other hemorrhagic conditions, secondary thrombocytopenia 2875 Purpura & other hemorrhagic conditions, thrombocytopenia, unspecified 71107 Pyogenic arthritis associated with infection, ankle & foot 71103 Pyogenic arthritis associated with infection, forearm 71104 Pyogenic arthritis associated with infection, hand 71106 Pyogenic arthritis associated with infection, lower leg 71109 Pyogenic arthritis associated with infection, multiple sites 71108 Pyogenic arthritis associated with infection, other specified sites 71105 Pyogenic arthritis associated with infection, pelvic region & thigh 71101 Pyogenic arthritis associated with infection, shoulder region 71100 Pyogenic arthritis associated with infection, site unspecified 71102 Pyogenic arthritis associated with infection, upper arm 0842 Quartan malaria 071 Rabies E8018 Railway accident involving collision with other object & other specified person E8011 Railway accident involving collision with other object & passenger on railway E8013 Railway accident involving collision with other object & pedal cyclist

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E8012 Railway accident involving collision with other object & pedestrian E8010 Railway accident involving collision with other object & railway employee E8019 Railway accident involving collision with other object & unspecified person E8008 Railway accident involving collision with rolling stock & other specified person E8001 Railway accident involving collision with rolling stock & passenger on railway E8003 Railway accident involving collision with rolling stock & pedal cyclist E8002 Railway accident involving collision with rolling stock & pedestrian E8000 Railway accident involving collision with rolling stock & railway employee E8009 Railway accident involving collision with rolling stock & unspecified person E8021 Railway accident involving derailment without antecedent collision & passenger on railway E8023 Railway accident involving derailment without antecedent collision & pedal cyclist E8022 Railway accident involving derailment without antecedent collision & pedestrian E8020 Railway accident involving derailment without antecedent collision & railway employee E8028 Railway accident involving derailment without antecedent collision of other specified person E8029 Railway accident involving derailment without antecedent collision of unspecified person E8038 Railway accident involving explosion fire or burning & other specified person E8031 Railway accident involving explosion fire or burning & passenger on railway E8033 Railway accident involving explosion fire or burning & pedal cyclist E8032 Railway accident involving explosion fire or burning & pedestrian E8030 Railway accident involving explosion fire or burning & railway employee E8039 Railway accident involving explosion fire or burning & unspecified person E8078 Railway accident of unspecified nature involving other specified person E8071 Railway accident of unspecified nature involving passenger on railway E8073 Railway accident of unspecified nature involving pedal cyclist E8072 Railway accident of unspecified nature involving pedestrian E8079 Railway accident of unspecified nature involving unspecified person E8050 Railway employee hit by rolling stock 2982 Reactive confusion 36101 Recent retinal detachment, partial, w single defect 36103 Recent retinal detachment, partial, with giant tear 36102 Recent retinal detachment, partial, with multiple defects 36104 Recent retinal detachment, partial, with retinal dialysis 36105 Recent retinal detachment, total or subtotal 55103 Recurrent bilateral femoral hernia with gangrene

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

55203 Recurrent bilateral femoral hernia with obstruction 55003 Recurrent bilateral inguinal hernia, with gangrene 55013 Recurrent bilateral inguinal hernia, with obstruction, without mention of gangrene 71837 Recurrent dislocation of ankle & foot joint 71833 Recurrent dislocation of forearm joint 71834 Recurrent dislocation of hand joint 71839 Recurrent dislocation of joint of multiple sites 71838 Recurrent dislocation of joint of other specified sites 71835 Recurrent dislocation of joint of pelvic region & thigh 71831 Recurrent dislocation of joint of shoulder region 71830 Recurrent dislocation of joint, site unspecified 71836 Recurrent dislocation of lower leg joint 71832 Recurrent dislocation of upper arm joint 55101 Recurrent unilateral or unspecified femoral hernia with gangrene 55201 Recurrent unilateral or unspecified femoral hernia with obstruction 55011 Recurrent unilateral or unspecified inguinal hernia, w obstruction, wo mention of gangrene 55001 Recurrent unilateral or unspecified inguinal hernia, with gangrene 0993 Reiter's disease 0870 Relapsing fever, louse-borne 0871 Relapsing fever, tick-borne 3133 Relationship problems specific to childhood & adolescence 7880 Renal colic 29562 Residual schizophrenia, chronic 29564 Residual schizophrenia, chronic w acute exacerbation 29565 Residual schizophrenia, in remission 29561 Residual schizophrenia, subchronic 29563 Residual schizophrenia, subchronic w acute exacerbation 29560 Residual schizophrenia, unspecified 77087 Respiratory arrest of newborn 769 Respiratory distress syndrome in newborn 77084 Respiratory failure of newborn 3061 Respiratory malfunction arising from mental factors 0796 Respiratory syncytial virus, RSV 5253 Retained dental root

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

78820 Retention of urine, unspecified 36100 Retinal detachment w retinal defect, unspecified 36281 Retinal disorders, retinal hemorrhage 47824 Retropharyngeal abscess 9997 Rh incompatibility reaction, not elsewhere classified 72888 Rhabdomyolysis 3920 Rheumatic chorea with heart involvement 3929 Rheumatic chorea without mention of heart involvement 390 Rheumatic fever without mention of heart involvement 7140 Rheumatoid arthritis 0401 Rhinoscleroma 0864 Rhodesian trypanosomiasis 0839 Rickettsiosis, unspecified 37231 Rosacea conjunctivitis 05609 Rubella w other neurological complications 05600 Rubella w unspecified neurological complication 4472 Rupture of artery 8712 Rupture of eye with partial loss of intraocular tissue 72750 Rupture of synovium, unspecified 9523 Sacral spinal cord injury without spinal bone injury 00323 Salmonella arthritis 0030 Salmonella gastroenteritis 0039 Salmonella infection, unspecified 00321 Salmonella meningitis 00324 Salmonella osteomyelitis 00322 Salmonella pneumonia 0031 Salmonella septicemia 07982 SARS Associated Coronavirus 0341 Scarlet fever 29572 Schizo affective type schizophrenia, chronic 29574 Schizo affective type schizophrenia, chronic w acute exacerbation 29575 Schizo affective type schizophrenia, in remission 29571 Schizo affective type schizophrenia, subchronic 29573 Schizo affective type schizophrenia, subchronic w acute exacerbation

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

29570 Schizo affective type schizophrenia, unspecified 30121 Schizoid personality disorder, introverted personality 30122 Schizoid personality disorder, schizotypal personality 30120 Schizoid personality disorder, unspecified 29522 Schizophrenic disorders, catatonic type schizophrenia, chronic 29524 Schizophrenic disorders, catatonic type schizophrenia, chronic w acute exacerbation 29525 Schizophrenic disorders, catatonic type schizophrenia, in remission 29521 Schizophrenic disorders, catatonic type schizophrenia, subchronic state 29523 Schizophrenic disorders, catatonic type schizophrenia, subchronic w acute exacerbation 29520 Schizophrenic disorders, catatonic type schizophrenia, unspecified 29512 Schizophrenic disorders, disorganized type schizophrenia, chronic state 29514 Schizophrenic disorders, disorganized type schizophrenia, chronic with acute exacerbation 29515 Schizophrenic disorders, disorganized type schizophrenia, in remission 29511 Schizophrenic disorders, disorganized type schizophrenia, subchronic 29513 Schizophrenic disorders, disorganized type schizophrenia, subchronic w acute exacerbation 29510 Schizophrenic disorders, disorganized type schizophrenia, unspecified 29532 Schizophrenic disorders, paranoid type schizophrenia, chronic state 29534 Schizophrenic disorders, paranoid type schizophrenia, chronic w acute exacerbation 29535 Schizophrenic disorders, paranoid type schizophrenia, in remission 29531 Schizophrenic disorders, paranoid type schizophrenia, subchronic state 29533 Schizophrenic disorders, paranoid type schizophrenia, subchronic w acute exacerbation 29530 Schizophrenic disorders, paranoid type schizophrenia, unspecified 29502 Schizophrenic disorders, simple type, chronic 29504 Schizophrenic disorders, simple type, chronic w acute exacerbation 29505 Schizophrenic disorders, simple type, in remission 29501 Schizophrenic disorders, simple type, subchronic 29503 Schizophrenic disorders, simple type, subchronic w acute exacerbation 29500 Schizophrenic disorders, simple type, unspecified 56782 Sclerosing mesenteritis 0812 Scrub typhus 9582 Secondary & recurrent hemorrhage as an early complication of trauma 4259 Secondary cardiomyopathy, unspecified 24920 Secondary diabetes mellitus; with hyperosmolarity; not stated as uncontrolled, or unspecified 24921 Secondary diabetes mellitus; with hyperosmolarity; uncontrolled

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

24910 Secondary diabetes mellitus; with ketoacidosis; not stated as uncontrolled, or unspecified 24911 Secondary diabetes mellitus; with ketoacidosis; uncontrolled 24960 Secondary diabetes mellitus; with neurological manifestations 24961 Secondary diabetes mellitus; with neurological manifestations; uncontrolled 24930 Secondary diabetes mellitus; with other coma; not stated as uncontrolled, or unspecified 24931 Secondary diabetes mellitus; with other coma; uncontrolled 24941 Secondary diabetes mellitus; with renal manifestations, uncontrolled 28982 Secondary hypercoagulable state 0204 Secondary pneumonic plague 2903 Senile dementia with delirium 29020 Senile dementia with delusional features 29021 Senile dementia with depressive features 2900 Senile dementia, uncomplicated 99591 Sepsis Revision vebiage 10/01/06 78552 Septic shock 77181 Septicemia (sepsis) of newborn 0383 Septicemia due to anaerobes 03842 Septicemia due to escherichia coli (E. coli) 03840 Septicemia due to gram-negative organism, unspecified 03841 Septicemia due to hemophilus influenzae (H. influenzae) 03843 Septicemia due to pseudomonas 03844 Septicemia due to serratia 03812 Septicemia; Methicillin resistant staphylococcus aureus septicemia 03811 Septicemia; staphylococcal; Methicillin susceptible staphylococcus aureus (Revised 10/2008) 0202 Septicemic plague 99813 Seroma complicating a procedure, not elsewhere classified 37201 Serous conjunctivitis, except ciral 7685 Severe birth asphyxia 3181 Severe mental retardation, IQ 20 - 34 64253 Severe pre-eclampsia, antepartum complications 64254 Severe pre-eclampsia, postpartum complications 64250 Severe pre-eclampsia, unspecified as to episode of care 64251 Severe pre-eclampsia, with delivery 64252 Severe pre-eclampsia, with delivery, with mention of postpartum complication

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

99592 Severe sepsis Revision verbiage 10/01/06 30279 Sexual deviations & disorders, w other specified psychosexual dysfunctions 3026 Sexual deviations & disorders, disorders of psychosexual identity 3020 Sexual deviations & disorders, ego-dystonic homosexuality 3024 Sexual deviations & disorders, exhibitionism 3022 Sexual deviations & disorders, pedophilia 30276 Sexual deviations & disorders, psychosexual dysfunction w functional dyspareunia 30273 Sexual deviations & disorders, psychosexual dysfunction w inhibited female orgasm 30274 Sexual deviations & disorders, psychosexual dysfunction w inhibited male orgasm 30272 Sexual deviations & disorders, psychosexual dysfunction w inhibited sexual excitement 30275 Sexual deviations & disorders, psychosexual dysfunction w premature ejaculation 30270 Sexual deviations & disorders, psychosexual dysfunction, unspecified 30251 Sexual deviations & disorders, trans-sexualism w asexual history 30253 Sexual deviations & disorders, trans-sexualism w heterosexual history 30252 Sexual deviations & disorders, trans-sexualism w homosexual history 30250 Sexual deviations & disorders, trans-sexualism w unspecified sexual history 3023 Sexual deviations & disorders, transvestism 3029 Sexual deviations & disorders, unspecified psychosexual disorder 3021 Sexual deviations & disorders, zoophilia 99555 Shaken infant syndrome 2973 Shared paranoid disorder 0042 Shigella boydii 0040 Shigella dysenteriae 0041 Shigella flexneri 0043 Shigella sonnei 0049 Shigellosis, unspecified 9954 Shock due to anesthesia, not elsewhere classified 6395 Shock following abortion, ectopic & molar pregnancies 78550 Shock, unspecified 31321 Shyness disorder of childhood 5272 Sialoadenitis of salivary glands 28242 Sickle cell thalassemias with crisis 28264 Sickle-cell / Hb-C disease with crisis 28263 Sickle-cell / Hb-C disease without crisis

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

28262 Sickle-cell disease, Hb-SS disease with crisis 28260 Sickle-cell disease, unspecified 3063 Skin disorder arising from mental factors 30747 Sleep disorders of nonorganic origin, other dysfunctions sleep stages or arousal from sleep 30744 Sleep disorders of nonorganic origin, persistent disorder initiating or maintaining wakefulness 30742 Sleep disorders of nonorganic origin, persistent disorder of initiating or maintaining sleep 30748 Sleep disorders of nonorganic origin, repetitive intrusions of sleep 30746 Sleep disorders of nonorganic origin, somnambulism or night terrors 30743 Sleep disorders of nonorganic origin, transient disorder initiating or maintaining wakefulness 30741 Sleep disorders of nonorganic origin, transient disorder of initiating or maintaining sleep 56401 Slow transit constipation 0501 Smallpox alastrim, variola minor 0500 Smallpox variola major 0509 Smallpox, unspecified 30722 Special symptoms or syndromes, chronic motor tic disorder 3071 Special symptoms or syndromes, not elsewhere classified, anorexia nervosa 3070 Special symptoms or syndromes, not elsewhere classified, stammering & stuttering 3073 Special symptoms or syndromes, stereotyped repetitive movements 30723 Special symptoms or syndromes, tics, Gilles de la Tourette's disorder 30720 Special symptoms or syndromes, tics, unspecified 30721 Special symptoms or syndromes, transient tic disorder of childhood 30740 Specific disorders of sleep of nonorganic origin, unspecified 56481 Specified functional disorders of intestine, neurogenic bowel 01382 Specified TB central nervous system, bacteriologic or histologic exam results unknown 01381 Specified tuberculosis central nervous system, bacteriological or histological exam not done 01385 Specified tuberculosis central nervous system, tubercle bacilli confirmed histologically 01386 Specified tuberculosis central nervous system, tubercle bacilli confirmed other by methods 01384 Specified tuberculosis central nervous system, tubercle bacilli found by bacterial culture 01383 Specified tuberculosis central nervous system, tubercle bacilli found by microscopy 31534 Speech and language developmental delay due to hearing loss 63422 Spontaneous abortion, complete, complicated by damage to pelvic organs or tissues 63412 Spontaneous abortion, complete, complicated by delayed or excessive hemorrhage 63462 Spontaneous abortion, complete, complicated by embolism 63402 Spontaneous abortion, complete, complicated by genital tract & pelvic infection

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

63442 Spontaneous abortion, complete, complicated by metabolic disorder 63432 Spontaneous abortion, complete, complicated by renal failure 63452 Spontaneous abortion, complete, complicated by shock 63472 Spontaneous abortion, complete, with other specified complications 63482 Spontaneous abortion, complete, with unspecified complication 63492 Spontaneous abortion, complete, without mention of complication 63421 Spontaneous abortion, incomplete, complicated by damage to pelvic organs or tissues 63411 Spontaneous abortion, incomplete, complicated by delayed or excessive hemorrhage 63461 Spontaneous abortion, incomplete, complicated by embolism 63401 Spontaneous abortion, incomplete, complicated by genital tract & pelvic infection 63441 Spontaneous abortion, incomplete, complicated by metabolic disorder 63431 Spontaneous abortion, incomplete, complicated by renal failure 63451 Spontaneous abortion, incomplete, complicated by shock 63471 Spontaneous abortion, incomplete, with other specified complications 63491 Spontaneous abortion, incomplete, without mention of complication 63481 Spontaneous abortion, incomplete,with unspecified complication 63420 Spontaneous abortion, unspecified, complicated by damage to pelvic organs or tissues 63410 Spontaneous abortion, unspecified, complicated by delayed or excessive hemorrhage 63460 Spontaneous abortion, unspecified, complicated by embolism 63400 Spontaneous abortion, unspecified, complicated by genital tract & pelvic infection 63440 Spontaneous abortion, unspecified, complicated by metabolic disorder 63430 Spontaneous abortion, unspecified, complicated by renal failure 63450 Spontaneous abortion, unspecified, complicated by shock 63470 Spontaneous abortion, unspecified, with other specified complications 63480 Spontaneous abortion, unspecified, with unspecified complication 63490 Spontaneous abortion, unspecified, without mention of complication 56723 Spontaneous bacterial peritonitis 7827 Spontaneous ecchymoses 5120 Spontaneous tension pneumothorax 84211 Sprain of carpometacarpal joint of hand 8408 Sprain of other specified sites of shoulder & upper arm 8400 Sprain or strain of acromioclavicular joint or ligament 84502 Sprain or strain of calcaneofibular ligament of ankle 84201 Sprain or strain of carpal joint of wrist

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

84842 Sprain or strain of chondrosternal joint 8474 Sprain or strain of coccyx 8401 Sprain or strain of coracoclavicular ligament 8402 Sprain or strain of coracohumeral ligament 8442 Sprain or strain of cruciate ligament of knee 84501 Sprain or strain of deltoid ligament of ankle 8403 Sprain or strain of infraspinatus muscle or tendon 84513 Sprain or strain of interphalangeal joint 84213 Sprain or strain of interphalangeal joint of hand 8431 Sprain or strain of ischiocapsular ligament 8481 Sprain or strain of jaw 8440 Sprain or strain of lateral collateral ligament of knee 8472 Sprain or strain of lumbar 8460 Sprain or strain of lumbosacral joint or ligament 8441 Sprain or strain of medial collateral ligament of knee 84212 Sprain or strain of metacarpophalangeal joint of hand 84512 Sprain or strain of metatarsaophalangeal joint 8470 Sprain or strain of neck 8430 Sprain or strain of of iliofemoral ligament 8488 Sprain or strain of other specified sites 8418 Sprain or strain of other specified sites of elbow & forearm 8438 Sprain or strain of other specified sites of hip & thigh 8448 Sprain or strain of other specified sites of knee & leg 8485 Sprain or strain of pelvis 8410 Sprain or strain of radial collateral ligament 84202 Sprain or strain of radiocarpal joint or ligament of wrist 8412 Sprain or strain of radiohumeral joint 8483 Sprain or strain of ribs 8404 Sprain or strain of rotator cuff capsule 8461 Sprain or strain of sacroiliac ligament 8462 Sprain or strain of sacrospinatus ligament 8463 Sprain or strain of sacrotuberous ligament 8473 Sprain or strain of sacrum 8480 Sprain or strain of septal cartilage of nose

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

84841 Sprain or strain of sternoclavicular joint or ligament 84840 Sprain or strain of sternum, unspecified site 8405 Sprain or strain of subscapularis muscle 8406 Sprain or strain of supraspinatus muscle or tendon 84511 Sprain or strain of tarsometatarsal joint or ligament 8482 Sprain or strain of thyroid region 8443 Sprain or strain of tibiofibular joint or ligament, superior of knee 84503 Sprain or strain of tibiofibular ligament, distal 8411 Sprain or strain of ulnar collateral ligament 8413 Sprain or strain of ulnohumeral joint 8489 Sprain or strain of unspecified site 84500 Sprain or strain of unspecified site of ankle 8479 Sprain or strain of unspecified site of back 8419 Sprain or strain of unspecified site of elbow & forearm 84510 Sprain or strain of unspecified site of foot 84210 Sprain or strain of unspecified site of hand 8439 Sprain or strain of unspecified site of hip & thigh 8449 Sprain or strain of unspecified site of knee & leg 8469 Sprain or strain of unspecified site of sacroiliac region 8409 Sprain or strain of unspecified site of shoulder & upper arm 84200 Sprain or strain of unspecified site of wrist 8407 Sprains & strains of shoulder & upper arm, superior glenoid labrum lesion 0050 Staphylococcal food poisoning 3203 Staphylococcal meningitis 03810 Staphylococcal septicemia, unspecified 04119 Staphylococcus Infection in Conditions Classified Elsewhere and of Unspecified Site, Other Staphylococcus 04110 Staphylococcus Infection in Conditions Classified Elsewhere and of Unspecified Site, Staphylococcus, Unspecified 47874 Stenosis of larynx 52800 Stomatitis and mucositis, unspecified 3202 Streptococcal meningitis 0380 Streptococcal septicemia 0340 Streptococcal sore throat 04101 Streptococcus infection in conditions classified elsewhere & of unspecified site, group A 04102 Streptococcus infection in conditions classified elsewhere & of unspecified site, group B

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

04103 Streptococcus infection in conditions classified elsewhere & of unspecified site, group C 04104 Streptococcus infection in conditions classified elsewhere & of unspecified site, group D 04105 Streptococcus infection in conditions classified elsewhere & of unspecified site, group G 04109 Streptococcus infection in conditions classified elsewhere & of unspecified site, other 04100 Streptococcus infection in conditions classified elsewhere & of unspecified site, unspecified 73395 Stress fracture of other bone 73394 Stress fracture of the metatarsals 73393 Stress fracture of tibia or fibula 5303 Stricture & stenosis of esophagus 5933 Stricture or kinking of ureter 7861 Stridor E9176 Struck by crowd, by collective fear or panic with subsequent fall E9171 Struck by crowd, by collective fear or panic without subsequent fall E9177 Struck by furniture with subsequent fall E9173 Struck by furniture without subsequent fall E9175 Struck by object in sports with subsequent fall E9178 Struck by other stationary object with subsequent fall E9174 Struck by other stationary object without subsequent fall E9172 Struck in running water without subsequent fall 2931 Subacute delirium 430 Subarachnoid hemorrhage 85212 Subarachnoid hemorrhage following injury w open intracranial wound, brief loss of consciousness 85216 Subarachnoid hemorrhage following injury w open intracranial wound, loss of consciousness of unspecified duration 85213 Subarachnoid hemorrhage following injury w open intracranial wound, moderate loss of consciousness 85211 Subarachnoid hemorrhage following injury w open intracranial wound, no loss of consciousness 85214 Subarachnoid hemorrhage following injury w open intracranial wound, prolonged loss of consciousness w return 85215 Subarachnoid hemorrhage following injury w open intracranial wound, prolonged loss of consciousness wo return 85210 Subarachnoid hemorrhage following injury w open intracranial wound, state of consciousness unspecified 85219 Subarachnoid hemorrhage following injury w open intracranial wound, with concussion, unspecified 85202 Subarachnoid hemorrhage following injury wo open intracranial wound, brief loss of consciousness 85206 Subarachnoid hemorrhage following injury wo open intracranial wound, loss of consciousness unspecified duration 85203 Subarachnoid hemorrhage following injury wo open intracranial wound, moderate loss of consciousness 85201 Subarachnoid hemorrhage following injury wo open intracranial wound, no loss of consciousness 85204 Subarachnoid hemorrhage following injury wo open intracranial wound, prolonged loss of consciousness with return

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

85205 Subarachnoid hemorrhage following injury wo open intracranial wound, prolonged loss of consciousness wo return 85200 Subarachnoid hemorrhage following injury wo open intracranial wound, state of consciousness unspec 85209 Subarachnoid hemorrhage following injury wo open intracranial wound, with concussion, unspecified 7722 Subarachnoid hemorrhage of newborn 7670 Subdural & cerebral hemorrhage due to birth trauma 85222 Subdural hemorrhage following injury wo open intracranial wound, brief loss of consciousness 85226 Subdural hemorrhage following injury wo open intracranial wound, loss of consciousness of unspecified duration 85223 Subdural hemorrhage following injury wo open intracranial wound, moderate loss of consciousness 85221 Subdural hemorrhage following injury wo open intracranial wound, no loss of consciousness 85224 Subdural hemorrhage following injury wo open intracranial wound, prolonged loss of consciousness w return 85225 Subdural hemorrhage following injury wo open intracranial wound, prolonged loss of consciousness wo return 85220 Subdural hemorrhage following injury wo open intracranial wound, state of consciousness unspecified 85229 Subdural hemorrhage following injury wo open intracranial wound, with concussion, unspecified 85232 Subdural hemorrhage following injury, with open intracranial wound, brief loss of consciousness 85236 Subdural hemorrhage following injury, with open intracranial wound, loss of consciousness of unspecified duration 85233 Subdural hemorrhage following injury, with open intracranial wound, moderate loss of consciousness 85231 Subdural hemorrhage following injury, with open intracranial wound, no loss of consciousness 85234 Subdural hemorrhage following injury, with open intracranial wound, prolonged loss of consciousness w return 85235 Subdural hemorrhage following injury, with open intracranial wound, prolonged loss of consciousness without return 85230 Subdural hemorrhage following injury, with open intracranial wound, state of consciousness unspecified 85239 Subdural hemorrhage following injury, with open intracranial wound, with concussion, unspecified 36811 Subjective visual disturbances, sudden visual loss 36812 Subjective visual disturbances, transient visual loss 7980 Sudden infant death syndrome V6284 Suicidal ideation E9557 Suicide & self-inflicted injury by firearms, air guns, explosives, paintball gun E9556 Suicide and self-inflicted injury by air gun E9581 Suicide and self-inflicted injury by burns, fire E9586 Suicide and self-inflicted injury by crashing of aircraft E9585 Suicide and self-inflicted injury by crashing of motor vehicle E9584 Suicide and self-inflicted injury by electrocution E9555 Suicide and self-inflicted injury by explosives E9583 Suicide and self-inflicted injury by extremes of cold E9552 Suicide and self-inflicted injury by hunting rifles

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E9572 Suicide and self-inflicted injury by jumping off natural sites E9571 Suicide and self-inflicted injury by jumping off other man-made structures E9553 Suicide and self-inflicted injury by military firearms E9554 Suicide and self-inflicted injury by other and unspecified firearms E9538 Suicide and self-inflicted injury by other specified means E9588 Suicide and self-inflicted injury by other specified means E9582 Suicide and self-inflicted injury by scalding E9551 Suicide and self-inflicted injury by shotgun E9587 Suicide and self-inflicted injury by substances, except poisoning E9531 Suicide and self-inflicted injury by suffocation by plastic bag E9559 Suicide and self-inflicted injury by unspecified firearm, air gun or explosive E9579 Suicide and self-inflicted injury by unspecified jumping from high place E9539 Suicide and self-inflicted injury by unspecified means E9589 Suicide and self-inflicted injury by unspecified means E9506 Suicide and self-inflicted poisoning by agricultural & horticultural chemicals, not plant food or fertilizer E9508 Suicide and self-inflicted poisoning by arsenic and its compounds E9501 Suicide and self-inflicted poisoning by barbiturates E9507 Suicide and self-inflicted poisoning by corrosive and caustic substances E9511 Suicide and self-inflicted poisoning by liquefied petroleum gas distributed in mobile container E9509 Suicide and self-inflicted poisoning by other and unspecified solid and liquid substances E9521 Suicide and self-inflicted poisoning by other carbon monoxide source E9504 Suicide and self-inflicted poisoning by other drugs and medicinal substances E9502 Suicide and self-inflicted poisoning by other sedatives and hypnotics E9528 Suicide and self-inflicted poisoning by other specified gases and vapors E9518 Suicide and self-inflicted poisoning by other utility gases E9503 Suicide and self-inflicted poisoning by tranquilizers and other psychotropic agents E9505 Suicide and self-inflicted poisoning by unspecified drugs or medicinal substances E9529 Suicide and self-inflicted poisoning by unspecified gases and vapors 9136 Superficial foreign body (splinter) of elbow, forearm & wrist, without major open wound & without mention of infection 9137 Superficial foreign body (splinter) of elbow, forearm & wrist, without major open wound, infected 9106 Superficial foreign body (splinter) of face, neck, & scalp except eye, without major open wound & without infection 9107 Superficial foreign body (splinter) of face, neck, & scalp except eye, without major open wound, infected 9156 Superficial foreign body (splinter) of fingers, without major open wound & without mention of infection 9157 Superficial foreign body (splinter) of fingers, without major open wound, infected

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

9177 Superficial foreign body (splinter) of foot & toe(s), without major open wound, infected 9147 Superficial foreign body (splinter) of hand(s) except finger(s) alone, without major open wound, infected 9146 Superficial foreign body (splinter) of hand(s) except finger(s) alone, wo major open wound & wo mention of infection 9167 Superficial foreign body (splinter) of hip, thigh, leg & ankle, without major open wound, infected 9197 Superficial foreign body (splinter) of other, multiple & unspecified sites, without major open wound, infected 9126 Superficial foreign body (splinter) of shoulder & upper arm, without major open wound & without mention of infection 9127 Superficial foreign body (splinter) of shoulder & upper arm, without major open wound, infected 9116 Superficial foreign body (splinter) of trunk, without major open wound & without mention of infection 9117 Superficial foreign body (splinter) of trunk, without major open wound, infected 9182 Superficial injury of conjunctiva 9181 Superficial injury of cornea 9180 Superficial injury of eyelids & periocular area 37020 Superficial keratitis, unspecified 46451 Supraglottitis, unspecified, w obstruction 46450 Supraglottitis, unspecified, wo mention of obstruction 0600 Sylvatic yellow fever 78704 Symptoms involving digestive system; Nausea and vomiting; Bilious emesis 78603 Symptoms involving dyspnea & respiratory system, apnea 78604 Symptoms involving dyspnea & respiratory system, Cheyne-Stokes respiration 78601 Symptoms involving dyspnea & respiratory system, hyperventilation 78602 Symptoms involving dyspnea & respiratory system, orthopnea 78605 Symptoms involving dyspnea & respiratory system, shortness of breath 78606 Symptoms involving dyspnea & respiratory system, tachypnea 78607 Symptoms involving dyspnea & respiratory system, wheezing 78600 Symptoms involving respiratory abnormality, unspecified 78891 Symptoms involving urinary system; other; functional urinary incontinence 7802 Syncope & collapse 7750 Syndrome of "infant of a diabetic mother" 0931 Syphilitic aortitis 09481 Syphilitic encephalitis 09322 Syphilitic endocarditis of aortic balve 09321 Syphilitic endocarditis of mitral valve 09324 Syphilitic endocarditis of pulmonary valve 09323 Syphilitic endocarditis of tricuspid valve

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

09320 Syphilitic endocarditis of valve, unspecified 09382 Syphilitic myocarditis 09381 Syphilitic pericarditis 09487 Syphilitic ruptured cerebral aneurysm 99594 Systemic inflammatory resp synd due to non-infectious process w acute organ dysfunction Revision verbiage 10/01/06 99593 Systemic inflammatory response synd due to non-infect process wo acute organ dysfunction Revision verbiage 10/01/06 99590 Systemic inflammatory response syndrome, unspecified 42821 Systolic heart failure, acute 42823 Systolic heart failure, acute on chronic 42822 Systolic heart failure, chronic 42820 Systolic heart failure, unspecified 95212 T1-T6 dorsal level with anterior spinal cord syndrome without spinal bone injury 95213 T1-T6 dorsal level with central spinal cord syndrome without spinal bone injury 95211 T1-T6 dorsal level with complete lesion of spinal cord without spinal bone injury 95214 T1-T6 dorsal level with other specified spinal cord injury without spinal bone injury 95210 T1-T6 dorsal level with unspecified spinal cord injury without spinal bone injury 95217 T7-T12 dorsal level with anterior spinal cord syndrome without spinal bone injury 95218 T7-T12 dorsal level with central spinal cord syndrome without spinal bone injury 95216 T7-T12 dorsal level with complete lesion of spinal cord without spinal bone injury 95219 T7-T12 dorsal level with other specified spinal cord injury without spinal bone injury 95215 T7-T12 dorsal level with unspecified spinal cord injury without spinal bone injury 7850 Tachycardia, unspecified 8361 Tear of lateral cartilage or meniscus of knee, current injury 8360 Tear of medial cartilage or meniscus of knee, current injury 7796 Termination of pregnancy (fetus) 037 Tetanus 7713 Tetanus neonatorum 7817 Tetany 66602 Third-stage postpartum hemorrhage, delivered 66604 Third-stage postpartum hemorrhage, postpartum condition or complication 66600 Third-stage postpartum hemorrhage, unspecified episode of care 4412 Thoracic aneurysm without mention of rupture 4411 Thoracic aneurysm, ruptured 8471 Thoracic sprain or strain

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

4416 Thoracoabdominal aneurysm, ruptured 4417 Thoracoabdominal aneurysm, without mention of rupture 64403 Threatened premature labor, antepartum condition 64400 Threatened premature labor, unspecified as to episode of care 24241 Thyrotoxicosis from ectopic thyroid nodule w mention of thyrotoxic crisis or storm 24240 Thyrotoxicosis from ectopic thyroid nodule wo mention of thyrotoxic crisis or storm 24281 Thyrotoxicosis of other specified origin w mention of thyrotoxic crisis or storm 24280 Thyrotoxicosis of other specified origin wo mention of thyrotoxic crisis or storm 24291 Thyrotoxicosis wo mention of goiter or other cause, w mention of thyrotoxic crisis or storm 24290 Thyrotoxicosis wo mention of goiter or other cause, wo mention of thyrotoxic crisis or storm 0821 Tick-borne rickettsioses, boutonneuse fever 08241 Tick-borne rickettsioses, ehrilichiosis chafeensis (E. chaffensis) 08240 Tick-borne rickettsioses, ehrilichiosis,unspecified 0822 Tick-borne rickettsioses, North Asian tick fever 08249 Tick-borne rickettsioses, other ehrlichiosis 0823 Tick-borne rickettsioses, Queensland tick typhus 0820 Tick-borne rickettsioses, spotted fevers 0829 Tick-borne rickettsiosis, unspecified 0632 Tick-borne viral encephalitis, Central European encephalitis 0631 Tick-borne viral encephalitis, louping Ill 0630 Tick-borne viral encephalitis, Russian spring-summer (taiga) encephalitis 0639 Tick-borne viral encephalitis, unspecified 87363 Tooth (broken) (fractured) (due to trauma) wo mention of complication Revision verbiage 10/01/06 87373 Tooth (broken) (fractured) (due to trauma), complicated Revision verbiage 10/01/06 60824 Torsion of appendix epididymis 60823 Torsion of appendix testis 6205 Torsion of ovary, ovarian pedicle, or fallopian tube 60820 Torsion of testis, unspecified 82342 Torus fracture of fibula with tibia 81345 Torus fracture of radius 82340 Torus fracture of tibia alone 24201 Toxic diffuse goiter with mention of thyrotoxic crisis or storm 24200 Toxic diffuse goiter without mention of thyrotoxic crisis or storm 9831 Toxic effect of acids

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

9897 Toxic effect of aflatoxin & other mycotoxin (food contaminants) 9854 Toxic effect of antimony & its compounds 9851 Toxic effect of arsenic & its compounds 98981 Toxic effect of asbestos 9820 Toxic effect of benzene & homologues 9882 Toxic effect of berries & other plants eaten as food 9853 Toxic effect of beryllium & its compounds 9855 Toxic effect of cadmium & its compounds 9822 Toxic effect of carbon disulfide 986 Toxic effect of carbon monoxide 9821 Toxic effect of carbon tetrachloride 9832 Toxic effect of caustic alkalis 9839 Toxic effect of caustic, unspecified 9892 Toxic effect of chlorinated hydrocarbons 9876 Toxic effect of chlorine gas 9856 Toxic effect of chromium 9830 Toxic effect of corrosive aromatics 9800 Toxic effect of ethyl alcohol 9880 Toxic effect of fish & shellfish eaten as food 9874 Toxic effect of freon 9803 Toxic effect of fusel oil 9890 Toxic effect of hydrocyanic acid & cyanides 9877 Toxic effect of hydrocyanic acid gas 9840 Toxic effect of inorganic lead compounds 9802 Toxic effect of isopropyl alcohol 9875 Toxic effect of lacrimogenic gas 98982 Toxic effect of latex 9870 Toxic effect of liquefied petroleum gases 9852 Toxic effect of manganese & its compounds 9850 Toxic effect of mercury & its compounds 9801 Toxic effect of methyl alcohol 9881 Toxic effect of mushrooms eaten as food 9872 Toxic effect of nitrogen oxides 9824 Toxic effect of nitroglycol

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

9841 Toxic effect of organic lead compounds 9893 Toxic effect of organophosphate & carbamate 9823 Toxic effect of other chlorinated hydrocarbon solvents 9871 Toxic effect of other hydrocarbon gas 9848 Toxic effect of other lead compounds 9828 Toxic effect of other nonpetroleum-based solvents 9894 Toxic effect of other pesticides, not elsewhere classified 9808 Toxic effect of other specified alcohols 9878 Toxic effect of other specified gases, fumes or vapors 9858 Toxic effect of other specified metals 9888 Toxic effect of other specified noxious substances eaten as food 98989 Toxic effect of other substance, chiefly nonmedicinal as to source, not otherwise specified 981 Toxic effect of petroleum products 98983 Toxic effect of silicone 9896 Toxic effect of soaps & detergents 9891 Toxic effect of strychnine & salts 9873 Toxic effect of sulfur dioxide 98984 Toxic effect of tobacco 9809 Toxic effect of unspecified alcohol 9879 Toxic effect of unspecified gas, fume or vapor 9849 Toxic effect of unspecified lead compound 9859 Toxic effect of unspecified metal 9889 Toxic effect of unspecified noxious substance eaten as food 9899 Toxic effect of unspecified substance, chiefly nonmedicinal as to source 9895 Toxic effect of venom 32371 Toxic encephalitis and encephalomyelitis 5582 Toxic gastroenteritis & colitis 24221 Toxic multinodular goiter w mention of thyrotoxic crisis or storm 24220 Toxic multinodular goiter wo mention of thyrotoxic crisis or storm 32372 Toxic myelitis 24231 Toxic nodular goiter, unspecified type, with mention of thyrotoxic crisis or storm 24230 Toxic nodular goiter, unspecified type, without mention of thyrotoxic crisis or storm 04082 Toxic shock syndrome 24211 Toxic uninodular goiter with mention of thyrotoxic crisis or storm

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

24210 Toxic uninodular goiter without mention of thyrotoxic crisis or storm 0761 Trachoma, active stage 0760 Trachoma, initial stage 5187 Transfusion related acute lung injury (TRALI) 78002 Transient alteration of awareness 4350 Transient cerebral ischemia, basilar artery syndrome 4352 Transient cerebral ischemia, subclavian steal syndrome 4351 Transient cerebral ischemia, vertebral artery syndrome 4353 Transient cerebral ischemia, vertebrobasilar artery syndrome 7814 Transient paralysis of limb 7774 Transitory ileus of newborn 7706 Transitory tachypnea of newborn 8877 Traumatic amputation of arm & hand complete or partial, bilateral any level, complicated 8876 Traumatic amputation of arm & hand, complete or partial, bilateral any level, without mention of complication 8874 Traumatic amputation of arm & hand, complete or partial, unilateral level not specified, without mention of complication8873 Traumatic amputation of arm & hand, complete or partial, unilateral, at or above elbow, complicated 8872 Traumatic amputation of arm & hand, complete or partial, unilateral, at or above elbow, without mention of complication 8871 Traumatic amputation of arm & hand, complete or partial, unilateral, below elbow, complicated 8870 Traumatic amputation of arm & hand, complete or partial, unilateral, below elbow, without mention of complication 8875 Traumatic amputation of arm & hand, complete or partial, unilateral, level not specified, complicated 8963 Traumatic amputation of foot, complete or partial, bilateral, complicated 8962 Traumatic amputation of foot, complete or partial, bilateral, without mention of complication 8961 Traumatic amputation of foot, complete or partial, unilateral, complicated 8960 Traumatic amputation of foot, complete or partial, unilateral, without mention of complication 8974 Traumatic amputation of leg(s), complete or partial), unilateral, level not specified, without mention of complication 8977 Traumatic amputation of leg(s), complete or partial, bilateral any level, complicated 8976 Traumatic amputation of leg(s), complete or partial, bilateral any level, without mention of complication 8973 Traumatic amputation of leg(s), complete or partial, unilateral, at or above knee, complicated 8972 Traumatic amputation of leg(s), complete or partial, unilateral, at or above knee, without mention of complication 8971 Traumatic amputation of leg(s), complete or partial, unilateral, below knee, complicated 8970 Traumatic amputation of leg(s), complete or partial, unilateral, below knee, without mention of complication 8975 Traumatic amputation of leg(s), complete or partial, unilateral, level not specified, complicated 8861 Traumatic amputation of other finger(s), complete or partial, complicated 8860 Traumatic amputation of other finger(s), complete or partial, without mention of complication

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

8851 Traumatic amputation of thumb, complete or partial, complicated 8850 Traumatic amputation of thumb, complete or partial, without mention of complication 8951 Traumatic amputation of toe(s), complete or partial, complicated 8950 Traumatic amputation of toe(s), complete or partial, without mention of complication 9585 Traumatic anuria 71617 Traumatic arthropathy, ankle & foot 71613 Traumatic arthropathy, forearm 71614 Traumatic arthropathy, hand 71616 Traumatic arthropathy, lower leg 71619 Traumatic arthropathy, multiple sites 71618 Traumatic arthropathy, other specified sites 71615 Traumatic arthropathy, pelvic region & thigh 71611 Traumatic arthropathy, shoulder region 71610 Traumatic arthropathy, site unspecified 71612 Traumatic arthropathy, upper arm 95893 Traumatic compartment syndrome of abdomen 95892 Traumatic compartment syndrome of lower extremity 95899 Traumatic compartment syndrome of other sites 95891 Traumatic compartment syndrome of upper extremity 8603 Traumatic hemothorax with open wound into thorax 8602 Traumatic hemothorax without mention of open wound into thorax 8605 Traumatic pneumohemothorax with open wound into thorax 8604 Traumatic pneumohemothorax without mention of open wound into thorax 8601 Traumatic pneumothorax with open wound into thorax 8600 Traumatic pneumothorax without mention of open wound into thorax 9584 Traumatic shock 9587 Traumatic Subcutaneous Emphysema 3501 Trigeminal nerve disorders, trigeminal neuralgia 04081 Tropical pyomyositis 0860 Trypanosomiasis, Chagas' disease w heart involvement 0861 Trypanosomiasis, Chagas' disease w other organ involvement 0862 Trypanosomiasis, Chagas' disease wo mention of organ involvement 0869 Trypanosomiasis, unspecified 63311 Tubal pregnancy with intrauterine pregnancy

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

63310 Tubal pregnancy without intrauterine pregnancy 01321 Tuberculoma of brain, bacteriological or histological examination not done 01322 Tuberculoma of brain, bacteriological or histological examination results unknown 01326 Tuberculoma of brain, tubercle bacilli confirmed by other methods 01325 Tuberculoma of brain, tubercle bacilli confirmed histologically 01324 Tuberculoma of brain, tubercle bacilli found by bacterial culture 01323 Tuberculoma of brain, tubercle bacilli found by microscopy 01320 Tuberculoma of brain, unspecified examination 01311 Tuberculoma of meninges, bacteriological or histological examination not done 01312 Tuberculoma of meninges, bacteriological or histological examination results unknown 01316 Tuberculoma of meninges, tubercle bacilli confirmed by other methods 01315 Tuberculoma of meninges, tubercle bacilli confirmed histologically 01314 Tuberculoma of meninges, tubercle bacilli found by bacterial culture 01313 Tuberculoma of meninges, tubercle bacilli found by microscopy 01310 Tuberculoma of meninges, unspecified examination 01341 Tuberculoma of spinal cord, bacteriological or histological examination not done 01342 Tuberculoma of spinal cord, bacteriological or histological examination results unknown 01346 Tuberculoma of spinal cord, tubercle bacilli confirmed by other methods 01345 Tuberculoma of spinal cord, tubercle bacilli confirmed histologically 01344 Tuberculoma of spinal cord, tubercle bacilli found by bacterial culture 01343 Tuberculoma of spinal cord, tubercle bacilli found by microscopy 01340 Tuberculoma of spinal cord, unspecified examination 01331 Tuberculous abscess of brain, bacteriological or histological examination not done 01332 Tuberculous abscess of brain, bacteriological or histological examination results unknown 01336 Tuberculous abscess of brain, tubercle bacilli confirmed by other methods 01335 Tuberculous abscess of brain, tubercle bacilli confirmed histologically 01334 Tuberculous abscess of brain, tubercle bacilli found by bacterial culture 01333 Tuberculous abscess of brain, tubercle bacilli found by microscopy 01330 Tuberculous abscess of brain, unspecified examination 01351 Tuberculous abscess of spinal cord, bacteriological or histological examination not done 01352 Tuberculous abscess of spinal cord, bacteriological or histological examination results unknown 01356 Tuberculous abscess of spinal cord, tubercle bacilli confirmed by other methods 01355 Tuberculous abscess of spinal cord, tubercle bacilli confirmed histologically 01354 Tuberculous abscess of spinal cord, tubercle bacilli found by bacterial culture

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

01353 Tuberculous abscess of spinal cord, tubercle bacilli found by microscopy 01350 Tuberculous abscess of spinal cord, unspecified examination 01362 Tuberculous encephalitis or myelitis, bacteriological or histological exam results unknown 01361 Tuberculous encephalitis or myelitis, bacteriological or histological examination not done 01366 Tuberculous encephalitis or myelitis, tubercle bacilli confirmed by other methods 01365 Tuberculous encephalitis or myelitis, tubercle bacilli confirmed histologically 01364 Tuberculous encephalitis or myelitis, tubercle bacilli found by bacterial culture 01363 Tuberculous encephalitis or myelitis, tubercle bacilli found by microscopy 01360 Tuberculous encephalitis or myelitis, unspecified examination 01301 Tuberculous meningitis, bacteriological or histological examination not done 01302 Tuberculous meningitis, bacteriological or histological examination results unknown 01306 Tuberculous meningitis, tubercle bacilli confirmed by other methods 01305 Tuberculous meningitis, tubercle bacilli confirmed histologically 01304 Tuberculous meningitis, tubercle bacilli found by bacterial culture 01303 Tuberculous meningitis, tubercle bacilli found by microscopy 01300 Tuberculous Meningitis, Unspecified Examination 01401 Tuberculous peritonitis, bacteriological or histological examination not done 01402 Tuberculous peritonitis, bacteriological or histological examination results unknown 01406 Tuberculous peritonitis, tubercle bacilli confirmed by other methods 01405 Tuberculous peritonitis, tubercle bacilli confirmed histologically 01404 Tuberculous peritonitis, tubercle bacilli found by bacterial culture 01403 Tuberculous peritonitis, tubercle bacilli found by microscopy 01400 Tuberculous peritonitis, unspecified examination 0020 Typhoid fever 0819 Typhus, unspecified 53021 Ulcer of esophagus with bleeding 53020 Ulcer of esophagus without bleeding 56982 Ulceration of intestine 0210 Ulceroglandular tularemia 7723 Umbilical hemorrhage after birth 5511 Umbilical hernia with gangrene 5521 Umbilical hernia with obstruction 7989 Unattended death 31201 Undersocialized conduct disorder, aggressive type, mild

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

31202 Undersocialized conduct disorder, aggressive type, moderate 31203 Undersocialized conduct disorder, aggressive type, severe 31200 Undersocialized conduct disorder, aggressive type, unspecified 31211 Undersocialized conduct disorder, unaggressive type, mild 31212 Undersocialized conduct disorder, unaggressive type, moderate 31213 Undersocialized conduct disorder, unaggressive type, severe 31210 Undersocialized conduct disorder, unaggressive type, unspecified 7852 Undiagnosed cardiac murmurs 55100 Unilateral or unspecified femoral hernia with gangrene 55200 Unilateral or unspecified femoral hernia with obstruction 55000 Unilateral or unspecified inguinal hernia, with gangrene 55010 Unilateral or unspecified inguinal hernia, with obstruction, without mention of gangrene 63722 Unspecified abortion, complete, complicated by damage to pelvic organs or tissues 63712 Unspecified abortion, complete, complicated by delayed or excessive hemorrhage 63762 Unspecified abortion, complete, complicated by embolism 63702 Unspecified abortion, complete, complicated by genital tract & pelvic infection 63742 Unspecified abortion, complete, complicated by metabolic disorder 63732 Unspecified abortion, complete, complicated by renal failure 63752 Unspecified abortion, complete, complicated by shock 63772 Unspecified abortion, complete, with other specified complications 63782 Unspecified abortion, complete, with unspecified complication 63792 Unspecified abortion, complete, without mention of complication 63721 Unspecified abortion, incomplete, complicated by damage to pelvic organs or tissues 63711 Unspecified abortion, incomplete, complicated by delayed or excessive hemorrhage 63761 Unspecified abortion, incomplete, complicated by embolism 63701 Unspecified abortion, incomplete, complicated by genital tract & pelvic infection 63741 Unspecified abortion, incomplete, complicated by metabolic disorder 63731 Unspecified abortion, incomplete, complicated by renal failure 63751 Unspecified abortion, incomplete, complicated by shock 63771 Unspecified abortion, incomplete, with other specified complications 63781 Unspecified abortion, incomplete, with unspecified complication 63791 Unspecified abortion, incomplete, without mention of complication E8919 Unspecified accident resulting from conflagration in other & unspecified building or structure E8909 Unspecified accident resulting from conflagration in private dwelling

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

E9109 Unspecified accidental drowning or submersion 04590 Unspecified acute poliomyelitis, poliovirus unspecified type 3089 Unspecified Acute Reaction to Stress 3099 Unspecified adjustment reaction 2919 Unspecified alcohol induced mental disorder 64193 Unspecified antepartum hemorrhage, antepartum complication 64190 Unspecified antepartum hemorrhage, unspecified as to episode of care 64191 Unspecified antepartum hemorrhage, with delivery 7689 Unspecified birth asphyxia in liveborn infant 7679 Unspecified birth trauma 9409 Unspecified burn of eye & adnexa 3239 Unspecified causes of encephalitis, myelitis, and encephalomyelitis 68100 Unspecified cellulitis & abscess of finger 68110 Unspecified cellulitis & abscess of toe 78650 Unspecified chest pain 8088 Unspecified closed fracture of pelvis 6399 Unspecified complication following abortion, ectopic & molar pregnancies 66993 Unspecified complication of labor & delivery, antepartum condition or complication 66991 Unspecified complication of labor & delivery, delivered 66992 Unspecified complication of labor & delivery, delivered with postpartum complication 66994 Unspecified complication of labor & delivery, postpartum condition or complication 66990 Unspecified complication of labor & delivery, unspecified episode of care 9989 Unspecified Complication of Procedure, Not Elsewhere Classified 67492 Unspecified complications of the puerperium, delivered with postpartum complication 67494 Unspecified complications of the puerperium, postpartum condition or complication 67490 Unspecified complications of the puerperium, unspecified episode of care 9219 Unspecified contusion of eye 71297 Unspecified crystal arthropathy, ankle & foot 71293 Unspecified crystal arthropathy, forearm 71294 Unspecified crystal arthropathy, hand 71296 Unspecified crystal arthropathy, lower leg 71299 Unspecified crystal arthropathy, multiple sites 71298 Unspecified crystal arthropathy, other specified sites 71295 Unspecified crystal arthropathy, pelvic region & thigh

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

71291 Unspecified crystal arthropathy, shoulder region 71290 Unspecified crystal arthropathy, site unspecified 71292 Unspecified crystal arthropathy, upper arm 3159 Unspecified delay in development 4239 Unspecified disease of pericardium 0319 Unspecified diseases due to mycobacteria 07799 Unspecified diseases of conjunctiva due to viruses 5759 Unspecified disorder of gallbladder 6089 Unspecified disorder of male genital organs 6079 Unspecified disorder of the penis 3129 Unspecified disturbance of conduct 30491 Unspecified drug dependence, continuous 30492 Unspecified drug dependence, episodic 30493 Unspecified drug dependence, in remission 30490 Unspecified drug dependence, unspecified use 2929 Unspecified drug induced mental disorder 63391 Unspecified ectopic pregnancy with intrauterine pregnancy 63390 Unspecified ectopic pregnancy without intrauterine pregnancy 9939 Unspecified effect of air pressure 9919 Unspecified effect of reduced temperature 9929 Unspecified effects of heat & light 3139 Unspecified emotional disturbance of childhood or adolescence 29690 Unspecified episodic mood disorder E8889 Unspecified fall 7746 Unspecified fetal & neonatal jaundice 53551 Unspecified gastritis & gastroduodenitis with hemorrhage 86110 Unspecified heart injury, with open wound into thorax 64093 Unspecified hemorrhage in early pregnancy, antepartum condition or complication 64091 Unspecified hemorrhage in early pregnancy, delivered 64090 Unspecified hemorrhage in early pregnancy, unspecified as to episode of care 7729 Unspecified hemorrhage of newborn 2879 Unspecified hemorrhagic conditions 4558 Unspecified hemorrhoids with other complication 3149 Unspecified hyperkinetic syndrome of childhood

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

56030 Unspecified impaction of intestine without mention of hernia 73097 Unspecified infection of bone of ankle & foot 73093 Unspecified infection of bone of forearm 73094 Unspecified infection of bone of hand 73096 Unspecified infection of bone of lower leg 73099 Unspecified infection of bone of multiple sites 73098 Unspecified infection of bone of other specified sites 73095 Unspecified infection of bone of pelvic region & thigh 73091 Unspecified infection of bone of shoulder region 73092 Unspecified infection of bone upper arm 73090 Unspecified infection of bone, site unspecified 71197 Unspecified infective arthritis, ankle & foot 71193 Unspecified infective arthritis, forearm 71194 Unspecified infective arthritis, hand 71196 Unspecified infective arthritis, lower leg 71199 Unspecified infective arthritis, multiple sites 71198 Unspecified infective arthritis, other specified sites 71195 Unspecified infective arthritis, pelvic region & thigh 71191 Unspecified infective arthritis, shoulder region 71190 Unspecified infective arthritis, site unspecified 71192 Unspecified infective arthritis, upper arm 6149 Unspecified inflammatory disease of female pelvic organs & tissues 6159 Unspecified inflammatory diseases of uterus, except cervix E9069 Unspecified injury caused by animal 86130 Unspecified injury of lung with open wound into thorax 86120 Unspecified injury of lung without open wound into thorax 90000 Unspecified injury to carotid artery 86100 Unspecified injury to heart, without mention of open wound into thorax 86610 Unspecified injury to kidney with open wound into cavity 86600 Unspecified injury to kidney without mention of open wound into cavity 86410 Unspecified injury to liver with open wound into cavity 86405 Unspecified injury to liver without mention of open wound into cavity 86500 Unspecified injury to spleen without mention of open wound into cavity 5609 Unspecified intestinal obstruction without mention of hernia

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

4329 Unspecified intracranial hemorrhage 8714 Unspecified laceration of eye 86415 Unspecified laceration of liver with open wound into cavity 7619 Unspecified maternal complication of pregnancy affecting fetus or newborn 319 Unspecified mental retardation 3009 Unspecified neurotic disorder, not otherwise classified 0499 Unspecified non-arthropod-borne viral diseases of central nervous system 3109 Unspecified nonpsychotic mental disorder following organic brain damage 8717 Unspecified ocular penetration 8089 Unspecified open fracture of pelvis 8719 Unspecified open wound of eyeball 8709 Unspecified open wound of ocular adnexa 3829 Unspecified otitis media 2979 Unspecified paranoid state 7779 Unspecified perinatal disorder of digestive system 5679 Unspecified peritonitis 2949 Unspecified persistent mental disorders due to conditions classified elsewhere E8059 Unspecified person hit by rolling stock, railway accident 3019 Unspecified personality disorder 29990 Unspecified pervasive developmental disorder, current or active state 29991 Unspecified pervasive developmental disorder, residual state 5119 Unspecified pleural effusion 3069 Unspecified psychophysiological malfunction arising from mental factors 7709 Unspecified respiratory condition of fetus & newborn 29592 Unspecified schizophrenia, chronic state 29594 Unspecified schizophrenia, chronic w acute exacerbation 29595 Unspecified schizophrenia, in remission 29591 Unspecified schizophrenia, subchronic state 29593 Unspecified schizophrenia, subchronic w acute exacerbation 29590 Unspecified schizophrenia, unspecified state 2909 Unspecified senile psychotic condition 0389 Unspecified septicemia 9529 Unspecified site of spinal cord injury without spinal bone injury 3824 Unspecified suppurative otitis media

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

6259 Unspecified symptom associated with female genital organs 01392 Unspecified TB central nervous system, bacteriologic or histologic exam results unknown 4557 Unspecified thrombosed hemorrhoids 51900 Unspecified tracheostomy complication 4359 Unspecified transient cerebral ischemia 2939 Unspecified transient organic mental disorder 01391 Unspecified tuberculosis central nervous system, bacteriologic or histologic exam not done 01395 Unspecified tuberculosis central nervous system, tubercle bacilli confirmed histologically 01396 Unspecified tuberculosis central nervous system, tubercle bacilli confirmed other methods 01394 Unspecified tuberculosis central nervous system, tubercle bacilli found by bacterial culture 01393 Unspecified tuberculosis central nervous system, tubercle bacilli found by microscopy 01390 Unspecified tuberculosis central nervous system, unspecified examination 0219 Unspecified tularemia 63720 Unspecified type abortion, unspecified, complicated by damage to pelvic organs or tissues 63700 Unspecified type abortion, unspecified, complicated by genital tract & pelvic infection 63710 Unspecified type of abortion, unspecified, complicated by delayed or excessive hemorrhage 63760 Unspecified type of abortion, unspecified, complicated by embolism 63740 Unspecified type of abortion, unspecified, complicated by metabolic disorder 63730 Unspecified type of abortion, unspecified, complicated by renal failure 63750 Unspecified type of abortion, unspecified, complicated by shock 63770 Unspecified type of abortion, unspecified, with other specified complications 63780 Unspecified type of abortion, unspecified, with unspecified complication 63790 Unspecified type of abortion, unspecified, without mention of complication 5579 Unspecified vascular insufficiency of intestine 55120 Unspecified ventral hernia with gangrene 55220 Unspecified ventral hernia with obstruction 07071 Unspecified viral hepatitis C with hepatic coma 0706 Unspecified viral hepatitis w hepatic coma 0479 Unspecified viral meningitis 7908 Unspecified viremia 4650 Upper respiratory infections, acute laryngopharyngitis 5062 Upper respiratory inflammation due to fumes & vapors 0601 Urban yellow fever 5970 Urethral abscess, not sexually transmitted

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

59780 Urethritis, unspecified, not sexually transmitted 5929 Urinary calculus, unspecified 9975 Urinary complications, not elsewhere classified 59969 Urinary obstruction, not elsewhere classified 59960 Urinary obstruction, unspecified 77182 Urinary tract infection of newborn 5990 Urinary tract infection, site not specified 13100 Urogenital trichomoniasis, unspecified 6183 Uterovaginal prolapse, complete 4560 Varicose veins of other sites, esophageal varices with bleeding 99771 Vascular complications of mesenteric artery, not elsewhere classified 99779 Vascular complications of other vessels, not elsewhere classified 99772 Vascular complications of renal artery, not elsewhere classified 29040 Vascular dementia, uncomplicated 29041 Vascular dementia, with delirium 29042 Vascular dementia, with delusions 29043 Vascular dementia, with depressed mood 4530 Venous embolism & thrombosis, Budd-Chiari syndrome 4533 Venous embolism & thrombosis, of renal vein 4539 Venous embolism & thrombosis, of unspecified site 4531 Venous embolism & thrombosis, thrombophlebitis migrans 064 Viral encephalitis transmitted by other & unspecified arthropods 0700 Viral hepatitis A w hepatic coma 0701 Viral hepatitis A wo mention of hepatic coma 07021 Viral hepatitis B w hepatic coma, acute or unspecified, w hepatitis delta 07020 Viral hepatitis B w hepatic coma, acute or unspecified, wo mention of hepatitis delta 07023 Viral hepatitis B w hepatic coma, chronic w hepatitis delta 07030 Viral hepatitis B wo mention hepatic coma, acute or unspecified, wo mention hepatitis delta 07031 Viral hepatitis B wo mention of hepatic coma, acute or unspecified, w hepatitis delta 4809 Viral pneumonia, unspecified 0841 Vivax malaria, benign tertian) 9586 Volkmann's ischemic contracture, posttraumatic muscle contraction 27650 Volume depletion unspecified 78703 Vomiting without nausea

Page 182: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

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0363 Waterhouse-Friderichsen syndrome, meningococcal 06641 West Nile fever with encephalitis 06649 West Nile fever with other complications 06642 West Nile fever with other neurologic manifestations 06640 West Nile fever, unspecified 0402 Whipple's disease 0331 Whooping cough due to bordetella parapertussis (B. parapertussis) 0330 Whooping cough due to bordetella pertussis (B. Pertussis) 0338 Whooping cough due to other specified organism 0339 Whooping cough, unspecified organism 9510 XInjury to oculomotor nerve 0609 Yellow fever, unspecified

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BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

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TennCareSelect 09/01/09

Page 357: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

Page 358: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

Page 359: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

Page 360: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

Page 361: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

Page 362: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

Page 363: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09

Page 364: BlueCare/TennCareSelect Effective: Medical Emergency … · 2009. 10. 7. · E8405 Accident to powered aircraft at takeoff or landing involving occupant of other powered aircraft

BlueCare/TennCareSelectMedical Emergency Diagnosis Codes - Alpha Sorted

Effective:BlueCare West 11/01/08BlueCare East 01/01/09

TennCareSelect 09/01/09